Often parents may be faced with the decision to either Snip or Laser Lip and Tongue ties*.
It's important to understand the difference in options so that you can make an informed choice that meets you and your child's needs.
For any procedure we encourage you to explore the options the Surgeons offer where scissor snipping is offered and the Practitioner is well versed in the procedure and offers you complete pre, during and post care.
As the understanding of the wider Medical and even Dental Profession is still evolving around the best options and implications of treatment or no treatment of Lip and Tongue Tie, the assumption that all tools provide the same results is not correct.
There is a range of surgical approaches to the treatment of tongue and lip ties. Factors that will influence the choice of tool will include the age of the child, with or without general anesthetic, the cost of the tool or what post-surgery sutures are required.
The two main approaches are to cut with scissors/scalpel or to ablate with a laser.
Laser: Ablation (to remove or take away) by Laser is a process of vaporizing the tissue by heating it in such a way that the water evaporates and remainder undergoes combustion in a matter of seconds. The significant benefit of this treatment approach is that the heating effect stops bleeding in the procedure.
By controlling the Laser, it is possible to minimise or eliminate bleeding along with the complete removal of the tissue. The benefit of this approach is that no stitches are required, and a vast majority of the procedures can be performed in a matter of minutes.
The use of a laser also reduces the risk of infection, and may also have an analgesic effect or boost wound healing, which reduces pain.
Snipping is usually undertaken with surgical scissors and can generate bleeding due to the fact that there is no cauterising or coagulating effect. To overcome this effect, stitches or electrosurgery is used to prevent the flow of blood.
Because the areas under the tongue are very vascular, there is a higher likelihood of bleeding. As a result, the Surgeon may be reluctant to fully release the tie underneath the membrane lining the mouth, leading to incomplete release. For older children, it is more likely that bleeding and stitches will be required, which generally is undertaken under general anaesthetic. "Given the risks of a general anaesthetic for young children and recent links to cognitive effects for those undergoing GA under the age of four, GA should be avoided wherever possible"
When scissors are used for snipping lip and tongue ties, they crush the cells as they cut. This has the effect of clotting with sticky healing factors, along with the production of fibrin and fibronectin which promotes wound healing. This process is known as primary intention healing. However, in the mouth intention healing is the process most commonly associated with the reattachment of released ties.
When you compare lasers with scissors, lasers do not crush or damage the tissues being treated. This results in the area around the laser wound will show less inflammation, with the laser reducing the production of fibrin and fibronectin which can contribute to re-attachment.
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* Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.