The American Academy of Pediatric Dentistry has created a highly-visual, easy-to-follow guide that can be printed and posted to refrigerators/bulletin boards so family members, teachers and babysitters know what to do should a tooth be chipped or knocked out!

Remember that once your child starts to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child. It should be used during any activity that could result in a blow to the face or mouth. A properly fitted mouth guard helps prevent broken teeth and injuries to the lips, tongue, face or jaw.

Infant tongue and lip tie is a congenital condition that affects nearly 5% of the population. This condition, which is caused by a short or tight frenulum under the tongue or in the upper lip, restricts the movement of the tongue and lips making breastfeeding and bottle-feeding difficult, and can cause future problems in speech development and overall oral health. Tongue and lip tie is often discovered when mothers are having difficulty breastfeeding. Unfortunately, this problem is often confusing and mothers don’t know where to turn for help.

Dr. Shawn Hanway, Board-Certified Pediatric Dentist, is trained in and passionate about correcting tongue and lip tie. She can perform a frenectomy with a soft-tissue laser in office – a procedure that takes between 2-3 minutes – and provide you with all the information and direction you need to help your infant heal quickly and continue to thrive.

Do you think your infant or child is tongue or lip tied? Refer to this checklist and call our office for a consultation.

Understanding a Frenectomy

Some children are born with shortened or tight frenums. This soft tissue connects the tongue to the lower jaw and the upper lip to the gums. When the tissue is tight it restricts the range of motion which can make latching extremely difficult. The inability to eat can cause the child to be rightfully fussy and may impact their ability to thrive. It also causes extreme pain and discomfort for nursing mothers. By performing a frenectomy, your pediatric dentist can release the tension and free the range of motion enabling your child to re-learn a correct latch, successfully eat, and grow.

To perform this procedure Dr. Shawn will first evaluate the severity of your child’s tongue or lip tie. Using adequate lighting and optimal positioning, she will then precisely remove the tissue that is restricting your child’s tongue and lips. This soft-tissue laser minimizes bleeding, inflammation, and postoperative discomfort, and due to the laser’s precision can be performed in between 2-3 minutes. Immediately after the procedure your baby will be brought to you to nurse and soothe in a quiet, private room. Please feel free to stay as long as you need to.

For 24 to 48 hours after the frenectomy your child will experience some discomfort. If breastfeeding and skin-to-skin contact do not calm them, appropriately dosed Tylenol can be used to relieve pain.

For an older child, we will use local anesthesia before the laser to decrease discomfort and provide a clean working environment. Afterwards, discomfort usually lasts for about 12-24 hours, although sometimes it may last longer. Ibuprofen (Tylenol) or Acetaminophen (Tylenol) may be given if necessary and should follow the correct manufacturer dosing instructions, every 4-6 hours.

Before Your Visit

Frenectomies are also performed on infants and children with speech and feeding difficulties. In order to better serve our patients and ensure a more successful release, these are some guidelines that we have set in place:

After the Frenectomy

In order to ensure that the procedure is a success, it is important for parents to follow all post-operative care instructions. Precise and quick stretches will be necessary to prevent the wound from healing incorrectly and the frenulum from reattaching. Dr. Shawn will explain these stretches to you before and after the procedure. Refer to this information sheet for infant and child if you have any questions about post-operative care. This website provides the best information and videos for post-op exercises.

It may take some time for your child to re-learn how to latch or articulate certain sounds after they have healed. Utilizing the knowledge of a lactation consultant and speech therapist is extremely helpful during this time. It generally takes a few weeks for a child to heal completely from a frenectomy, and a post-procedure check-up will be scheduled one week after the frenectomy is performed. Once again, don’t hesitate to call with concerns and questions, we are happy to help in any way we can.

For more information about the tongue and lip tie procedure, please see this information sheet.

Here is a video showing an actual infant lip and tongue tie surgery.

Best Practices

• For nitrous oxide, we recommend a light meal before the appointment.

• For conscious sedation, remember no milk or food after midnight and only clear liquids up to 3 hours before their visit. If your child becomes sick (ear infection, cough, cold, virus) please call to reschedule.

• For IV sedation, the nurse will contact you with eating/drinking instructions the day before.

Our Expertise Includes

Credentialed to provide in-office IV sedation. We proudly work with Pediatric Dental Anesthesia Associates, whose mission is to provide, safe, affordable and convenient pediatric anesthesia care to children in the pediatric dental office based setting.

Dr. Shawn’s training at UF including treating patients along the wide spectrum of autism, unique syndromes, complex medical histories, immunocompromised, wheelchair bound, and children with craniofacial anomalies. Please let us know on the phone ahead of time any tips to help the appointment go smoothly (1st appointments of the day, fears the child has or past experiences) and you can help us by bringing an updated list of medications, consults from physicians and phone numbers of specialists they see.

Teeth Brushing

Brushing can be a fight for a child with special needs, especially those with oral aversions. Often we recommend a 3-sided toothbrush to make it easier for the caregiver to make sure they are cleaning a surfaces of the teeth. This helps brushing get done faster for overly-sensitive kids and adults.

Read this social story with your child to learn the routine. Your child may also read the story independently.

The most likely location for a cavity to develop in your child’s mouth is on the chewing surfaces of the back teeth. They are filled with tiny grooves referred to as “pits and fissures,” which trap bacteria and food particles. The bristles on a toothbrush can’t always reach all the way into these dark, moist little crevices. This creates the perfect conditions for tooth decay.

Dental sealants are white resin coatings that smooth out the chewing surfaces of the back teeth, making them resistant to decay. They are proven most effective on permanent molars so we typically start applying sealants around age 6. A sealed tooth is far less likely to develop a cavity, require more expensive dental treatment later on, or, most importantly, cause your child pain. Most insurances cover sealants 100% as a preventive procedure.

Why space maintainers?

Did you know that children should visit the dentist by their first birthday?

Tooth decay is the number one chronic infectious disease affecting children in the United State but is largely preventable. By age 5, about 60% of children will be affected by tooth decay. One effort, adopted and advanced since 2001 by national specialty organizations—including the American Academy of Pediatric Dentistry (AAPD) and the American Academy of Pediatrics (AAP)—is the age one dental visit, which holds strong promise in primary disease prevention and in early identification of at risk infants and toddlers. Our office has a room specifically designed for infant oral health and love to see parents who start regular dental visits early.

But what if they only have two teeth?

It’s more than just looking at the teeth. These appointments include prenatal counseling, a comprehensive lap exam (evaluating the tongue, gums, tonsils, teeth eruption patterns), toothbrush cleaning, x-rays (if needed), oral hygiene instruction, nutritional counseling, anticipatory guidance, teething tips, managing pacifier/thumb sucking habits, and custom fluoride/xylitol recommendations.

Actually saves you money

Cost-benefit analysis of the “Age One Dental Visit” for private insured (published in Pediatric Dentistry 2015) concluded lowered annual cost per child supports age one dental visits in the privately insured population.

So bring your little one in. Teach good habits early. Avoid fear of dentist.

• First visit (by age 1)
• Which toothpaste? (Fluoride, Xylitol, training, etc.)
• Prenatal counseling
• Teething
• Bottle to cup
• Early signs of caries
• Pacifier/thumb habits