Question 1

I'm scared to be in pain; Is the procedure worth doing as an adult?

Accepted Answer

It is all about quality of life. A small amount of discomfort can easily be controlled with ibuprofen. This outweighs years of repeated trauma to the body from restrictions. Anxiety is more about not knowing what to expect. We will talk you through the process before and during the procedure. Each site takes a matter of seconds and our topical anesthesia works very well on normal tethered tissues. The areas are well healed within two weeks which is a very short time compared to the need for continued manual therapy and repeated courses of Orthodontics and dental procedures. Fixing tethered tissues will not undo years of chronic damage but it will prevent further deterioration and provide better eating, speaking, and sleeping patterns. It is never too late to feel better!

Question 2

Why choose a CO2 laser to repair the ties instead of just a pair of scissors or a simple diode laser?

Accepted Answer

​Dr. Sacker has used all 3 so she knows first-hand! Scissors are sharp and make an even cut that can more likely reattach.  It is also very common to not cut enough or not be able to cut enough because of the tie depth, location, or extent of restriction.  The doctor can only cut what he or she can see and what is safe to cut.  Since the doctor cannot see what is under the area being clipped, he or she would have to stop short.  It is very common for providers to cut the anterior, or front portion, of the tongue tie in front of the salivary glands and leave the posterior portion intact.  The problem with this is that the posterior portion is what controls the middle and back portion of the tongue- the area that is needed for proper swallowing. It is also very difficult to cut into a submucosal tie that is more of a sheath attached to the surface of the tongue. It will bleed and the doctor cannot open it fully as a result of the bleeding and safety issues. Buccal ties also cannot be cut with scissors because of their location and size. Upper lip ties can be partially cut by skimming the gumline with a sharp instrument. The upper lip tie is covered by a sheath of sensitive tissue so it always hurts and bleeds with scissors. The doctor would be unable to cut it completely into the groove between the teeth, leaving the remainder of the cord attached to the bony area and upper gumline.  Lasers can repair an incompletely released lip tie at a later date, but the area is more sensitive and has scarring from the previous clip so more laser energy is required, making the procedure itself and the healing more challenging.  
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The CO2 laser is the most gentle soft tissue laser on the market right now. Most of the time, there is no bleeding. Using this laser can also be faster than using scissors. It is safer than scissors because it works above the tissue, cauterizing while vaporizing the tissue in a bloodless field. This allows for a clear view of vessels and nerves. The diode laser works with heat and requires more energy to release the tissue, causing more scarring, especially with submucosal ties. The diode laser is also very hot and unsafe to use on buccal ties, unlike the CO2 laser. Just like our iPhones and other similar technology, we have better ways to do things now; we just need the medical community and insurance companies to catch up so our families can get the best care possible!