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Ride the Bull: Hope for Healing after Frenectomy

7/15/2015

15 Comments

 
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Did you know that full healing of the frenectomy site can take up to 6 months?

It has been my observation that there are significant changes occurring long after the surface layer has healed! The connective tissue in the floor of the mouth goes through an amazing process over the months following a release. When you consider the profound impact these tiny pieces of tight tissue have on (at times) the entire body, the unfolding of function that follows such a release is quite remarkable! 

For many moms who find themselves in the midst of a "Tether-berg" situation, I tell them, for the sake of their baby or child, to "Ride the Bull." As many moms have experienced, the weeks and even months after oral tissue release can literally be a wild ride, filled with many ups and downs. From what I understand about bull riding, the goal is to hang on for a certain amount of time and try not to get thrown to the ground; recovering and attaining new oral function can be no different than trying to win a rodeo. 
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Many Moms feel: 
"this is not what I signed up for!"

Muscle movement from the tongue helps recover the nervous system (not just of the tongue, but the whole body). Input from the nervous system helps heal the tissue. Freed tissue helps drive muscle movement and synergistic feedback continues to drive this changing, dynamic system. There are many ways in which positive impact can be made: touch and pressure (exercises and massage), movement (breastfeeding and muscle work), vibration and stimulation (sensory work and chiropractic care, tummy time and yoga), and most importantly, establishing proper nasal breathing and solid quality nutrition.

All of these methods open up the oral system, help break up old patterns, and encourage new movement. The goal of frenectomy and oral rehabilitation is optimal oral function. Optimal nasal breathing and oral function helps drive proper facial growth and development. Adequate airway formation and facial growth, along with a stable nervous system, are part of the foundation of a healthy life. 
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If you feel that you are not getting perfect or ideal results and feel that function is not shaking out as you'd hoped, just remember that oral rehabilitation is a process, not an event. Like steps on a staircase, you'll take steps and then take a break as you work your way to optimal. Over the childhood years, addressing residual or new needs as they arise is a way of gifting your child with health that lasts a lifetime. 
Many moms address the breastfeeding or feeding issues in their children with frenectomies. Most are hoping that they will also address a host of future issues as well. While it's true that snoring, TMJD (temporomandibular joint disease), orthodontic issues and posture are closely correlated with oral restrictions, all of those future issues will not resolve unless the whole person is addressed throughout the early growth years. 

Situations like less than ideal healing, neurological imbalances, muscle weaknesses, and mouth breathing are all occurrences that must be worked through. Other concerns like sleep issues, gagging on solids, mouth breathing, and dental arch development are all opportunities to continue guiding your child to optimal growth and development. 

By keeping your eyes focused on the GAINS, and a pulse on what is lacking, you can keep "Riding the Bull" with confidence. Ride and don't get thrown. Ride to win!

Don't give up! Don't get thrown!

15 Comments
Maureen
7/18/2015 01:06:40 pm

Thank you for this. How can I tell if we have optimal breathing? I cannot tell how well the site healed, either.

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Michale link
7/18/2015 01:14:12 pm

Maureen,
Optimal breathing for all people would consist of characteristics such as: Silent breathing through the nose, no snoring or heavy breathing at night and use of the diaphragm (not the chest or shoulders) to breathe to name a few.

Site healing varies from person to person. Some people scar, other sites are very stretchy with little visible reformation of a frenum. Some have a very pronounced frenum but remain functional. I suggest that healing be evaluated by the function gained and the correction of postural issues.

I hope this helps!
Michale

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Maureen Thompson
7/20/2015 03:21:18 pm

hmm she doesn't always have silent breathing. We are going to an MD, IBCLC. Hoping to get some more insight. Yes, that is helpful.

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Liam
7/25/2015 04:01:38 am

my ortho said i have posterior tongue tie, i should be able to touch the palate with my tongue even when the mouth is fully open, is it true?

will a frenectomy make it easy to keep the posterior tongue on the palate?

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Michale
7/25/2015 04:47:07 am

There are two questions here dealing with two different aspects of the tongue.

Touching the anterior or tip of the tongue to the palate allows part of the assessment of an anterior tongue tie. The inability to touch the palate with the tongue tip indicates that there could be restriction. One needs to take into account the vault of the palate when assessing.

The release of a posterior tongue tie will help the posterior tongue stay in the palate but only with a plan that includes tissue release, myofunctional therapy, cranial nerve integration and probably good quality bodywork such as myofascial release, chiropractic care, CFT or CST. The posterior or base of tongue will not automatically do it's job simply by releasing it, if not helped.

