Exploring the Impact of Tongue Ties

Speaker 1 0:42

Welcome to the Beauty of Breathing podcast . We are over here with Dr Suraj . I'm going to let him introduce himself to you guys . Go for it .

Speaker 2 0:53

Well , thank you for having me , renata . So just to introduce myself to everyone , I'm Dr Suraj Batish . I practice in Chelsea , london and I form part of the Tongue Time Breathing Center here at Happy Kids Dental . My passion is always finding out the root cause , always asking the question why . I started my dental training in Valencia in Spain , and I trained as an oral surgeon and in periodontics and then , about three , four years ago , I found my calling doing tongue ties . About three , four years ago , I found my calling doing tongue ties . Now , the funny story is actually I did tongue ties during my residency with scissors and I swore I'd never , ever do them again . And now literally my day-to-day life is less implants , less surgery , more tongue tie releases . So life always brings you in really funny circles .

Speaker 1 1:46

Wow , that's incredible . I'm not sure you guys on Instagram . Please let me know how the volume is . Make sure you guys can hear it . Well , if you can also mute yourself on your phone every time that you speak , I'm going to play your voice through mine , so I think that that will work well . So , keep the volume off and the mute . You can just mute your mic on there . Perfect , all right , great . So what made you get even interested in tongue ties ? How did that all start so ?

Speaker 2 2:16

it was actually quite accidental .

Speaker 2 2:18

So in the practice where I'm at , we had a lot of demand for tongue tie patients and airway-based dentistry come in and naturally I was approached to come in , take over this and , as I said to you , my training was doing it with scissors , doing it in the traditional oral surgery way , lifting the tongue up , snipping everything and then doing a couple of stitches just to hold it in , and we then invested in a laser .

Speaker 2 2:44

So I said , okay , things are going to be probably a bit easier for me . And then I started to do Dr Baxter's training , dr Zaghi's training , and I was like this is answered . So many of my questions started to see things so differently . I understood why my patients were suffering from more gum disease , suffering from crooked teeth , were mouth breathing a lot more , grinding their teeth , and my world was changed and since then I've literally I'm one of the few tongue tie release providers in the UK I think in London there's only two of us and we're both on a mission to kind of spread the word . Spread the word of early prevention , looking at the root cause and giving everyone all the information they need .

Speaker 1 3:36

Oh , my goodness . Well , I know that we shared some patients before and I'm so excited to have somebody in the UK . So many people , especially here on Instagram , come over to us and ask is there anybody in the UK ? So many people , especially here on Instagram , come over to us and ask is there anybody in the UK ? Because , as we , the more that we learn in this field , the more we realize that it's not everyone who is trained in doing the release how Dr Baxter or Dr Zaghi teaches . So from your training , how different was it before you were introduced to Dr Baxter or Dr Zaghi teaches ? So from your training , how different was it before you were introduced to Dr Baxter and Dr Zaghi's technique ?

Speaker 2 4:14

It's a huge difference and I would say like it's the difference between in Spanish we say , between the sky and the sea , because the traditional way of doing a tongue tie release has always been like lift up the tongue , snip the fibers , and you're never told kind of when to stop and you're not kind of training the tongue as a muscle .

Speaker 2 4:35

You're treating it as just like treating a skin tag , where you're slicing , you get to your end point and you stop , and what I saw was my rate of reoccurrence was a lot higher and that was then making me really doubt the procedure , because I said what's the point of me putting my patients through a procedure that's not going to work , be successful ? Now , what happened from that point onwards was that I then looked at the functional approach , how Dr Baxter and Dr Zaghi did , and I then started to see the tongue more as a mobile joint like the hip or like the knee , and that then definitely revolutionized my surgery . My complication rate dropped , my patient satisfaction rate went up a lot higher and I actually saw visible change in people's lives and their sleep and their speaking and their neck and back tension , and , from a dentist point of view , we look at grinding teeth as a lot . So my implant patients who was giving mouth guards to stop the growing the teeth didn't need those mouth guards anymore . It was crazy .

Speaker 1 5:38

Wow . I do remember seeing research from Zaghi showing a 91% in reduction of clenched and grinding on patients that had a tongue tie . Release Over here , our listeners , please let us know right in the comments on Instagram , or send us a message after this is on Beauty of Breathing to let us know do you grind your teeth ? Have you ever heard that maybe it could be caused by a tongue restriction ? Somebody said yes , my daughter had a sip and clip as a baby , and here we are at six . What is the best way of going about this ? If there's a parent out there who already had this procedure done and they're still seeing symptoms on their child , how long should they wait ? What is usually the process like for a revision ?

