What to Expect Before, During, and After a Frenectomy

By Your Health Magazine

Your Health Magazine

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What to Expect Before, During, and After a Frenectomy

Hearing that your baby may need a frenectomy can stir up a mix of relief, worry, and a hundred questions. Will it hurt? How long will it take? When will feeding improve? This practical walkthrough answers those questions and more, drawing on the everyday experience of our pediatric frenectomy team in Vineland, NJ. Armed with clear expectations, you’ll walk into the appointment confident and leave ready to help your little one heal quickly.

Before the Frenectomy

The Diagnostic Visit

Most families arrive after a referral from a lactation consultant, pediatrician, or speech therapist who suspects tongue-tie (ankyloglossia). At the consultation:

• Oral exam: The dentist gently lifts the tongue to see how tight, thick, or short the frenum is.
   
• Functional test: Babies may be observed during a short nursing or bottle-feeding session. Older children are asked to lick their lips or lift the tongue to the roof of the mouth.
   
• Scoring tool: A standardized scale such as the Hazelbaker Assessment combines appearance and mobility scores to determine whether release is likely to help.
   

If restriction is mild and the child feeds, speaks, and grows well, watchful waiting may be suggested. When symptoms disrupt daily life, scheduling a frenectomy is the straightforward next step.

Questions to Ask at the Consult

1. Is a laser or scissors technique recommended, and why?
    
2. How much (if any) injected anesthetic will be used?
    
3. What stretching routine prevents re-attachment?
    
4. How soon can we breastfeed or bottle-feed after the procedure?
    
5. What follow-up appointments are needed?
    

Clear answers set realistic expectations and reduce last-minute jitters.

Home Prep Tips

• Practice stretches: If your baby tolerates it, gently lift the tongue with a clean finger once or twice a day so the motion feels familiar.
   
• Stock the fridge: Frozen breast-milk pops, chilled teething rings, and room-temperature formula all soothe post-procedure tenderness.
   
• Arrange support: A second set of hands (partner, grandparent, friend) helps with soothing, stretching, and extra cuddles during the first 48 hours.
   

Day-of Checklist

• Dress baby in easy-access clothing—a swaddle sack or onesie with snaps.
   
• Pack a fresh feeding—nursing parent, pre-pumped bottle, or formula.
   
• Bring a favorite blanket for comfort and warmth in the office.
   

During the Procedure

Getting Settled

Infants are swaddled; toddlers sit on a parent’s lap in a knee-to-knee position with the dentist. Protective goggles go on everyone in the room—the low-level laser light is safe, but eye shields are best practice.

Anesthesia and Comfort

A flavored topical gel numbs the frenum in about 20 seconds. For deeper ties, the dentist may add a tiny drop of local anesthetic with a short, fine needle. Most babies fuss only briefly, if at all.

The Release Itself

1. Positioning (15 seconds): The dentist lifts the tongue with sterile gauze.
    
2. Laser pulses (30–45 seconds): Concentrated light vaporizes the tight tissue while simultaneously sealing blood vessels. There is little to no bleeding.
    
3. Gentle stretch (10 seconds): A quick lift confirms full release and mobility.
    

Start-to-finish chair time is often under five minutes; the laser’s active time is rarely more than one minute. The quiet hum surprises many parents who expected drill-like noise.

Immediate After-Check

Right after the release, the dentist encourages breastfeeding, bottle-feeding, or pacifier sucking in the chair. This comforts the baby, confirms an improved latch or suction, and lets parents see the benefit right away.

Aftercare and Healing

What the Site Looks Like

A diamond-shaped white or yellow film forms within 12 hours—this is healthy fibrin tissue, not infection. It may last a week before turning pink.

Pain Management

• Cuddles and feeding on demand are usually enough.
   
• If needed, infant acetaminophen can be given at the pediatrician’s recommended dose.
   
• For toddlers, a cool fruit pouch or frozen breast-milk cube doubles as distraction and soothing.
   

Stretching & Exercises

To prevent re-attachment, perform gentle stretches three to five times a day for two weeks:

1. Lift: Place a clean fingertip under the tongue and raise it toward the palate until it blanches. Hold for two seconds.
    
2. Sweep: Glide left, right, then forward under the tongue to keep the wound edges from fusing.
    
3. Twist (for toddlers): Encourage licking yogurt off the lip or sticking the tongue out “like a puppy.”
    

Consistency beats force—quick, frequent motions are better than rare, aggressive ones.

Feeding Transitions

• Breast-feeding: Many parents notice deeper latch and quieter, shorter sessions within 24 hours, though some babies need a few days to coordinate the new motion.
   
• Bottle-feeding: Use a paced-feeding position (bottle horizontal) to help the baby adjust suction strength.
   
• Solids: Older infants and toddlers may explore new textures more eagerly once tongue mobility increases.
   

If weight gain was an issue pre-release, schedule a weigh-in about a week later to celebrate progress or tweak the plan.

Red Flags to Watch

• Uncontrolled bleeding (rare with laser releases)
   
• Fever above 100.4 °F (38 °C)
   
• Refusal to feed for more than six hours
   
• Swelling that worsens after day three
   

Call your dentist if any of these occur; most concerns are easily resolved with a quick check.

Frequently Asked Questions

How long before the tongue-tie could reattach?
The highest risk is in the first 10 days. Faithful stretching nearly eliminates it.

Will my baby be fussy afterward?
Most are soothed by feeding right away. A small percentage may be irritable for 24 hours—skin-to-skin snuggles help.

Do speech improvements happen instantly?
Toddlers often articulate sounds more clearly within weeks. Additional speech therapy can speed habit retraining if needed.

Can we combine lip-tie and tongue-tie releases in one visit?
Yes—doing both reduces total healing time and office visits.

Tracking Success

Keep a simple log during the first week: feeding duration, milk transfer, comfort level, and any stretches completed. Most parents see:

• Shorter feeds and longer sleep intervals by day three to five.
   
• Steady or increased weight gain at the one-week check.
   
• Less dribbling and no clicking sounds at the breast or bottle.
   

Celebrate small victories; they add up quickly once the tongue is free to move as nature intended.

When to Schedule the Follow-Up

Your dentist will likely want to see the site at two weeks to ensure full mobility and answer lingering questions. Bring videos or notes of any concerns—sometimes a minor tweak in stretching technique makes all the difference.

Ready to Take the Next Step?

If your baby struggles with latch, weight gain, or early speech sounds, a frenectomy might be the gentle fix you’ve been waiting for. Visit our page on pediatric frenectomy linked above or call our Vineland office to book an evaluation. Clear expectations, a quick in-office procedure, and a short healing window can transform feeding frustrations into peaceful bonding time—one tiny snip (or laser pulse) at a time.