Yes. Every person is born with oral frenula - lingual, labial and buccal. They are normal connective tissues in our mouth to help stabilize range of motion. A frenectomy should only be recommended when there is a true functional and anatomical indication due to a short, restrictive frenulum.

Absolutely. During development, the tongue starts off completely attached to the floor of the mouth. Once the tongue is fully formed in utero around week 8, it begins to separate from the base of the mouth, becoming free to move around. The lingual frenulum is the name given to the connective tissue remnant under the tongue that serves to support and limit its movement in different directions. We all have this tissue!

However, for approximately 5-10% of babies, the tongue and floor of mouth separation process is disrupted in utero, leading to an abnormally short frenulum. The medical term for tongue tie is “ankyloglossia” and studies show the defect is hereditary. The presentation can vary widely in thickness, elasticity and specific location on the tongue and floor of the mouth. Sometimes a frenulum may completely tether the tip of the tongue to the edge of the lower jaw!

Different presentations may restrict tongue range of motion to varying degrees, and may impact oral motor development, feeding skills and breathing habits even in infancy.

The medical professionals who provide better, less invasive, more appropriate care are those who are APPROPRIATELY TRAINED. The reality is, infant tongue tie assessment and diagnosis are not properly covered in medical school or dental school.

A frenectomy should only be recommended when there is anatomical and functional need to do so and this starts with understanding normalcies in structures and physiology. Realistic expectations should be addressed. Trauma should never be a normalized part of treatment or post-operative care. Concepts are getting lost or overcomplicated with hearsay. We all have the ability to steer our own ship... and to represent an approach that resonates with ourselves and the families we serve.

I started my educational journey into the world of infant tongue ties 8 years ago when I learned from and shadowed leaders and researchers in the field. As time passed, I used my own clinical experience and observations to evolve my practice approach while creating mentorship opportunities for others in the field. I certainly implement a very different protocol than I first learned back in 2016. In 2018, I became the only doctor in Los Angeles county to solely dedicate my practice to focus on infant/toddler oral ties. It’s been one of the greatest honors in my life supporting parents and helping babies thrive.

The IFP course stands behind educating professionals to provide proper care in a controversial field. Our long-term goal is for the Infant Frenectomy Protocol to be part of the medical and dental school curriculum. To be THE credible foundational education course.

The NYT article used a sensationalized headline and one-sided journalism to instill fear. Like most news stories or click-bait, the article highlights negatives. What about the thousands of babies who were guided and cared for in a loving way… All of the cases where frenectomy treatment was warranted and a thoughtful, efficient procedure allowed babies to finally elevate their tongues enough to then create a proper suction to efficiently transfer milk from the breast or swallow foods or liquids without coughing and strain? The breastfeeding journeys that were saved, the parents that felt informed and empowered by their professional care team. The babies that embraced their newfound range of motion to support eating, sleeping, breathing and speaking habits as they grew.

I will be the first to say that the negatives and traumatic experiences in the article certainly deserve to be addressed, not dismissed. In fact, these concerns are EXACTLY what fueled my  fire to launch the Infant Frenectomy Protocol educational platform to inspire providers to take ownership over their treatment approach. To work comprehensively with colleagues that also provide empowering care - to avoid overdiagnosis, overtreatment and overwhelm.

As a proponent of research-backed care, the NYT article completely failed to recognize a huge publication in 2023, instead claiming a lack of research. “Severity and Prevalence of Ankyloglossia-Associated Breastfeeding Symptoms: A Systematic Review and Meta-Analysis” (Cordray et al., 2023)… out of 1,328 screened studies, 39 high quality studies were included - a BIG deal as it’s the first meta-analysis stating that tongue tie release improves maternal self-confidence, infant reflux, nipple pain and latch quality.

It is clear that controversy, polarization and concerns continue to exist within the field. The IFP course aims to change this.

I encourage interested providers to watch the highlights video on our website and take a look at the complete list of modules and objectives.

Yes, there has been a significant rise in frenectomy diagnosis and treatment as shown by Walsh and colleagues. While there’s an increase in awareness on ankyloglossia and the impact on feeding and oral motor function, orofacial development, and breathing patterns as babies grow… there is also no standardization of care. Many, many providers lack proper training on diagnosis and procedural protocol, without any understanding of normalcies in infant oral anatomy and physiology. This leads to overdiagnosis and overtreatment. On the flip side, there’s little ones with true tongue ties that struggle for months and months as they are completely missed or dismissed.

The purpose of this course is to take a stand and proudly share our goal to universalize an updated, respected and trusted standard of care. Professionals that provide accurate, non-invasive, mindful care… that know when intervention is NOT needed… that get it… are those that are properly trained. That type of education is our mission.