Speaker 2 6:31

So it depends on how the initial release was done , the post-op follow-up . So , for example , in the UK we do get a lot of patients who I see have had previous scissor releases done by their midwives , done by the hospitals , and they've not been given correct referrals to an osteopath , to an OT and they've not been in any exercise post release . So a lot of parents at that point were like breastfeeding never improved , the symptoms stayed the same and we just decided to get on with it . And what I always tell them . I say if you've had a revision or a release , you want to get it . You want to start to see benefits within the three to four week mark ? If not , then it's better you come back , you see a release provider and then get a second opinion or see another release provider and find out what's going on , because at that point things should be started to stable up . But it's always about the process .

Speaker 2 7:24

I say it's not just the release and that's one thing I've learned a lot more . It's a lot about in older patients , the myo , the body work , the pre-op preparation than actual surgery itself .

Speaker 1 7:36

Exactly how important is working with other professionals for a baby with an IBCLC or a body professional for other patients with myofunctional therapy ? What is the importance of a team approach when it comes to a tongue tie release in your office ?

Speaker 2 7:55

It's essential we only work with a team-based approach and I explain to patients the importance of why . Because , firstly , I'm not lactation trained , so I cannot support a baby on that side . Post release and the lactation device , I cannot diagnose any feeding issues . I can only release the tongue .

Speaker 2 8:17

But , to get optimal results they do need to see a body worker , like an osteopath or chiropractor , for babies and they do need to see an IBCLC and for older patients . We do pre-op , post-op myofunctional therapy , with pre-op and post-op body work and speech and language therapy if needed as well .

Speaker 1 8:36

Very good . Do you have a certain requirement for a baby before a release ?

Speaker 2 8:43

So ideally I do like them to see an IBCLC before , because in my experience feeding is usually a bit difficult following a release and some parents get very worried and scared because their child may not be feeding the same way . They may have some other feeding difficulties afterwards . So it's always very important to get that support from an IBCLC before always very important to get that support from an IBCLC before . I have been seeing that some patients who have had pre-op osteopathy . I do find those tissues a bit softer to release as well . Now I do obviously advise that wherever possible that they get at least a couple of sessions of osteopathy to see me . But sometimes if the child is too small and they're not gaining weight very quickly , we do kind of do that more postoperatively .

Speaker 1 9:27

Perfect . Somebody's asking can there still be a significant problem even if breastfeeding is going well ?

Speaker 2 9:35

It depends on , obviously , the structure as well . Now , as we know , the tongue helps function . The tongue helps develop the palate , it helps as a switch for on and off the nose breathing , and so what we want to do is we want to make sure that all these things are happening at the same time . Now , when we look at breastfeeding , we need to make sure that the child is getting enough milk , he's putting on weight and he's growing in the right percentile . Now if , following a tongue tie release , we're not seeing that , then that's something we need to take further advice on Usually see a pediatrician , make sure the gut bacteria is okay and there's no other underlying issue that we don't we could have missed .

Understanding Body Work for Tongue Ties

Speaker 1 10:17

This is a great question . What do the body work professionals do ? What should we , as parents , ask for ? It's going to depend on the age of the child , and I feel like that's a common question for parents . What exactly is body work , even though we are not body professionals here ? Um , what do you usually ? Who do you usually work with where you are ?

Speaker 2 10:36

so it's a common question I get asked as well and I sat in with one of the osteopaths that I work with and refer to and it looks almost as if they're doing Reiki or they're doing kind of nothing .

Speaker 2 10:48

Because it's really strange to see , because they're talking to you , they're holding the baby in their hand and then all of a sudden you see this baby who's really crying intense , melt away into a pool of calmness . I do see the actual effects in the mouth Now when I compare patients who've had osteopathy post and pre and post release and patients who don't , those tissues are really tense in the patients who don't have it . What they actually do is they work on these other compensating muscles . So when the tongue's restricted we get a lot of tension in the floor of the mouth , jaw , occiput , back of the neck and even up to the diaphragm . And a good osteopath or cranial osteopath will work on these tense passions and release them and doing so I believe it takes that stress off that tongue , which is now moving a lot more freely and allows it to get into correct zone of function .

