Infant Laser Frenectomy

Pediatric Frenectomy in Vero Beach, FL

If your infant is struggling to breastfeed, your toddler has a noticeable gap between their front teeth, or your school-age child has speech or sleep concerns, a tongue-tie or lip-tie may be part of the picture. At Nickel Pediatric Dentistry, Dr. Andrew Nickel - a board-certified pediatric dentist (ABPD Diplomate) - performs in-office laser frenectomies for infants, toddlers, and older children at our Vero Beach office. This page walks you through what a frenectomy is, who actually benefits from one, what the procedure looks like, and the questions parents most often ask before scheduling.

What Is a Frenectomy?

A frenum is a small fold of tissue connecting two parts of the mouth - the underside of the tongue to the floor of the mouth (the *lingual* frenum), or the upper or lower lip to the gums (the *labial* frenum). When that tissue is too tight, too short, or attached too far forward, it can restrict movement enough to interfere with feeding, speech, dental development, or sleep. A frenectomy is the procedure used to release the frenum and restore normal range of motion.

There are two types we perform:

• Lingual frenectomy - releases a tongue-tie (also called *ankyloglossia*).
• Labial frenectomy - releases an upper or lower lip-tie.

Both are performed in our office using a CO2 dental laser, which lets Dr. Nickel complete the release in seconds with minimal bleeding, no stitches, and no general anesthesia. For most infants, the procedure itself takes less time than it took to get them settled on the table.

Who Benefits from a Frenectomy?

Not every tight frenum needs treatment. The decision to release one - and *when* to release it - depends on the child’s age and the symptoms the family is seeing. We separate this conversation into two age groups, because the indications look very different.

Infants (newborn to 12 months)

For nursing infants, a tongue- or lip-tie can interfere with the latch and the seal a baby needs to feed effectively. Common signs include:

• Poor latch or repeated unlatching
• Clicking or smacking sounds during feeding
• Long, exhausting feeds - and a baby still hungry afterward
• Slow weight gain or “failure to thrive” flagged by the pediatrician
• Reflux symptoms or excessive gas from swallowed air
• Painful nursing for the mother - cracked or bleeding nipples, mastitis, low milk supply

These symptoms can have many causes - not all of them ties - which is why an honest evaluation matters before any procedure. When a tie *is* the cause, releasing it early can transform a difficult feeding relationship within days.

Toddlers, school-age, and older children

Beyond infancy, the symptoms shift. By the time a child is two or three, feeding has usually adapted around the tie - but new effects can emerge as the mouth, jaw, and speech develop:

• A persistent gap between the upper front teeth (a *diastema*) caused by a tight upper lip-tie
• Speech difficulty with sounds that require tongue elevation - *t, d, l, r, s*
• Mouth breathing or trouble keeping the mouth closed at rest
• Poor sleep, snoring, or restless nights
• Difficulty with certain foods (licking ice cream, chewing certain textures)
• Low tongue posture affecting palate and jaw development
• Discomfort with orthodontic appliances later on

These cases often involve a team - Dr. Nickel may coordinate with your pediatrician, a speech-language pathologist, an orthodontist (such as Dr. Zoey Orthodontics next door for older children moving toward braces), or a myofunctional therapist before or after the release.

How We Perform a Frenectomy

Most parents picture a frenectomy as something out of an older era - a child sedated in a hospital, a scalpel, sutures. That is not how a modern frenectomy looks. We perform releases in the office using a CO2 dental laser - the same technology used in pediatric airway centers and lactation-focused practices nationwide.

What that means for your family:

• No general anesthesia. Infants and most children are awake. We use a small amount of topical numbing for comfort.
• No scalpel, no sutures. The laser cauterizes as it cuts, so there’s minimal bleeding and no stitches.
• Seconds, not minutes. The active part of the release usually takes 10-30 seconds.
• Same-day feeding. For nursing infants, we encourage feeding immediately after - many mothers report a noticeably improved latch within the same visit.
• In-office, in one visit. No hospital stay, no operating room scheduling.

Before any release, Dr. Nickel performs a careful evaluation - looking at the frenum’s attachment, the function it’s affecting, and the family’s specific concerns - to confirm that a frenectomy is actually the right answer.

Cost and Insurance - Office vs. Hospital

This is one of the most-searched questions parents have, and most pages won’t answer it directly. Here’s a clear picture:

• In-office laser frenectomy typically costs in the range of $400-$1,500, depending on whether one or two ties are released and the complexity of the case. Many medical and dental insurance plans cover the procedure when it’s medically necessary (feeding difficulties, failure to thrive, documented speech delay).
• Hospital frenectomy under general anesthesia can run $5,000-$8,000 or more when facility fees, anesthesia, and surgical billing are included. This is the path some children take when an in-office release isn’t appropriate - but for most families, it’s not the necessary path.

We’ll verify your insurance benefits before the appointment and give you a clear out-of-pocket estimate. For families paying out of pocket, we’re happy to walk through the numbers ahead of time.

When a Frenectomy Isn’t the Right Call

It’s worth being direct: not every tight frenum needs to be released. Some tongue-ties resolve functionally as a child grows. Others cause symptoms that look like a tie but turn out to be unrelated - feeding latch issues that are positioning-related, speech delays with developmental causes, gaps that close on their own as adult teeth come in.

When that’s the case, we’ll tell you. A frenectomy is a small, low-risk procedure - but it’s still a procedure, and the right answer for some families is to wait, watch, and address the underlying cause first. You won’t leave Nickel Pediatric Dentistry with a release recommendation unless we genuinely think it will help.

After the Procedure

For older children, post-procedure care is simple - soft foods for a day or two, gentle stretching exercises we’ll show you, and a check-in at one week.

For infants, the protocol is a bit more involved:

• Stretching exercises 3-4 times per day for 2-3 weeks to prevent the released tissue from reattaching.
• Continued feeding support - if you’re working with a lactation consultant (IBCLC), we’ll coordinate with them. If you don’t have one, we can suggest local options.
• One-week follow-up in our office to check healing and answer questions.

Most families notice improvement within the first few feeds. Full benefit - especially for infants where new motor patterns have to develop around an unrestricted tongue - typically takes a few weeks.