Orthopedic
Orthodontics

    Classes of Lip Tie and Tongue Tie

    Tongue Tie

    Tongue ties have classifications that confuse many. They are classed class 1, 2, 3, 4 and submucosal. These classifications are not in indication of need to treat or severity. The simplest way to describe the tongue ties is either normal, anterior or posterior.

    Normal - No lip or tongue tie
    Normal
    Anterior Tongue or Lip Tie
    Anterior
    Posterior Tongue Tie
    Posterior
    After treatment there are often significant changes to tongue elevation and extension that is observable to the parent. See the example of an immediate tongue tie release:
    Anterior Tongue Tie before treatment
    Before Treatment
    Anterior Tongue Tie after treatment
    After Treatment – improved elevation
    Lip Ties
    There are times when the lip alone or many times in concert with a tongue tie do prevent the proper ability of the mouth to open and flange on a breast or on a bottle. Many instances of baby snorting, bobbing on and off of the breast in frustration, lip blisters (not always a reason for concern) noisy breathing, puffiness under the eyes due to restricted tear duct flow into the nose that the compress lip can block, are just a few of the lip related tie concerns. There are also many times when a mother has minimal to no breastfeeding symptoms and weight gain is “fine” because she has such a great milk “letdown” that an efficient latch is not necessary. Yet, there are still baby symptoms for spitting, gagging and fussiness. (This is another reason for a thorough evaluation by the appropriately trained professional). You may hear that the lip will cause spacing and tooth decay in the future and many want this treated early. Here again there needs to be a proper diagnosis of a current problem to justify treatment. The reasons for infant tie treatment is for the feeding, swallowing and breathing related issues only.
    Classifications
    Some of the classification types of lip tie (which are only a simple anatomical description and not a diagnosis for severity):
    Class 1 Lip Tie
    Class 2 Lip Tie
    Class 3 Lip Tie
    Class 4 Lip Tie
    Notice the different tie shapes in a single classification:
    Class 4 Lip Tie - Fibrous
    Class 4 Lip Tie - Fleshy
    Class 4 Lip Tie - Thick
    Class 4 Lip Tie - Thin
    How should the lip look after treatment? The images below represent a sequence through a procedure:
    Lip tie treatment - start
    Start of Procedure
    Lip tie treatment - midway
    Midway
    Lip tie treatment - finished
    End of Procedure

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