Speaker 1 11:39

So for adults , yes , this can definitely be done . For an adult it will be a little bit different . Usually we recommend myofunctional therapy before , and I have several providers that will not release the patient unless I tell them that the patient is ready , myofunctional wise , to be able to have great results after that release Body professional wise . For an adult , I like what you mentioned craniosacral therapy , cranio osteopath , even a massage therapist is going to depend on what kind of professional you have around you and you have , you know , easily accessible . However , tons of this I can hear myself is a volume on in your phone it keeps turning itself back off .

Speaker 2 12:24

Let me try and because I can .

Speaker 1 12:26

You can actually turn the uh , your mute back on and I'll just put earbuds on and then you won't . There he goes . You can unmute yourself on your phone oh perfect hold on , let me just make sure that it connects over to my earbuds . Hold on just a second right here . All right , how is that ? No echo everybody . Can you hear me ?

Speaker 2 12:54

I can still , I can hear you I'm trying to unmute . Uh , instagram's not letting me completely remove the volume there for some reason okay , I think it worked .

Speaker 1 13:05

You're in my ear now okay okay , I think it worked .

Speaker 1 13:10

Is it good everybody ? Sorry , I want to make sure the sound is really really good for you guys . All righty , so now let's see if we have any other questions . Yes , as an adult , I have heard of so many different types and of course there are good professionals and there are great professionals . I have had craniosacral therapy done where I didn't really feel much , and then I have had some sessions with different practitioners that I busted out crying the first session . You know that you can feel the changes , but it's just going to depend on the amount of training that they had they have . I know that for craniosacral you want somebody that's been trained by the Upledger Institute and you can go on the Upledger website and find a professional around you . But I know that those are like Upledgers who came up with craniosacral therapy , so that's a good one . Do you have any good craniosacral or craniosopaths around you ? They usually refer to .

Speaker 2 14:09

We do . We have quite a few . So I work very closely with Lucy Rayner , who's a traditional osteopath , who's also trained in cranial work , alexandra Freeman and Laura Tilson Osteopathy , who we they're all traditional osteopaths who have done the cranials training . Now in the UK cranial sacral therapy is not very well regulated and I haven't in my experience found a very good , persistent one that I can say I can refer to pure cranial sacral therapist . So I generally tend to refer to chiropractors or osteopaths who are cranial trained and we get great results with those people . But usually what I tell parents to do is A if you're looking for an osteopath or a cranial sacral therapist , ask do they have experience with tongue ties ? Have they treated any patients in the the past and do they know what to do afterwards ?

Speaker 1 15:01

very , very good . Somebody's asking uh , kevin is asking what does post therapy look like for an adult tongue tie release in your practice ? How often do you see them after so ?

Speaker 2 15:14

the osteopath I work with . We're doing guided releases , so she's kind of those are amazing .

Speaker 1 15:20

Can you explain what a guided release is ?

Speaker 2 15:23

So a guided release happens that we prepare the patient with pre-op myofunctional therapy , some body work , a couple of days before and my osteopath and I we work together on the same day . She's got her hands on the patient's head and as I'm releasing she's feeling that tension kind of drop off those muscles . She's doing some work on those cranial , on the occiput , on the neck , and as soon as I finish she's then doing her manipulations and working on those the floor of the mouth and the upper thoracic area , and she's also done a course on face massage as well , which we're going to hopefully incorporate into our guided releases as well . Now patients afterwards report that they've just been transported to another realm . They're really relaxed , they feel all the tension drop off and for me when I see these patients in about one week when I did my first review , the healing is very fast .

Speaker 2 16:14

It's not very scabby . I'm not seeing those like usually tongue tie healing . You get a lot of scabs coming up . That one week point . And these patients they've got so much mobility . So usually what's happening ? Osteopaths are reporting that they're able to manipulate the joints a lot better . They're not having to force the joints to get into the correct position all of a sudden the fascia work becomes a lot easier to work on and I'm seeing this in real time as well . I'm feeling my osteopaths like wait , this , the occiput's kind of dropped off this side is a bit stiff still . And then I'm looking at those fibers when I'm releasing and I'm like , is this making any difference ? And I can then guide the releases , guided by both of us working together to see safely , what we can release at that point .

Speaker 1 16:53

Wow , how long does it usually take for an adult release ?

