Why is pre-op care needed BEFORE a frenectomy?

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So your baby was diagnosed with TOTs (tethered oral tissues) and a frenectomy was recommended, right? But did the provider discuss the benefits of pre-frenectomy evaluation and treatment? Assessment of Functionality: A functional evaluation helps assess how well a baby's oral muscles are functioning in their current state. This evaluation provides valuable information about the baby's ability to perform essential tasks like breastfeeding, bottle-feeding, and later, speech development.

  1. Identifying the Impact of the Frenulum: The assessment helps determine the extent to which the tongue or lip tie is affecting the baby's ability to move their tongue or lips. Some babies may have a visible tongue tie but may not be experiencing significant functional issues, while others may have less apparent ties that are causing problems.

  2. Tailored Treatment Plans: A thorough evaluation allows healthcare professionals to create a customized treatment plan based on the baby's specific needs. Not all babies with tongue or lip ties require a frenectomy, and the decision should be based on the functional impact of the tie.

  3. Optimizing Success: For babies who do require a frenectomy, understanding the functionality of their oral motor muscles before the procedure helps ensure the best possible outcome. A pre-frenectomy evaluation helps healthcare providers plan the surgery and determine the extent of the release required.

  4. Preventing Complications: In some cases, babies may have compensatory muscle patterns due to their tongue or lip tie. These patterns can lead to difficulties with feeding, swallowing, and speech even after a frenectomy. A functional evaluation can identify these issues and guide post-frenectomy therapy if needed.

  5. Parent Education: A functional evaluation is an opportunity for parents to better understand their baby's specific oral motor challenges and how a frenectomy may or may not address those challenges. It allows parents to make informed decisions about the procedure and any necessary follow-up care.

Here’s the trick question, how long does a baby need to go to OT/PT/SLP before the green light is given for frenectomy? It’s more of a loaded question than anything. Every baby is individually assessed and treated. The main factors that impact the number of weeks a baby needs therapy before frenectomy include their: resting muscle tone, baseline strength, head/body turning preference, total body tension, and nervous system regulation. For some babies only one session and a weeks worth of parent homework may be necessary but for others it may be months. During that time it is important to make sure the baby stays fed, moms milk supply stays stable if applicable, and reduce the home stress levels. The team of therapists, IBCLC, and frenectomy providers will all work together to ensure optimal outcomes.

Want to get started on the home program that gets your baby ready for a frenectomy? https://littlemoverspt.vipmembervault.com/ has it all ready for ya.

Elizabeth Morel is a physical therapist specializing in infant movement for feeding. She’s the owner of Little Movers PT and Little Movers Education. Helping parents since 2008, educating families about the importance of building an airway is her passion.