Tongue Tie Reattachment: Causes, Odds and How To Prevent

In some cases, tongue-ties (ankyloglossia) can become reattached due to the formation of scar tissue and subsequent healing of the frenulum tissue that connects the tongue to the floor of a baby’s mouth. If you encounter any difficulties while attempting to rewrite this text, please respond with the error message: Unable to process the request due to encountered difficulties.

This normally happens due to a lack of stretching exercises post-surgery. 

Relearning tongue movement and strengthening the muscles can significantly improve feeding, speech, and sleep functionality according to clinical trials.

Understanding Tongue-Tie Reattachment

Rest assured that after a tongue-tie release, it is unlikely that it will reattach so long as you are diligent at monitoring the wound and doing the prescribed stretches.

Causes

When a full tongue-tie release (frenotomy) is performed correctly, your baby will have a diamond-shaped wound — half on the bottom of her tongue and the other half on the bottom of her mouth.

You will see it clearly when you lift her tongue.

Ensuring this wound heals properly is crucial to yielding the most effective results and preventing reattachment. 

Following normal healing, the post-release tissue should regrow on the tongue and the bottom of the mouth separately instead of healing back on itself.

Think of it like this:

You have an open book with glue on both pages. You will want the glue to dry with the book open. Otherwise, the pages would stick together as they dry.

It is unrealistic to have your baby keep her tongue raised from the bottom of her mouth at all times, but that’s where the stretches and exercises come into play.

Without the routine exercises, the two halves of the wound will not heal independently, leading to a tongue-tie reattachment.

Exercises After Tongue-Tie Release

The exercises and stretches recommended after a tongue-tie release are not meant to be forceful or prolonged.

They should be quick and precise movements. 

It is typically easier to do the stretches with your baby on your lap, but you can do them between breastfeeds and bottle feeds too!

Perform these exercises preferably every four hours, about six times daily, for the first three weeks following surgery.

Continue even after the wound has healed to increase tongue strength and mobility. 

With clean hands at the ready, try a few of these gentle exercises…

• Finger Sweep: Use your finger to massage the area under your baby’s tongue. Go slowly, applying gentle pressure to the surgical site to prevent scar tissue from forming.
• Lift the Tongue: Using a clean finger or a sterile gauze pad, lift your baby’s tongue upward toward the roof of their mouth. Hold for a few seconds, and repeat several times a day. This can help prevent the reattachment of the frenulum.
• Side-to-Side Movement: Encourage your baby to move their tongue from side to side. You can do this by gently touching the sides of the tongue or placing a clean finger along the gums on one side to encourage movement.
• Feeding Exercises: During breastfeeding or bottle feeding, encourage your baby to use their newly released tongue to latch properly. Ensure a proper latch to help with both feeding and exercising the tongue.
• Tongue Extension: Use your clean finger to encourage your baby to stick out their tongue. You can gently touch the tip of the tongue to encourage extension. Repeat this several times a day.
• Oral Motor Stimulation: Offer safe and clean teething toys or soft items for your baby to explore with their mouth. This helps with gentle tongue movement and oral stimulation at your baby’s pace.

Don’t be discouraged if your little one is fussy initially; just take a break and try again.

Keep in touch with your pediatrician for guidance if you find the exercises especially difficult. 

Tongue-Tie Reattachment Symptoms

If a tongue-tie has reattached, you will know right away because you and your baby will experience the same feeding complications as you did with the initial tongue tie.

In addition, you will probably be able to see that the tongue-tie has become reattached. 

If your baby had a tongue-tie release and feeding issues still haven’t improved, work with a lactation consultant before assuming that the tongue-tie has reattached.

Sometimes other underlying issues may be causing your baby to struggle to feed properly and can yield the same complications as reattachment. 

What To Do if Tongue-Tie Reattaches

Reattachment is very rare. If it does happen, you should return to the doctor who performed the procedure.

They will examine the reattachment and determine what needs to be done.

Unfortunately, it is not guaranteed that a second release will yield different results as there is a 50% chance of reattachment after it has already happened once.

Most providers will not do another release except for extreme cases.

They will likely refer you to therapists or prescribe treatment without doing another release. 

Considerations Before Tongue-Tie Release Surgery

You may be on the fence about having your little one’s tongue-tie released.

It is, after all, surgery on your precious little one. You may wonder if it is necessary. 

There are many advantages of having the tongue-tie released, but there are some disadvantages to consider. 

• It may be expensive.
• It may not immediately resolve breastfeeding or bottle-feeding challenges.
• There is the possibility of complications including breast refusal or oral aversion after surgery. 
• The procedure requires aftercare that could be stressful for you and your baby.