Frenectomy treatment immediately following birth is not always better. Instead, each child’s unique scenario and anatomical presentation should be considered. After all, health care is not one-size-fits-all. On another note - sometimes a snip in the hospital is not done completely. Sometimes it is. Sometimes too much tissue is snipped leading to scar tissue and unideal healing. I say this because these families come to my office seeking guidance. I have seen children treated inappropriately by doctors in the hospital including severed salivary ducts, one family told me the doctor used his cell phone light to complete a procedure. I cover these types of cases and important treatment “timing” considerations in the course.

There is. Many noteworthy studies in the field were published by reputable ENTs who have dedicated their careers to advancing the understanding of feeding & swallowing of breastfeeding infants and the complexities of the lingual frenulum.

I’d love to direct you to “Severity and Prevalence of Ankyloglossia-Associated Breastfeeding Symptoms: A Systematic Review and Meta-Analysis” (Cordray et al., 2023)… out of 1,328 screened studies, 39 high quality studies were included - a BIG deal as it’s the first meta-analysis stating that tongue tie release improves maternal self-confidence, infant reflux, nipple pain and latch quality.

Unfortunately, there are providers that will surgically treat every single baby that comes into their office. Huge red flag and an uncomfortable reality. These individuals lack proper training on diagnosis and procedural protocol, without any understanding of normalcies in infant oral anatomy and physiology. This leads to overdiagnosis and overtreatment.

Ankyloglossia a real medical condition limiting tongue elevation and appropriate range of motion. Research shows this can impact feeding, breathing patterns and craniofacial development. Many noteworthy studies in the field were published by reputable ENTs in the last several years. This entire course is backed by research. Pediatricians refer little ones to my practice because they respect and trust my assessment and treatment protocol. Professionals that provide accurate, non-invasive, mindful care… that know when intervention is NOT needed… that get it… are those that are properly trained. That type of education is our mission.

Infant tongue tie assessment and treatment are not properly covered in medical school or dental school. Concerning isn’t it?

As a specialist, hundreds of families come in to my practice seeking insight on their baby’s feeding struggles. There are many, many days I don’t pick up my surgical laser a single time. I guide parents through their concerns and provide them with the knowledge to support their child’s oral motor skills - including appropriate therapeutic and feeding support referrals. I also proudly utilize Photobiomodulation (PBM) as part of my treatment protocol. PBM has been a game changer in optimizing oral motor movement patterns, flexibility and comfort for both mother and baby. I follow up with every one of these families and witness their baby’s progress without surgical intervention. What’s sad is knowing they could have gone to a different provider who may have done an unnecessary procedure. Some doctors treat babies because someone else told them the baby needed the procedure - lacking full clarity and ownership over their care.

I’ve seen and heard it all over the past 8 years. A mom at my son’s basketball game told me her sister felt like they “visited a tongue tie factory” in their city, walking out with minimal guidance. I’ve seen photos of large, deep wound sites in babies’ mouths online that make my stomach turn upside-down. I’ve heard stories from parents saying their friend’s baby was “in the treatment room with the doctor for 20 minutes” for what should be a 15 second procedure and “was in extreme pain for days following, refusing to eat.” The type of treatment and messaging that feels so out of touch from the care I preach and provide. One time a mother told me she took her baby in for an evaluation with an ENT and he said “I’m not even sure they need it, but if you think they do, I’ll do it.” Crazy. It’s unacceptable and unfortunate.

I am proud to have helped thousands of babies thrive over my career. I put my energy and focus into developing a proper comprehensive educational training to allow medical providers to assess and treat infant oral ties mindfully and conservatively with confidence. This is the type of care babies and parents deserve.

When done properly, a minimal, conservative incision using the proper technique and tool allows for best healing outcomes. Every day parents express their baby’s incredible and significant progress following frenectomy treatment at my office - they are over the moon excited to witness their baby efficiently and comfortably removing milk from the breast… their toddler eat solids without coughing, gagging, and struggling… significantly reduced gas pains and colic symptoms as their child’s seal during feeding has improved. Babies often sleep better, digest better and breathe better. This is not by chance, but by science. Breastfeeding mechanics. Bolus control. Tongue to palate postural shifts, vagus nerve stimulation.

Lots. Dr. Pinto’s Summus medical laser utilizes well established and studied wavelengths (650, 810, 915, 980nm) in regards to photobiomodulation (PBM). Please email us at [email protected], and we’ll happily provide you with the link to a readily accessible library of published literature for your exploration!