Your Visit
At your initial visit, you will meet with Dr. Aaronson and review your medical and dental history, as well as any symptoms you may be experiencing related to tongue tie and airway. If you have been working with a myofunctional therapist and you are ready to have your tongue tie released, we are now offering same-day treatments combined with the initial visit. See below for more details.
Consultation
In order to understand the impact that a tongue tie may be having on your body, it is important for Dr. Aaronson to complete a thorough evaluation of your mouth, jaws, throat, and any other areas that may be impacted by a tongue tie. The consultation also includes a sleep evaluation to determine whether it is necessary to do more imaging prior to any surgical procedures.
If you are not yet working with a myofunctional therapist, you will be provided with a list of providers (or you are welcome to do research to find one who may not be on our list!) and you will be asked to continue working on the myofunctional exercises prior to returning for a release.
If you are already working with a myofunctional therapist, and you are ready for a release, we can do the release at the same visit, if you would like to do so.
Airway Evaluation
If you have any signs or symptoms of airway issues, sleep-disordered breathing, enlarged tonsils, or an inability to breathe through your nose, we will need to take a Cone Beam CT scan of your airway prior to treatment. The CBCT allows us to ensure that your nose and throat are clear and that your tongue will be able to rest in the correct position to allow for proper breathing after the procedure. If there is a concern about your airway and you do not wish to have a CT scan taken in our office, we may not be able to treat until one is taken.
The CBCT is a very low dose of radiation, and allows us to visualize your nasal passages, your sinuses, the back of your throat, and your TMJ. We are happy to provide you with a copy of your CBCT scan, as well.
If the CBCT scan confirms an airway blockage, you will be referred to an Ear, Nose and Throat doctor for further evaluation and treatment prior to being cleared for tongue tie release.
Treatment
If treatment is indicated and if you are ready to proceed, Dr. Aaronson will review treatment goals, discuss risks and benefits and alternative treatment options. Once you have asked any questions and have signed the informed consent, treatment can begin.
We begin with documentation - we will take photos and measurements of the tongue before treatment, so that we can compare them to the mobility of the tongue after the release.
Then we will anesthetize the area under the tongue (and lip, if you are also having a lip tie released). This is usually done with a topical gel, followed by an injection of Lidocaine.
Once the tongue is numb, Dr. Aaronson will use a LightScalpel CO2 laser to gently and safely release the tension under the tongue. Once the tie is no longer restrictive, she will confirm the mobility of the tongue, as well as confirm the reduction in compensations and tension on the floor of the mouth.
When the tongue has been sufficiently released, Dr. Aaronson will close the wound under the tongue with either sutures, PeriAcryl glue (a liquid glue meant for soft tissue), or a combination of both. She will then take post-operative photos and measurements and we will review post-op management and answer any questions you may have.
Post-Operative Care
It is critical to continue your myofunctional therapy after the tongue tie release is completed. Furthermore, doing manual therapy/bodywork (e.g. chiropractic care, osteopathy, craniosacral, massage, etc.) will also help ensure that the tension that had been present under the tongue does not return.
You will continue to follow up with your myofunctional therapist as needed. There is no need to return to our office for a follow-up unless there is a concern with healing. There is no charge for follow up visits within the first 3 months of treatment, as long as you have been continuing to work with your myofunctional therapist. If you have not followed up with therapy, there may be a charge for any subsequent visits and/or pretreatment.