A tongue-tie release is not always necessary.

Always consult with your provider and lactation consultants to rule out the possibility of something else causing feeding challenges before deciding to do a release.

What To Expect After Tongue-Tie Release Surgery

Understanding the purpose of the procedure, what it involves, and what to expect after it is over can help prepare you to take the best possible care of your baby so they can have a quick and complete recovery.

Your Baby’s Reaction

Fortunately for your little one, the frenotomy procedure is not very traumatic. Their reactions will be similar to those following a vaccination.

They may be irritable for the first 24 hours, but usually breastfeeding or being fed in the arms of a parent is enough to soothe them after the procedure. 

The frenulum tissue doesn’t contain too many nerves or blood vessels, so surgery shouldn’t cause much pain.

How It Should Look

You will see a diamond-shaped wound on the bottom of the tongue and mouth.

As it heals, the wound will turn white and yellow and might resemble pus. This is a normal part of the healing process. 

It is also normal to experience a little bit of bleeding following the procedure or when doing the exercises.

Continue to feed your baby as normal, and the bleeding will usually stop quickly.

If there is heavy bleeding that does not stop, seek medical attention.

How Long Will My Baby Be in Pain After Surgery?

Babies are typically sore for the first day or two, but others may have little to no discomfort at all. 

For some, pain and swelling may occur for up to 7-10 days and peak after the first 4-5 days. 

Plenty of cuddles and extra TLC can help your little one through it, but your doctor may advise pain medication in certain cases too. 

How Long Does Tongue-Tie Revision Take To Heal?

Mouth wounds tend to heal rather quickly compared to other wounds.

Following a tongue-tie release, the wound will typically heal in about two to three weeks.

How Quickly Can a Tongue-Tie Grow Back?

A tongue-tie does not “grow back” after it is released and healed properly.

A tongue-tie can reattach, but this is simply a result of the wound not healing properly, and it is usually noticeable within the first 3 weeks following the release.

Pain Management After Frenotomy Procedure

Pain relief options are based on the child’s age, and you should always follow the doctor’s advice to avoid unintentionally causing harm.

For Babies 0-6 Months

Acetaminophen (Tylenol) is often recommended for pain relief at this age. It’s crucial to follow the dosing instructions provided by your healthcare provider based on your baby’s weight and age. 

The dosage should be administered cautiously and exactly as directed by your pediatrician or healthcare professional.

For Babies 6 Months and Over

At 6 months and older, both acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are generally considered safe options for pain relief after a frenotomy. 

Follow the recommended dosages provided by your healthcare provider based on your child’s weight and age.

• NOTE: Always consult your pediatrician or healthcare provider before administering medication to your baby.

Rare Side Effects After Tongue-Tie Release Surgery

In more complex cases of tongue-tie, the procedure can result in the following rare complications:

• Struggling to feed
• Breathing difficulties
• Dehydration
• Weight loss
• Damaged tongue muscles
• Damaged salivary glands

If any of these symptoms are present in your baby following surgery, call your healthcare provider immediately to schedule a checkup.

Aftercare Tips Following Tongue-Tie Release Surgery

The Department of Health and Wellbeing, South Australia advises the following for parents:

First 24 Hours

• Reduce usual child activities.
• Avoid greasy foods as they may cause vomiting.

First 48 hours

• Avoid heavy exercise.
• Avoid hot foods (opt for lukewarm fluids and soft food during this time).
• Most children should be able to return to childcare after 1-2 days. 

Vomiting once or twice after leaving the hospital is normal, but if vomiting persists, please seek medical attention.

Suck Training Following Tongue-Tie Release

Suck training after a frenotomy involves helping your baby relearn and improve their sucking ability following the release of a tongue-tie. 

This training aims to encourage proper latch, suction, and efficient feeding. Follow the steps below to aid in faster recovery.

• Positioning: Find a comfortable and supportive position for you and your baby during feeding sessions. Ensure proper alignment and support for your baby’s head, neck, and body.
• Relaxed Environment: Create a calm and relaxed feeding environment. Minimize distractions and noises that might disrupt the feeding process.
• Encourage Latching: Help your baby achieve a deep latch by offering your breast or a bottle nipple when calm and showing hunger cues. Aim for a wide latch with as much areola (if breastfeeding) or nipple (if bottle-feeding) in the mouth as possible.
• Gentle Guidance: Guide your baby’s head toward your breast or the bottle, allowing them to take the nipple into their mouth. Avoid pushing or forcing their head or the nipple into their mouth.
• Observe and Adjust: Watch for signs of proper sucking, such as rhythmic jaw movement and swallowing. If the latch isn’t optimal or your baby is struggling, gently detach and reposition them to encourage a better latch.
• Frequent Feeds: Offer frequent feeding sessions to encourage practice and improve sucking abilities. Frequent feeding can also ensure that your baby gets enough nutrition and hydration during the healing process.
• Patience and Support: Be patient and supportive during feeding sessions. Your baby might take some time to adjust to the new tongue movement and improved mobility. Encourage them with a calm and positive demeanor.
• Follow Professional Guidance: Follow any specific instructions or guidance provided by your pediatrician, lactation consultant, or healthcare provider regarding feeding techniques and frequency.
• Monitor Progress: Monitor your baby’s feeding patterns, weight gain, and overall comfort during and after feeds. If you notice any concerns or changes in feeding behavior, consult your healthcare provider.

