Newborn

Sometimes babies are born with what are called "natal" teeth. These are usually fully erupted teeth with very poorly formed roots and may be loose. Often times these teeth are removed asap for a few reasons. They can be uncomfortable for the baby as well as breastfeeding mothers. They can become dislodged and present a choking hazard. And often times there are another set of true baby teeth that will come in under them.

Removing natal teeth is an extremely fast process and typically done by a pediatric dentist with hospital privilege's or in a dentists office. A small amount of sugar water will be placed in the babies mouth. This causes a sedative effect and essentially sedates the baby so the use of true anesthesia is not required. The dentist will remove the teeth typically with forceps and sometimes will instruct mom to hold a small amount of gauss over the area. Fortunately these wounds heal extremely fast.

A tongue tie is an excessive attachment of tissue from the tongue to the floor of the mouth by something called a "frenum". Everyone has a frenum but when it is connected more towards the tip of the tongue it is deemed as a "tie". The same is true for the upper and lower lip with an attachment to the gums. There are varying degrees of tongue/lip ties and most of the time there is no need for intervention. More severe tongue ties can cause issues with feeding, speech and even sleep. 

The first indication that the baby may be tongue or lip tied presents itself during nursing. This is difficult with first time nursing mothers as nursing itself is typically painful and a challenge to master at first. However, if you are experiencing extreme pain every single time and if your baby cannot achieve a deep latch this may be due to a tongue tie. A certified lactation consultant is always your first and best advocate for nursing.

She will likely refer you to a local pediatric dentist or Oral surgeon (most hospitals have a list on hand). One of these doctors will render the final diagnosis and determine if the child is truly tongue or lip tied. And remember you can ALWAYS get multiple opinions, do not feel pressured into or out of  services.

There is a spectrum of lip and tongue ties and most often there is no need for intervention. If intervention is recommended then a "release" procedure will be performed. This is either done with a scalpel or laser and is extremely fast and simple. Often times sugar water can be used for newborns for sedation. Stretches may be recommended for parents to do post procedure to ensure the tie doesn't re attach. These are simple and different for each type so best to speak with your doctor about them.

Yes, the child may have difficulty feeding from a bottle and this could cause discomfort or fussiness. Severe tongue or lip ties can also affect speech, tooth development, jaw development and even breathing. Ask the lactation consultant if they notice any signs or symptoms even if strictly bottle feeding.

Technically within 6 months of the eruption of the first teeth. However, establishing a dental home should be done asap. This does not mean true appointments but calling your dentist and asking if they see infants, or referring you to a place that does. Build a patient chart and make sure your insurance is accepted, if it is not you do have the ability to change your plan to cover your baby. The office manager can often help with this.

Childbirth is often a whirlwind of emotion, joy and worry. Being educated on topics such as natal teeth and tongue ties will help mom and dad be more prepared to handle these situations if they arise.

While in the hospital use every resource available while you can. Your lactation consultant will be your best advocate for this.

Most offices will prepare a patient chart for baby with as little as a name so this can be done during pregnancy. This is helpful if your child needs a tongue or lip tie procedure or has natal teeth. A preformed chart streamlines patient care.

Discuss this with your dentists office, sometimes they do not see infants and will refer you to a trusted pediatric dentist. The pediatric dentist may only take specific insurances and will often guide you on how to enroll for them. This will streamline patient care.