Frenectomies in San Marino

Frenectomy and Oral Motor TherapyWHAT IS A TONGUE TIE?Signs & SymptomsHow does this work?What to expect after the procedure?Common Findings and Tips

Collaborative care for you and your baby

Our joint comprehensive approach yields optimal results

Dr. Choi understands the importance of a team approach, which is why she has teamed up with Dr. Christine Nguyen, OTD, OTR/L, SWC, a board-certified Occupational Therapist who specializes in infant tethered oral tissues, playing an important role in helping babies relearn proper tongue function. We are the only facility in the San Gabriel Valley that offers the frenectomy procedure with the full support of an occupational therapist in one location, simplifying scheduling and saving time.

As a team, we can complete a full functional assessment and make a diagnosis. We then help to determine what the next best step is for you and your baby. Additional team members may include an IBCLC, and a bodyworker such as a chiropractor or cranial sacral therapist.

Why a team approach?

Having a tongue tie is like running with your shoelaces tied together all your life. Once those shoelaces are cut, rehabilitation of your legs and muscles is required so that you can run and jump again properly. Occupational Therapy is the rehabilitation of the tongue, helping to retrain tongue movement by providing oral exercises and whole body movement to achieve optimal results, i.e tummy time.

gentle care for tongue & lip ties

Laser Frenectomies

Tongue and lip ties, also known as “ankyloglossia,” can affect your child’s ability to nurse, eat, and even speak properly. At San Marino Pediatric Dentistry, Dr. Jessica Choi is here to help. Dr. Choi can help diagnose tongue and lip ties in infants and toddlers, and provide them with minimally-invasive frenectomy treatment with our state-of-the-art CO2 LightScalpel laser.

little girl showing her teeth
little girl showing her teeth

Understanding the Basics


A tongue tie is a band of tissue under the tongue that limits its range of motion and functional use. A lip-tie is a band of tissue that restricts the upper lip from moving freely.

All babies are born with some of this tissue, but when that tissue is too tight or too short it can limit tongue movement, resulting in dysfunctional swallowing, speech, and breathing. This can cause issues during breastfeeding, speech articulation issues, and sleep issues as they continue to develop.




  • Falling asleep while nursing 
  • Sliding off the breast while latching/feeding 
  • Leaking or spilling milk from the mouth while feeding 
  • Colic symptoms/reflux & gas
  • Gagging/choking while eating 
  • Upper lip curls inward when latched 
  • Frustrated at breast 
  • Mouth open at rest 
  • Gumming/chewing of nipple 
  • Clicking sounds while nursing 
  • Disorganized tongue movement
  • Noisy breathing (snoring/snorting)


  • Mouth breathing 
  • Difficulty swallowing certain textures of food 
  • Choking/gagging on select solid foods 
  • Narrow upper jaw
  • Teeth grinding 
  • Speech delay 
  • Dental crowding


  • Nipple pain and damage
  • Lipstick shaped, creased, bleeding nipples
  • Low milk supply
  • Poor breast drainage
  • Flattened nipples after breastfeeding

Painless Procedures

What to Expect

The laser frenectomy treatment is quite simple, pain-free, and takes only a few minutes at San Marino Pediatric Dentistry. 

First, your child’s mouth will be cleaned and numbed with a topical anesthetic. Then, Dr. Choi will quickly release the frenulum with our CO2 LightScalpel laser, allowing your child’s tongue or lips to move freely. Because the CO2 LightScalpel laser cauterizes immediately, laser therapy for frenectomies ensures quick and painless healing. Plus, the entire process takes less than 15 minutes!

Some of the many benefits of using the CO2 LightScalpel laser include:

  • minimized bleeding
  • less swelling and discomfort
  • faster healing
  • reduced risk of infection
  • increased precision
  • complete removal of a tie
little girl showing her teeth

does my child Need a Frenectomy?

Together with our occupational therapist, we will complete a full functional assessment to determine if your baby has anatomical restrictions in their oral cavity and if it's hindering normal function.

How the procedure works?



We'll review symptoms, make a functional assessment, and do a physical exam. We will then assess the need for a Frenectomy and/or Oral Motor Therapy and determine the optimal timing of the release.



If it is deemed necessary, our state-of-the-art CO2 LightScalpel Laser will be used to release the ties with little to minimal bleeding.


