May 26, 2014

Upper Lip Tie and Posterior Tongue Tie Treatment Without Sedation

It seems that in the past few years, upper lip tie and posterior "hidden" tongue tie has become increasingly recognized as factors affecting breast-feeding which correspondingly has led to higher numbers of referrals for evaluation and treatment.

Prior to 2011, I probably received only one or two consultations a year to evaluate these two conditions. Ever since than, it seems more and more infants are being diagnosed with these two conditions, especially by lactation consultants.

Anterior tongue tie and upper lip tie have historically been easily treated in the clinic under local anesthesia using common tools any ENT has.

Posterior tongue tie, given its relative rarity (at least from a referral basis), has historically been treated under sedation in the operating room given the need for specialized equipment and more aggressive surgical dissection.

However, given the increasing number of referrals for posterior tongue tie evaluation, specialized instruments needed to treat this condition have been purchased in order to address this condition without the need for sedation (assuming an infant). Young children with teeth may still need to be sedated.

In our office, we use laser, scissor, coblation, and/or electrocautery techniques. Regarding the laser, we use a 1064nm laser diode system.

We also treat adults desiring tongue tie release due to symptoms felt secondary to an immobile tongue.

Read more about these conditions:

Anterior Tongue Tie
Posterior Tongue Tie
Upper Lip Tie






Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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