Speaker 2 16:59

So my surgical time is now about 15 minutes maximum .

Speaker 1 17:03

Wow .

Speaker 2 17:04

So it's really kind of smooth , and that includes obviously initial incision sutures and periapical glue afterwards . But I put that down to having a very good nurse who always knows where I'm working and having a lovely laser that I can work with at the same time .

Speaker 1 17:21

So how different are those from a baby's release ?

Speaker 2 17:26

So a baby's release is a lot , I'd say , faster . A baby's release almost takes a few seconds . We're not going very deep in a baby's release . We want to kind of preserve the genioglossus which in um , which now in adults we start to do as well . We're kind of working a lot more with body work in that sense . But a baby's release is um , you're leaving a diamond , um . I'm not suturing babies as such , yet I know there are some practitioners now starting to suture babies . I've had to suture one baby because I did see an artery which I preserved with the laser , so I put a stitch in just because I didn't want anything to happen to it . But it's never . It's not the easiest task . And even with someone who would like me , who loves my sutures , I wish I could be able to put them on babies but and kind of reduce the emphasis on the parents for aftercare . But , but with babies I'm usually leaving an open wound and the parents are doing post-op care about three times a day .

Speaker 1 18:20

Amazing . I will answer the same question that Kevin asked what does post-therapy look like for an adult tongue tie release with the myofunctional therapy perspective ? If there's no sutures , I'll see this patient about three days after . If there are sutures , I'll see this patient about five to seven days after the release . However , I'd rather all of my adult patients have sutures . I really fight with my patients for them to go to a provider that I'm used to working with , because we are , you know , on the same thought process when it comes to pre and post release . Also , I will start with exercises first and then we start with stretches after all the sutures come off .

Speaker 1 19:09

I don't usually start working with a patient with chewing or swallowing until way after the patient is healed . That's whenever we start adding a little bit of that . I don't work with that before the release either , because I can't push somebody to swallow a certain way if their tongue is restricted . So I'll wait until the release is done before I even do that . So we can vary eight sessions , 10 sessions , 18 sessions . It really varies patient by patient how much post-op we're going to need . If somebody is super low tone , it's going to take a little bit longer for the muscles to respond . If somebody doesn't eat red meat , it's going to take longer for the muscles to respond . Muscle needs movement and food protein . Another question my daughter is 14 and had an expander . What measurement should she have after her ? Ortho seems to believe 37 is not all women and she won't measure . She does not seem to know about myotherapy , so this is a little bit different than the tongue tie um topic that we have today . Do you want to touch on this at all ?

Speaker 2 20:14

so obviously I work with a lot of functional orthodontists and , uh , there there are some ranges of where the palate should be and obviously we want to push for around 37 to 40 millimeters . But what I always say to everyone you want to see that tongue when you do a suction hold to kind of fit in around the area . Now I'm the worst person to show you because I've got a tongue space issue myself . So , like Renata , yeah , I've had expansion now .

Speaker 2 20:41

I know I had four premolars removed so I've been compressed because of . I was a mouth breather when I was younger , because of a lot of allergies , and although my mother did try her best to take me to everyone and said why is he always constantly breathing through his mouth ? What's going on here ? No one ever knew the answer why . So at 13 years old I had braces .

Speaker 2 21:01

The orthodontist decided to remove four of my premolars , close everything . Give me a very kind of , I'd say . I've got a nice smile . You can see I've got straight teeth . Is it functional ? Still , my molars don't meet yet I've got a slight tongue space issue , so I'm prone to the odd snoring . But had we had the information that my mother was going at from when I was very young , I don't think I would be in the same position . I would be right now . So that's another thing I really advocate for is getting the right help early If your child's mouth breathing , see a functional orthodontist , ask your questions , go to your GP , go to your dentist and really ask them well , why is my child breathing through their mouth ?

Speaker 1 21:41

Yes , every time we talk about tongue tie releases , we do have to address tongue space issues . So is it safe to release the tongue or not , based on if there's good space or not ? If your orthodontist do not know about myofunctional therapy , I would go ahead and contact a myofunctional therapist Every single time there's a structural change . You also need to address the muscle so the muscle functions properly and he has enough tone and he has enough strength . So starting myo now with your 14-year-old daughter will be perfect . Also , there's no perfect number . Like Dr Suraj said , there's this range that we try to stay in between .