Please get an evaluation by someone trained in the area of assessment before doing a procedure.

I hope that you are able to accomplish your goals.

Michale

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Maureen Thompson
7/25/2015 07:55:04 am

Liam, I am on a tongue tie support page. A patient of Dr. Ghaheri's informed me that the touching of tongue to roof of mouth is actually not a good way to access for tongue tie according to Dr G. I had been told otherwise before, though. So now my new thinking is this is not a reliable way to accessing it. She had a complete release done by him and was told she may or may not be able to do that over time. She is getting bodywork, though. I just wanted to share this because it gave me more realistic expectations.

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Michale
7/25/2015 08:03:58 am

Maureen, Thus my comment regarding the degree of vaulting in the palate. If you have a high, cupped palate, then the tongue would not reach up and touch. That would be a unrealistic expectation of whether one had lingual restriction.

Assessing lingual restriction is a functional exam and best done with a full intake; history, oral exam and postural assessment.

The tips and tricks given on support pages do not constitute a true exam and should not be used exclusively for diagnosis and evaluation of treatment.

Maureen
7/25/2015 03:13:27 pm

Sorry, I was not disagreeing. :) I was just trying to share that it may be a bit of a misconception about the tongue reaching. I noticed this demonstration of ability come up during one of the number of evaluations in which my baby and I were present. I definitely would urge anyone concerned to have a formal evaluation.

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Michale
7/25/2015 11:18:53 pm

No apologies necessary, Maureen!

There is so much information available now regarding oral restriction and dysfunction which people use for self evaluation.

Since there are always conditions under which aspects of assessment are effective and yield negative or positive results, having the 'whole picture' is so very important. Evaluating the person in their whole body context helps rule out false negatives of positives as well.

Best to you and your little one on your healing journey.

Michale

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Maureen
7/27/2015 05:55:47 pm

So true. And thank you.

Andre Beluchi link
4/7/2016 01:28:43 pm

A friend of mine talked to me about frenectomy because of a surgery that she was going in for. This type of procedure had me research the term and what the benefits to it are. Well, what are the benefits of doing this?

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Michale
4/7/2016 02:19:16 pm

Hi Andre,
The benefits of doing the procedure, if necessary, are as unique as the person who requires the procedure be done. In other words, the benefit is specific to your clinical presentation.

For example, in my case, the benefit was to solidify and give a consistent "place" in my movement. By doing the release, I was able to let go of a restriction and move fluid movement patterns emerged.

In other cases, the result might be achieving the tongue lift in the back of the tongue, if that is the presented functional deficit.

There are many benefits; too many to list here. Not all people receive the same benefit if they do not present with that issue. However, if the treatment plan addresses all of the presenting issues and deficits then a tongue tie release can be a valuable part of gaining significant lasting functional movement or postural changes.

Hope that helps.

Michale

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Jessica
5/17/2016 11:45:46 pm

We have a 2 y o and he received two revisions that got us to a decent place in infancy...weight gain and lessened spit up. We did CST periodically and baby led weaning to encourage movement. He is still bfing, but has crowded teeth, is small for his age, and mouth breathes and now bruxism. We are figuring out our next steps, which include recommended andenoid and tonsilectomy, possible third revision (our idea, not the regular ENT's), and CST. Any thing else we can do to address the 'whole child/whole body' as he grows? We also have the myomunchee which he chews on every now and then.

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Michale
5/21/2016 04:36:56 pm

Hi Jessica,
Yes, there is much that can be done to address these issues "whole child/ whole body". In fact, this approach is the only way to get lasting results and the most optimization of function and hewing.

Typically, when I work with a family who wishes to get to the bottom of these issues, we proceed with a detailed intake and create a detailed plan to address issues that are directly impacting the child.

It is possible to do this on your own with careful research and an understanding of the root of the issues you are trying to correct.

Your story is very common, unfortunately. I do appreciate that you are so committed to the best for your child and that you are trying to address the underlying issues related to the "symptoms" that you are seeing.

Best to you!

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Chelsea Pinto link
3/9/2017 05:13:33 pm

I think there is a lot of wisdom in this post. The healing process post-frenectomy is exactly that: a process. The end result (greater tongue mobility and improved breastfeeding) is certainly worth it!

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    Michale Chatham, BSN, LMT

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