Your Child’s Visit
At your initial visit, you will meet with Dr. Aaronson and review your child's medical and dental history, as well as any symptoms they may be experiencing related to tongue tie and airway. If your child has been working with a myofunctional therapist and they are ready to have their tongue and/or 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 child's 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 your child has not been 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 your child returning for a release.
If your child is 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. Please note: if Dr. Aaronson feels your child's cooperation is not sufficient to allow for a safe and atraumatic experience, she may be unable to treat at the initial visit if behavior (e.g. fear, refusal to sit still, etc.) is a concern.
Airway Evaluation
If your child has any signs or symptoms of airway issues, sleep-disordered breathing, enlarged tonsils, or an inability to breathe through their nose, we may need to take a Cone Beam CT scan of their airway prior to treatment. The CBCT allows us to ensure that their nose and throat are clear and that their tongue will be able to rest in the correct position to allow for proper breathing after the procedure.
The CBCT is a very low dose of radiation, and allows us to visualize your child's nasal passages, sinuses, the back of the throat, and the TMJs. We are happy to provide you with a copy of your child's CBCT scan.
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. If there is a concern about your child's airway and you do not wish for them to have a CT scan taken in our office, we may not be able to treat until one is taken. We can refer you to an ENT for imaging if you would prefer to be seen in a medical setting where insurance may cover more of the treatment.
Treatment
If treatment is indicated and if you are ready to proceed, Dr. Aaronson will review treatment goals, discuss risks and benefits, and you will be asked to sign an informed consent form.
We will anesthetize the area under the tongue. 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 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 or your child 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.