Speaker 1 22:18

Some people have messaged me saying my orthodontist expands everybody to 43 millimeters , molar to molar . It's impossible . You know you can't do that . I went from a 30 to a 37 millimeter . I , at 40 , would have looked weird . My face , I feel like it's wide enough now , so it's not going to fit everybody . And then , of course , you have the issue that the lower jaw might not be able to catch up because you cannot expand the lower jaw . Um , we have more questions . What do you recommend ? Uh , oh , they cannot hear you . They just told me that is your . Are you muted on your phone ?

Speaker 2 22:54

I think I should .

Speaker 1 22:56

I have oral surgeon as an orthodontist tell me there's no evidence for this . It's very frustrating . Evidence for tongue tie or evidence for all guys I totally missed this thing that there was no sound . Did you put your microphone on again ?

Speaker 2 23:10

I think I put it on again . Yeah , okay you're going to be slightly echoing , I think so . Sorry , what was the question again ? Uh , renata here .

Speaker 1 23:20

I'll turn it down . Um , we were talking about the , the expansion . How do I find a myofunctional therapist ? If you guys go on my resources right now , go to wwwairwaycirclecom slash directory , we have a whole directory of multidisciplinary professionals myofunctional therapists , dentists , orthodontists , ents , body professionals oh no , they missed all of you . Let's see . Would you love to hear recommendations on CSCs and osteos ? No , sir ,

Assessing the Impact of Tongue Ties

Speaker 1 23:49

okay , we . This episode is going to go on beauty and the beauty of breathing . Next week , on Tuesday , is going to be released , so you guys are going to go on beauty and the beauty of breathing . Next week , on Tuesday is going to be released , so you guys are going to be able to to have the audio version . Let's see . There's another question over here . Nope , there was everybody just letting me know that there was no sound . All right , perfect , let me make sure we got everybody . Yes , all the questions are answered here . Okay , now there's echo for me . I'm so sorry . We're trying to make sure that this works . I don't know what else to do .

Speaker 2 24:22

It's been a tricky one , I think , with the audio visual today . I think either I didn't have enough light and then and my camera was not on at all .

Speaker 1 24:30

So I use this um software that I can go live everywhere , and software you know was not working where my camera wouldn't turn on . But anyways , again , this will be on Beauty of the Breathing . You guys are going to be able to have full access to the audio version of this podcast . What is the post-op recovery look like in a five-month-old ? Is there any potential side effects of releasing the tongue tie ? I'm going to let you answer that .

Speaker 2 25:01

Okay . So it depends on , obviously , a five . When I treat patients for about five months old , you've got to understand . They're a bit more aware of what's going on . Now the most difficult thing about treating a five month old is the post-op aftercare or the stretches , because that's where a lot of patients the parents really struggle with them . Now we also got to understand at this point it's quite a tricky from a development point , because that's when we start to kind of switch over to solids and things then start to get a bit more , so we may run the risk of an oral aversion .

Speaker 2 25:38

I still don't withhold treatment , but I always make sure that these patients are under the care of a feeding specialist , ibclc , and that we're kind of justifying the procedure at this point , because we usually can see that these are the patients who have been struggling to feed up to this point . They've been let down by the midwives , by the some other , like some of the other professionals who see them , and they've been told there's no tongue tie or their reflux is just there because it's there . So this is these , the patients that we really do need the extra support with . But it is this if there's indications or if there's symptoms that we're worried about like uh , still refluxing , colicky , very windy , sleeping with their mouth open , and you see your baby's always tight and not sleeping well , that would be an indication for me for treatment , but I would make you see a feeding specialist first . Get a feeding plan in place just in case , well case , to reduce the risk of any oral aversions that could be potentially caused by the release of the post-op exercises .

Speaker 1 26:42

Somebody did ask me . Yesterday . She decided to stop breastfeeding and she said are there any possible issues that could happen afterwards if I don't release my newborn right now ? Baby was found to have a lip tie and a tongue tie . If parents , if moms , don't release my newborn right now , baby will sound to have a lip tie and a tongue tie . If parents , if moms , gave up on breastfeeding and they are deciding , or they're pumping or they're feeding formula , whatever their decision was , what are some possible consequences in the future ?

