Finding a good provider takes research for any child, but when you’re looking for a provider for a child with tethered oral tissues (TOTs), that decision is even more important. Not every frenectomy provider has the experience, skill, and knowledge to treat tethered oral tissues, but it can be crucial for both you and your child to find an experienced frenectomy provider to get the best post-procedure outcome. When searching, you can take some steps to find a good fit. Finding the right frenectomy provider who is an expert in their tool of choice and prioritizes collaborative care sets your child up for success. Here are some tips for selecting a provider that specializes in frenectomies for Lip and Tongue Ties!

Considerations regarding Provider Skill for a safe and effective procedure:

• Do they provide a ‘small clip’ of the tissue or a full release of the tether(s)?

A small clip is not the same as a full release, and a full release is indicated for a good range of motion of the tongue and lip and total symptom resolution.

• Do they have the highest level of proficiency and certifications from accredited laser dentistry organizations?

Clinical training in the form of didactic education as well as hands-on training is important for gaining the necessary skills required for the safe and thorough removal of ties. Providers that have gone the extra mile to obtain their education, training, and certifications from an accredited organization, such as the Academy of Laser dentistry or World Clinical Laser Institute have a proven record of their knowledge and skill level. Advanced Proficiency and Master Level Status in Laser Dentistry are the highest level of certifications achieved by professionals. They have to go through the steps of didactic examinations, Case Presentations, and Peer Case Reviews in oral and written format. This allows for review and critique of their diagnosis, treatment planning, and short-term as well as long-term outcomes.

• Do they have experience with a variety of age levels?

Taking into consideration the experience and comfort level of each provider is important. Laser treatments of infants and toddlers is challenging on more than one level. A board-certified pediatric dentist has years of additional training for landmarks, anatomy, and physiology of infants, toddlers, and children with special needs. They can use their knowledge to assess the proper function and impact of ties on the growth and development of your child. Infants are truly unique as they are not just ‘tiny adults’.

• Do they have a background in infant feeding and lactation support?

Understanding the dynamics of a feeding relationship between a baby and mom is an expertise that is gained by special training outside of just dental or medical training. Knowledge of Infant feeding and oral motor functional assessments are key to proper diagnosis and treatment. Hours of didactic education and examination of knowledge acquired is a long process that curates the provider’s understanding of breastfeeding physiology as well as oral mechanics.

Considerations regarding provider protocols and support for best long-term outcomes:

• Do they provide aftercare wound instructions?

Proper management of the healing is important to prevent reattachment of the tissue and to see optimal functional improvement after the procedure.

• Do they have an Infant Care Team that supports communication and guidance post-procedure?

A supportive treatment team that checks in on you and provides guidance
on post-procedure care and outcomes can make all the difference! Having a designated
person or infant team that coordinates with your other care providers, is easily
accessible, and can give you all the best tips for making your baby’s frenectomy
experience a positive one is so important!

• Do they offer follow-up appointments?

Being seen for strategically timed follow-ups to check progress with wound healing and successful aftercare at home is absolutely essential for the best long-term outcomes.

• Do they coordinate care with lactation support or feeding therapy for optimal support of both maternal and infant health and feeding?

The frenectomy itself gives the lip and/or tongue the ability to have a full range of motion, but translating that to the skill of feeding efficiently relies heavily on targeted functional support from infant feeding specialists such as lactation consultants or feeding therapists as applicable.

• Do they consider the mouth-body connection and focus on neuromuscular regulation as well as optimal suck, swallow, breathe rhythmic coordination?

Providers that understand the mouth-body connection are able to assess and impact the overall function and have excellent long-term outcomes by collaborating with occupational therapists, physical therapists, chiropractors, and infant massage therapists as applicable.

Consider resources for detailed pre-appointment research:

• Today’s patients are empowered by accessibility to online resources in the form of
  articles and informational videos; Social media presence and online reputation are one
  of the ways to evaluate and set the right expectations regarding a provider and their
  teams’ approach to patient care.
• Consider the recommendations of your therapeutic support team to find a frenectomy
  provider that is respected for their known outcomes from a professional perspective.
• Local friends and family that have had children treated for TOTs are another great
  resource for experience sharing.
• Gather as much information beforehand as possible! By doing your research, asking the
  right questions, and preparing, you can increase your chances of finding the ideal
  frenectomy provider for your infant.

It is important to work with a knowledgeable, skilled frenectomy provider who considers your
child’s wellness in a comprehensive way. Without comprehensive, collaborative care, many do
not see full symptom resolution from surgical release alone. Smile Wonders strives to educate
the families of frenectomy patients and spread awareness on all the ways that we can help
promote optimal oral function and development.