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topdog1961

Any dentists among us?

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topdog1961

My 18 year old daughter has two dental appointments with the local small town dentists this week. We had to reschedule them from earlier due to her automobile accident. This is about her 3rd time seeing this dentist. Previously since birth she saw one in a larger town about 30 miles away. My wife switched her for convenience, and I think to help the young lady dentist who bought the practice from a retiring male dentist. Anyway, this new dentist recommended today they my daughter have her perform a procedure to release her frenulum, the tissue that ties your tongue to the bottom of your mouth. In other words, she's saying my daughter is adult tongue tied. Now we've never seen obvious signs of this, such as speech difficulty, and then other dentist never mentioned it.  But this dentist says even mild tongue tied can cause headaches and tension in the neck and shoulders. My daughter has often complained of this. Apparently it's a simple painless laser procedure, and my daughter will have to perform some daily tongue exercises for awhile until it heals. She wants to do it Wednesday at her next appointment for a filling. My concern is that this is a young doctor with a lot of debt from school and buying the practice, and she may be trying to pad her income. If we do have any dentists among us, what is your opinion of this procedure? Are there any potential complications? For once, I couldn't find much info on the web, only that it's currently a "hot topic" among dentists. There was lots of info on infant tongue tie, but little on adults. 

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J_ellard

I believe it would be worth the miles for a second opinion, maybe even a third. Doesn't sound like something to discard by any means,  but I would for sure want some more info other than a " hey let's do this"  

 

 

 

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Kemo Sabe

Topdog,

 

I’ve been in dental practice for over 40 years. I do treat TMJ patients, which involves all different issues with facial pain and headaches. I spent 12 years at the UCSF TMJ  Clinic, and was a long time member of the Craniomandibular Institute.

 

With that said:

 

1). I’ve never heard it to be that being tongue tied can cause headaches and neck tension — but you never know. In your daughter’s case, this seems unlikely since she has no pain or discomfort in that immediate area. 

 

2). Releasing a frenulum is a procedure that should be done by an oral surgeon, not a general dentist. 

 

3). I think your concerns about this young dentist trying to “pad her income” is something to think about. 

 

I suggest getting a second second opinion from both another general dentist and an oral surgeon who’s not associated with your current dentist.

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VizslavsBird

Kemo Sabe is spot on.  Having a grandson that has had multiple mouth deformities/irregularities, go to an oral surgeon!  Dentist are great for what they are trained to do.  And they can probably diagnose multiple things that they haven't had lots of training in treating.

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GSPpurist
56 minutes ago, Kemo Sabe said:

Topdog,

 

I’ve been in dental practice for over 40 years. I do treat TMJ patients, which involves all different issues with facial pain and headaches. I spent 12 years at the UCSF TMJ  Clinic, and was a long time member of the Craniomandibular Institute.

 

With that said:

 

1). I’ve never heard it to be that being tongue tied can cause headaches and neck tension — but you never know. In your daughter’s case, this seems unlikely since she has no pain or discomfort in that immediate area. 

 

2). Releasing a frenulum is a procedure that should be done by an oral surgeon, not a general dentist. 

 

3). I think your concerns about this young dentist trying to “pad her income” is something to think about. 

 

I suggest getting a second second opinion from both another general dentist and an oral surgeon who’s not associated with your current dentist.

I agree with the above although the ENTs usually cut those in my community.  New grads are always trying to do things they were taught.  Income consideration perhaps, but expounding on what they have learned and trying to help the patients with their knowledge base.    Never heard of any indication as an adult unless cutting away a tumor.  If she can articulate her "T's and D's" then the frenulum is good.  

 

Laser tx is a much more expensive way compared to a needle driver and pair of scissors and 3 seconds. 

 

May want to consider a work-up for HA and if failed consider alternative therapies such as acupuncture, massage, manual manipulation. That said, if it works, it works despite literature.  

 

Just a few random thoughts and writings from the bathroom walls. 

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Fishnfowler

I've been performing frenulectomies for 20 years, but only in newborns with a severe condition.  In my time, it has become less popular to perform this procedure with evidence suggesting it doesn't really cause problems as an adult.  I'm at a loss as to how it would cause her symptoms and would probably advise against it in a patient of mine.  FWIW, it takes a second in a newborn, requires a deft hand, and I do it gratis for those who wish to have it performed.

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Fire Marshal Bill

Topdog, thanks for asking this question. It just proves once again the talent and expertise that participate on this board. Thanks again Brad for keeping UJ up and running!!!

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Brad Eden

The knowledge and expertise and resources outside the Upland arena continue to amaze me here on UJ.

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Virgil Kane

I would think that being tongue tied would be an evaluation that a speech pathologist would make, not a general dentist. 

You've got some good advice here from UJ members.

 

Virgil

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topdog1961

Thanks all for the responses. They mirror my concerns. Im not going to let this dentist cut on my daughter without at least a second opinion. 18 years and no complaints and suddenly she wants to cut her tomorrow? More research on line shows many websites touting the benefits of this procedure, but they all seem to be tied to someone providing the service or the equipment to do it with. 

 

Edit: according to some of the self evaluation tools to determine if you "need" this procedure, I need it. For example, can you open your jaws as wide as possible and still touch the tip of your tongue to the back base of your front teeth?  

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Kemo Sabe
7 hours ago, topdog1961 said:

Thanks all for the responses. They mirror my concerns. Im not going to let this dentist cut on my daughter without at least a second opinion. 18 years and no complaints and suddenly she wants to cut her tomorrow? More research on line shows many websites touting the benefits of this procedure, but they all seem to be tied to someone providing the service or the equipment to do it with. 

 

Edit: according to some of the self evaluation tools to determine if you "need" this procedure, I need it. For example, can you open your jaws as wide as possible and still touch the tip of your tongue to the back base of your front teeth?  

 

Topdawg,

 

20 years or so, many of the orthodontists in my area were having that done on their younger patients when it presented. None are recommending that now unless it’s a speech impediment issue. 

 

Without any discomfort in the immediate area, and no speech issues, I would advise against doing that procedure on your daughter at this time.

 

Also, many times the medical advise you get from “online research” can often be misleading. Stick with information from 4 star research sources like the New England Medical Journal. In dentistry, reaching out to the American Dental Association with your questions will get you honest and direct answers.

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WPG Gizmo
7 hours ago, topdog1961 said:

For example, can you open your jaws as wide as possible and still touch the tip of your tongue to the back base of your front teeth?  

I am screwed as I can touch all my teeth front and back or maybe I have a long tongue 👅 

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ccavacini

Try touching the tip of your nose with your tongue.  

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blanked

I find dentist to be the the most lopsided information I have heard in my personal experience.  When I was 18 my dentist told me I needed to have a tooth pulled or the pain will be a factor.  35 years later I still have that tooth and today’s dentist has no remarks about pulling that tooth.  35 years ago another dentist said I had gum disease.  Go to a periodontist.    Nothing done as of today.  No complaints from today’s dentist

 

todays dentist said 2 years ago I have a cavity.  My first.  I ignored him.  Hasn’t brought it up again

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Bob Blair

I'm a board certified Oral and Maxillofacial surgeon and I have done hundreds of frenectomies in my 40 years of practice. None have been performed to treat headaches, tension or stress.

 

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