Speaker 1 27:11

And I am going to add that usually my advice to these moms are whatever it's in your heart is the right answer . You know you're going to have many friends and professionals and family members everybody trying to give you advice , but if you are in those early stages of breastfeeding , it is extremely difficult and if , for some reason , you decide that it's not for you , it is okay . You know your mental health first . Your baby is going to get the nutrition that they need . However , we are in airways , so we're just going to mention what we see with several children and adults that did not get their ties released . It's not everybody . This is just generalized information that may affect you or it may not generalize information that may affect you or it may not .

Speaker 2 28:02

I 100% agree with what you've said and what I always tell parents and patients as well . My job is to guide you and we can only guide you based on what we see . So I see babies , I see toddlers , I see adults and I kind of see patients go through one of two routes . We see a small percentage of population . So I've seen anterior grade four tongue ties and they've come to me as adults just because they can't stick their tongue out or wanted to lick an ice cream and when I asked them about their sleep , their speech . I've even had one patient had a very , very well developed jaw and had no tongue space issues for grade four , which for me was like wow , wow , but this is a very . These are small percentages of the population .

Speaker 2 28:42

So what I say to you you can either be one of these patients who compensates and their body's able to work that 80 to 90 percent or whatever percentage , harder than someone who's not tongue-tied . So the way I describe it as well a bit dramatic is you've got one leg and you might have managed to run the marathon . Not everyone with one leg can run a marathon , but you'll get those people who will push through it and make sure everything's fine . Amazing . That's one option .

Speaker 2 29:09

Option number two is you may start to see sleeping issues , so you may start to see snoring , early signs of sleep disorder , breathing which will affect behavior , which will affect how the child functions . You'll see mouth breathing which also will lead to enlarged tonsils , reduce the airflow and oxygen in the body , increasing the sympathetic nervous system stimulation a lot more . You may see some speech issues and you may see poorly developed mouths or palates and needing orthodontic treatment later on in life anyway , as we speak . So it's always like I tell parents , I said in the day I'm here to guide you .

Speaker 2 29:47

It's your child . I want you to make an informed decision . I don't want to be the one telling you this is what you need to do . My job is to give you all the information present to you , the different options , what can go on ? You take your time and you decide what you feel is best for your child and I'll support you through , no matter what you decide exactly even if it's a case of me saying , okay , you'd bring your child to me every month to say , okay , dr suraj .

Speaker 2 30:09

I said okay , if I have a look and see if my child is feeding well , the development's going well , and I'll be like , okay , well , it's going well so far . We can carry on watching it and we can always do treatment later on . I'm here to support my patients for that very good .

Speaker 1 30:22

I feel like , however , that was one of the the mistakes that I made .

Parental Experience With Tongue Tie Releases

Speaker 1 30:27

Um , in a way , when benny was born my youngest one I knew what a tongue tie , what a lip tie were . When , when zoe was born , I did not , so she had both and I missed both and she was , you know , regurgitating um milk .

Speaker 1 30:39

I mean it was coming out of , and she was , you know , regurgitating milk , I mean it was coming out of her nose . She was turning purple . Three times I had to turn her upside down , suck her nose because she was choking on it . She was the colicky baby . They used to start crying every nine to 9 PM and go until 11 PM , one in the morning , sometimes nonstop . For six months I dealt with that and I I didn't know she was gaining weight slower , but she was gaining weight , um , and she , but she just cried a lot . I had so much pain . I cried for 12 weeks with Zoe , for eight weeks with Benny .

Speaker 1 31:09

I'll never forget , however , when I knew about things with Benny , I had an ENT on um . You know , immediately on my phone number I called him um , the day that I had Benny , and he came in hours later to release him . It was just a phrenotomy , which is a snip . They barely released some of the tongue tie . It was not a full release and everybody , including myself , missed the lip , um , the way that I looked at the lip . I did not lift all the way up , I kind of just I went like this instead of pulling the lift out and over . So I really missed the lip tie . And as he got older I saw that it was just you know how obvious it was .

Speaker 1 31:53

But I kept pushing . I had PPD after Benny . I couldn't get out of the house . You know , my uh closer provider was two hours away , um , and I still had pain , even his , even after his frenotomy got a little bit better , but still not great , um , and I just kept pushing so I said , no , okay , three months . No , let's wait a little bit more . Six months . And I feel like the older he got , the harder it got for me as a mom to decide to go through with the release . And then there are some providers that will not even release toddlers . There are some providers that don't even will not even release toddlers . What do you usually recommend for this , that age , you know , whenever they start moving out a lot and it's a little little bit harder , how differently do you do those releases ?

