LIP-TIE AND TONGUE-TIE POST-OP INSTRUCTIONS
Common post-operative healing consequences:
- Rarely there can be a small amount of swelling of the surgical site. This does not require any treatment
- Low grade fever (99-102 degrees F)
- Slight bleeding of the surgical area for one to two days: IF bleeding does not stop with nursing or pressure with gauze within 10-15 min, contact Dr. Prather.
- Extreme fussiness and frustration the first day.
- Improvement with breastfeeding may not be immediate. It can take time for your baby to learn how to use his/her tongue and other orofacial muscles in an effective manner.
NO IMMEDITATE RESTRICTIONS: You may breastfeed, bottle feed and give a pacifier to your baby immediately following surgery.
COMFORT MANAGEMENT: Most babies experience minimal discomfort after the procedure. However minimizing and preventing the discomfort is recommended. Tylenol or Motrin can be given to help with discomfort **NOTE: Dosage schedule may be obtained from the pharmacist or pediatrician and is always based on your baby’s weight. There are also other natural options you can try such as Arinca, CBD and other homeopathic remedies. MOTRIN SHOULD NOT BE USED UNTIL AFTER 6 MONTHS OF AGE.
GUIDING HEALING: Your baby’s mouth heals quickly and guiding healing after the procedure is very important for optimal results. Before starting, make sure that your hands are clean and your fingernails are short. This process are NOT meant to be prolonged. Keep it short and sweet! Sing a happy song, provide a soothing environment and talk in a sing song voice to your little one to lessen their stress.
- Buccal Tie Aftercare: Place your middle fingers in the cheeks and roll up and beside the jaw bone pulling out and as you push up toward the cheek bones.
- Lip-Tie Aftercare: Using your thumb and middle finger in a pincer grasp firmly grasp the upper lip and lift out and up over the nostrils. Hold for a few seconds while pressing your index finger across the surgical site once. Repeat every 4 hours for 21 days with the exception of night one.
- Tongue-Tie Aftercare: Using 1 finger to anchor the jaw down just inside the lower lip, open the mouth as wide as possible and use the other index finger to press the pad of the index finger down into the floor of the mouth under the tongue. Maintaining downward pressure begin moving the index finger back toward the base of the tongue and push the tongue back and toward the throat. You will press over the surgical site as you do this and you need to put enough pressure to cause it to open and lengthen. Hold the stretch for a few seconds. Switch and do the same thing on the opposite side. Repeat every 4 hours 21 days with the exception of night one. If the baby is biting and opening the mouth is difficult try using a finger as a bite prop back between the jaws in the molar area and use the opposite finger to push down and back under the tongue.
- If the wound site(s) is/are still open or the area feels tight at the 21 day point these sessions should be continued for an additional 7-14 days 3 times during the day. Night time sessions are not recommended after the 21 days.
Tonight do aftercare before bedtime. DO NOT wake baby tonight for aftercare or feedings unless weight gain is a concern and baby is less than 2 weeks old. Tomorrow please start every 4 hours for the next 21 days
**In case of emergency call (615) 669-7610**
After the surgery:
Patient can expect some swelling, pain and/or discomfort as a normal process recovery. Over-the-counter pain medications or other natural methods and recommended to manage discomfort. Ibuprofen usually works better than Acetaminophen and is recommended at least the first day to control pain.
Immediately after surgery:
- Bleeding: It is normal to experience some bloody oozing during the first 1-2 days. If steady bleeding occurs, place damp gauze at the origin of the bleeding and hold pressure. If it is not controlled in 10-20 min contact the office.
- Pain Medications: We recommend using ibuprofen or acetaminophen as needed for pain. If you are already taking chronic pain medications, we recommend contacting your doctor about what you can do to manage the added discomfort. Epsom salt rinses can be very helpful during recovery.
- Sutures: We use absorbable sutures that will dissolve about 7-10 days after surgery. After the sutures come out, we can then encourage you to massage the surgical site with a soft cloth or gauze.
- Oral Hygiene: We recommend rinsing with salt water and/or alcohol-free mouthwash such as Closys several times a day to keep the wound clean and reduce the risk of infection. Colloidal silver spray is an excellent antimicrobial option.
Myofunctional Therapy Exercises: It is extremely important to perform the stretches and exercises as prescribed by your therapist to obtain the most optimal results.
Lip and buccal ties: Using index fingers in the cheeks pull them all the way out swinging up and down and then grab and lift the upper lip up over nose. Grab lower lip and pull down over chin. Place silicone tube inside lips over revision sites. Close lips together and hold for 5 min. working up to 30 min, three times per day for the first 4 days. Continue these exercises 4 times per day for the next 2 weeks.
Tongue ties: Starting day 7, use gauze firmly grasp the tongue gently pulling straight out, then right and left holding for a few seconds in each position. Repeat 4 times per day. You can begin myofunctional therapy exercises right away as directed by your therapist.
Be gentle with exercises for the first 5-7 days.
Stretching exercises are better than straining.
At any time, call our practice if you experience any of the following:
Severe pain that does not improve with medication, bright red continuous bleeding, severe swelling at the site of the surgery, difficulty breathing, fever higher than 102