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Post Operation Aftercare Exercises

Every child responds differently and heals differently after a labial and/or lingual frenectomy. A labial frenectomy takes a shorter period of time to heal than the lingual frenectomy and is easier to stretch and tends to have less pain associated with it.

The lingual frenectomy is more difficult to manage post-operatively. Dr. Lentfer recommends performing stretches no less than every six hours for 4-6 weeks. The stretches are not easy, but it is so important to perform them regularly to help your child have the best chance of success with the release.

In addition, follow up with your lactation consultant, craniosacral therapist and/or speech and/or occupational therapist, depending on what your child’s age and needs are. Dr. Lentfer is the mechanic. She can get the car started, but it’s really the other team members who can teach your child how to drive the car.

We understand the frustration and want to help you.

Below are several helpful video resources that we have received permission to share from Dr. Baxter and Dr. Kotlow.

C02 Laser Treatment Release on 1 Month Old

Post Frenectomy Stretching Excercises

Post Surgery Care For Your Infant After Revisions of TOTS

POST-OP INSTRUCTIONS FOR INFANT LIP/TONGUE-TIE RELEASE

Your goal is to have the frenum heal and re-form as far back as possible. You should do the stretches with the baby laying down on a bed or couch facing away from you like during the exam. There is a video on the following website at www.EugeneTongueTie.com. Please follow-up within 7-10 days. Begin doing the stretches the DAY AFTER the procedure. Gloves (preferred) or clean hands with nails trimmed should be used for stretches.

  1. If the lip was revised also, first put your fingers all the way in the fold of the lip and pull the lip up and out as high as possible, so you can see the white diamond and cover the nostrils. It may bleed slightly the first day or two, this is not a concern.
  2. With one or two fingers, lift the tongue up and back just above the white diamond to put tension on the wound and hold for 10 seconds. It may bleed slightly the first day or two, this is not a concern.
  3. The main issue is to open the “diamond” all the way up on the lip and especially the tongue. If you notice it is becoming tight, then stretch a little more to open it back up.
  4. Repeat this ideally 6 times a day (4 minimum) (change up the time during the day).
  5. Repeat this for 3 weeks.
  6. At other times, play in your child’s mouth a few times a day with clean fingers to avoid causing an oral aversion. Tickle the lips, the gums, or allow your child to suck your finger.
  7. Tummy-Time as much as possible. Visit www.TummyTimeMethod.com for helpful tips.
  8. The released area will form a wet scab after the first day. It will appear white and soft. It may change color to yellow or even green. This is not infection, but is just a scab in the mouth. The white / yellow area will get smaller each day lengthwise, but HEALING IS STILL HAPPENING!  So even though the white scab will heal you must continue stretching or the new frenum will not be as long as possible and the surgery may need to be repeated. If you have any concerns, please contact our office.

Follow up with a lactation consultant is critical if nursing. Bottle-feeding babies will benefit from visiting a feeding therapist. A bodyworker (chiropractor, CST, etc.) is also very helpful. You should expect one better feed a day (two better feeds the second day, etc.). Sometimes there’s an immediate difference in feeding, and sometimes it takes a few days. Skin to skin, warm baths, and soothing music can be very beneficial to calm the baby. 

For pain make sure to give CHILDREN’S TYLENOL (160mg / 5mL) starting WHEN YOU GET HOME and for the next 2-3 days every 4-6 hours for children over 1 month old. If under 1 month old, every 6-8 hours. For babies who weigh 6lbs give 40mg or 1.25mL, 7lb give 1.5mL, 8lb give 1.75mL, 9lb give 2mL, 10lb give 2.25 and 11lb give 2.25mL. Babies 12-14lb can have 80mg or 2.5mL, 15-17lb give 3mL. If your child is 6mo old and 12-17lbs, you can give Infant’s Motrin (ibuprofen) at 1.25mL (50mg). If your baby is refusing to nurse or seems to be in pain, please make sure the Tylenol dose is correct.

Your child’s lip will swell up slightly that evening or the next day. It is normal and will go down after a day or two but may appear “puffy” for a week or more. The area will be sore for a few days, at one week look much better, and at two weeks look much better and almost normal. 

If you have any questions, please call us at 541-636-4344 or Dr. Lentfer after hours 541-300-0242

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POST-OP INSTRUCTIONS FOR CHILD LIP/TONGUE-TIE RELEASE

TONGUE-TIE RELEASE:

Your goal is to have the frenum heal and re-form as far back as possible.

  1. With a clean or gloved finger, lift the tongue at the top of the diamond in the middle of the tongue. Your goal is to see the whole diamond open up and lengthen. It may bleed slightly when it is stretched or re-opened. This is not a concern. Begin doing this the morning after treatment.  Try to make a game of it if possible and keep it playful. Repeat this 3 times a day, at various times during the day for 3 weeks.
  2. Encourage the child to move the tongue as much as possible by sticking it out and holding for 10 sec, gumball (hold 10 sec) into the left cheek, right cheek, open wide and lift up the tongue (paint the roof), make clicking noises (tick tock), and lick the upper lip (windshield wiper). Do these exercises 10x each or for 10 sec, as often as possible, but try for 3-4 times a day for 5 weeks.
  3. The released area will form a wet scab after the first day. It will appear white or yellow and soft because it is wet. This area is what you will be pressing against. The healing will be happening under the scab, just like a scrape anywhere else on your body. The white area will get smaller each day, but healing is still happening!  So even though the white scab will heal you MUST continue the stretching or the new frenum will not be as long as possible and the surgery may need to be repeated.

 

LIP-TIE RELEASE:

The goal is for the frenum to heal and re-form as high as possible.

  1. Pull the lip up as high as possible, high enough to press against the nose. You want to see the whole white diamond open up. Press gently but firmly against the wound to massage it and keep the diamond open. It may bleed slightly when this is done, but this is not a concern. Try to make a game of it if possible and keep it playful. Repeat 3 times a day, at various times during the day for 3 weeks.
  2. The released area will form a wet scab after the first day.  It will appear white or yellow and soft because it is wet. This area is what you will be pressing against. The healing will be happening under the scab, just like a scrape anywhere else on your body. The white area will get smaller each day, but healing is still happening! So even though the white scab will heal you MUST continue the stretching or the new frenum will not be as long as possible and the surgery may need to be repeated.

The child can eat whatever foods he or she can tolerate. Pain relief is needed the first few days. Give Motrin (ibuprofen) or Tylenol as directed on the package based on weight.  If the lip-tie was released, the child’s lip may swell up slightly that evening or the next day. It is normal and will go down after a day or two. The wound will be sore for a few days, at one week look much better, and at two weeks look almost normal. Drooling is common after a tongue-tie procedure. A slight fever is normal the first day. They should eat and sleep normally. If you’re concerned it is growing back together, come back for a visit or email a picture. Follow-up with a myofunctional therapist and bodyworker (Chiropractor, CST) is recommended for full rehabilitation.

If you have any questions, please call us at 541-636-4344, or Dr. Lentfer’s cell at 541-300-0242.

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