Speaker 2 32:44

So when , for example , I treat a toddler or I treat someone over the age of one , it's a very tricky area because we've got teeth to contend with when parents are doing the stretches . We've got a child who's probably got some structural issues to work in , the body's been very tight because of the tie as well . So what we kind of aim to do at that point I kind of do is aim to kind of limit the damage going forward to make things a bit easier for them and my parents , my patients know that when I do a release on a toddler that they probably may need a second release when they're a bit older . Now we do have use of obviously correct restraint methods here to make sure that they're nice and still and I do feel that using a CO2 laser makes the release a lot safer and cleaner . For example , it does allow me within a few seconds to get if I've got good surgical visibility , which we usually get with our methods , we can get a nice keen release in about a minute and with the effects of the topical anesthesia which we've got is really strong .

Speaker 2 33:53

It's almost as if the child is having a blood test . So children will have the same kind of discomfort they have when they're going to get their jabs or having a discomfort , and then afterwards you give them some Calpol or Tylenol and then they usually almost forget about it . And at that point some of them you'll be surprised how resilient children are . They almost go to my waiting room downstairs where we've got a huge pirate ship and they're playing and the parents are like we didn't even know , so he didn't even act like he had a procedure done oh , my goodness .

Speaker 1 34:23

So I guess that's one of the things that I regret . I should not have waited as long as I did , because as he got older I kept going what's going to be harder ? It's going to be harder to hold them now . They know what's going on . Now they're gonna fight more . So if you're in doubt , talk to your professionals , find , uh , some good people to evaluate your child and you can make a decision informed decision that way . Somebody said ENT in the UK often missed the full release needed . There you go . Now you have Dr Suraj that you can go to and he will be able to help you . My goodness , this has been such a wonderful chat with you . Any last remarks you would like to share with our audience ?

Speaker 2 35:04

well , firstly , it's been a pleasure to speak to you as well and thank you for having me . I know , amongst all the , for example , the lighting and everything , but uh , I'm sure we can figure that . But last thing I want to say to everyone is always ask the question why ? Now a lot of health professionals will come to you and tell you the reason . Now a lot of health professionals will come to you and tell you the reason for a lot of things . They'll tell you you've got this , you've got that . Now what I'm trying to educate people is ask why and the importance of breathing .

Speaker 2 35:32

I think in the uk we're very symptom . We are very symptomatic based approach to treating with issues . You've got a headache , your gp is going to give you some paracetamol and that's it . No one ever asks why . We've got a lot of children I'm working with with behavioral disorders who have been put on adhd medicine who I believe there's never .

Speaker 2 35:53

Their breathing has never been addressed . And I'm now . One of my patients was a psychiatrist who once we had discussion he put his head in his hands and he felt so bad that he'd let so many patients down because he never looked at the breathing . And he's changed his practice to work with us . He's actually sending us over the children with slight behavioral issues and saying , well , look , I think , first get a breathing assessment , look at your breathing . He's even referring to our myofunctional therapist in-house because he finds that that's actually aiding his therapy , that he's doing .

Speaker 2 36:22

So if I'm going to say to everyone always ask the question why ? And trust your gut . For mothers , if we didn't have mother's intuition , we wouldn't be around as a species . It's nature we want to nurture , that we don't want to . Don't let any other professional tell you there's no tongue tie , it's in your head , et cetera . If you still feel in your gut which most mothers , 98% of mothers will you follow that , follow up . Come to see myself , come see any other tongue tie release provider who's local to you In the UK . There's myself , there's Dr Levenkind up in North London and anyone . I think that's really it . So you can either see either one of us . We'd be more than happy to help you .

Speaker 1 37:05

Amazing . Can you let everybody know how to reach out to you ?

Speaker 2 37:09

So there's a couple of ways . You can either book in through the Happy Kids Dental website , so that's happykidsdentalcouk . You can contact me on my Instagram , which is at Dr S Vatish DDS . And for adults we have a practice called American Smile , which is in the same building , so I see adults and children in the same place . American Smile you can Google it . You can book directly in through our website and to see me about tongue ties , lip ties or even any oral surgery careers you have .

Speaker 1 37:42

All right , that sounds perfect . Thank you so much for hanging out with us today . Again , this episode will be out next week . Thank you everyone . Have a wonderful day .

Speaker 2 37:51

Thank you Bye .