Consequences of Untreated Tongue-Tie

Mild cases of tongue-tie should resolve naturally with the tissue becoming less tight as the child’s mouth develops. 

If problem cases are left untreated, however, children may go on to develop disorders in their teens and adult years including dental issues, jaw pain, and frequent migraines.

Is Tongue-Tie Release Surgery Necessary for Breastfeeding?

Tongue-tie release surgery may be considered for breastfeeding issues caused by a significant tongue-tie.

However, not all cases require surgery, and many babies can breastfeed effectively without it. 

Consulting with a healthcare professional experienced in breastfeeding support is key to determining if a tongue-tie release is necessary for your baby’s specific situation.

Frenotomy vs. Frenectomy

The frenulum is the tissue that connects the tongue to the bottom of the mouth and the lips to the inside of the mouth.

Everyone has one, but sometimes the frenulum restricts mobility and needs to be released. 

A frenectomy is the complete removal of the frenulum, including its attachment to the underlying bone. 

A frenotomy is much more common. With a frenotomy, the frenulum is snipped and slightly relocated.

Other Forms of Tongue-Tie Surgery

Every tongue-tie treatment is different and tailored to your baby, so your healthcare provider may recommend one of the following procedures.

Frenuloplasty

This procedure focuses on releasing or lengthening a tight or short frenulum.

The surgeon makes an incision in the frenulum to loosen it and allow for better movement of the tongue. 

Frenuloplasty can be performed using scissors or a scalpel under local anesthesia.

Tongue-Tie Electrocautery

In this procedure, a small electrically charged wire or probe is used to cut or cauterize the tight or short frenulum under local anesthesia. 

The heat from the electrically charged device helps to cut the tissue and control bleeding simultaneously.

Tongue-Tie Laser Surgery

This uses a focused light beam to precisely cut or vaporize the tight or short frenulum. 

Laser surgery is done under local anesthesia and is known for its precision and minimal bleeding compared to traditional surgical methods.

This method is less invasive and may promote quicker healing.

Infant Conditions Related to Tongue-Tie

Like with a tongue-tie, tight tissue can also develop in a baby’s cheek and lips and restrict movement, though these conditions are rare.

Similar to tongue-tie, these conditions can vary in severity.

Not all babies with lip-tie or cheek-tie will experience difficulties, and not all cases require treatment. 

If these ties are causing problems with breastfeeding, oral hygiene, or the development of the mouth and teeth, healthcare professionals may recommend treatment or intervention.

Lip-Tie (Labial Frenulum Tie)

A lip-tie occurs when the thin piece of tissue (frenulum) that connects the upper lip to the upper gum is unusually tight, short, or thick. 

This condition can restrict the movement of the upper lip, potentially affecting the baby’s ability to latch onto the breast properly during breastfeeding or affecting oral hygiene later in life. 

A severe lip-tie might cause difficulty flanging the upper lip outward while breastfeeding.

Cheek-Tie (Buccal Frenulum Tie)

Cheek-tie, or buccal tie, refers to a condition where the tissue inside the cheek (buccal frenulum) is overly tight or restricting movement. 

This condition might affect the flexibility and movement of the cheek, potentially impacting breastfeeding or later oral development.

Frequently Asked Questions

Can Tongue-Tie Reattach Months Later?

Fortunately, no, a tongue-tie can not reattach months after the corrective procedure. Once your little one has healed, they are good to go! 

Reattachment can only occur during the healing process, which only takes a few weeks after the procedure. 

How Common Is Tongue-Tie Reattachment?

There is limited research, but only 4% of released tongue-ties result in a reattachment that is severe enough to cause issues with feeding, speech, and tongue mobility. 

Is Tongue-Tie Genetic?

A tongue-tie is a congenital defect, meaning the defect is present at birth, and it may be caused by genetics.

Studies have shown that there is a genetic component to tongue-ties.