Follow ups

We will see you and your baby for a minimum of 2 follow-ups after the procedure to ensure wound care and healing is progressing well. After the procedure is completed, Dr. Choi expects to see the baby for their first follow-up within the first week.

little girl showing her teeth

Benefits of our CO2 LightScalpel Laser

Some of the many benefits of using the CO2 LightScalpel laser include:

  • Minimized bleeding allowing for a clear field for complete release 
  • Less swelling and discomfort
  • Faster healing
  • Reduced risk of infection
  • Increased precision
  • Complete removal of a tie

“White Diamond” Healing Patch

We commonly refer to the wound as a “white diamond.” This is the shape that the laser creates when releasing the tongue or lip tie. In the oral cavity, a soft white scab will form about 24-48 hours after the procedure, which is considered nature's band-aid. The diamond can be white or yellow/orange in color.

Guiding Little Ones to Rapid Recovery

The Healing Process

Your child may experience some mild discomfort from their frenectomy for a few days after their treatment, but their frenulum will be fully healed within a few weeks. It’s important to perform the after care exercises that ensure the tissues do not grow back together during healing. Dr. Choi will show you these exercises and give you instructions of when to perform them. 

Dr. Choi understands that post-revision care and follow up is vital to the success of the procedure. Dr. Choi will see families for a  minimum of 2 follow ups to ensure healing is going well. While some babies show improvement immediately after the procedure, other babies may need help from additional professionals. Part of your team can include an International Board Certified Lactation Consultant (IBCLC) who can help improve latch, provide exercise to increase strength of the oral cavity, and support you as you and baby go through the healing process. Other professionals include a chiropractor and or cranial sacral therapist who can help release tight muscles that have helped to compensate.

An occupational therapist also plays an important role in helping babies to relearn how to use their tongues. After having 3 tongue-tied babies herself, Dr. Choi understands the frustration that many mothers are having. Dr. Choi is passionate about giving mothers the chance to not only feed their infant successfully but also promote growing healthy airways.

little girl showing her teeth

Guiding Little Ones to Rapid Recovery

The Healing Process

PostOperative Instructions

Days 1-3

  • Baby will be very sore
  • Baby may be fussy
  • Healing white patch forms
  • Difficulty with latch
  • Have a back up feeding plan (pumped breastmilk)
  • 2-4 day follow up with Dr. Choi

Week 1

  • Baby will not be as sore
  • Baby may still be fussy but less
  • Healing white patch is still present
  • Baby begins to relearn suck
  • Consult with LC, OT and bodyworker recommended
  • 1-2 week follow-up with Dr. Choi

Weeks 2-4

  • Soreness should be gone
  • Healing patch shrinking
  • Pain meds not needed
  • New frenum forming
  • Continue LC, OT, and bodywork follow up
  • Improvement in feeding

Weeks 4-6

  • Baby no longer sore, exercises no longer needed after 5 weeks
  • Healing patch gone, new frenum formed
  • Bodywork, LC, OT follow-up as needed
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Common Findings

after a Frenectomy

Excess fussiness and crying

For the first few days or even the first week – this is why it is so important to stay ahead of the pain to avoid any discomfort.  When children are in pain and uncomfortable it makes exercises more difficult to do.


Some patients may bleed a little after the procedure, especially after the first few stretches. This is normal, and when mixed with saliva, it can look like a lot of blood.

Difficulty with latching in the first week

This is common and why it is so important to follow up with your IBCLC after the procedure, ideally in the first week. Your baby may also benefit from some bodywork as well.

Increased saliva (drooling) and bubbles

This occurs because of healing and an increased movement of the tongue and is usually temporary.

Increased sleeping

This can occur because of medication and exhaustion from crying after the procedure. It also acts as a coping mechanism for discomfort.

little girl showing her teeth


  • You can use a swaddle to help stabilize your baby during wound care. 
  • Visualization of the wound is key. Use an LED headlamp for better visibility or have a second person help to hold a flashlight. 
  • Frozen breast milk chips can be placed in frenectomy areas to help with the pain.


The stretches - The stretches ensure that the lasered area does not reattach. Stretching the wound periodically will allow the new fibers to have increased elasticity, allowing for an increased range of motion.

How often - Stretches should be done every 3-4 hours during wake hours and up to 6 hours at night for a minimum of 2 weeks.

mouth massage exercises

Reattachment…oh my!

It is important to perform aftercare exercises to ensure that the tissues do not reattach i.e. do not grow back together during healing. Even with a full surgical release of the tongue and lip, if the stretches are not done properly, the tissues can and will reattach, and the benefits of the release can be lost or diminished. The quality of the aftercare stretches is critical to the success of the release. Dr. Choi will show you these stretches and give you specific instructions on how and when to perform them.

more resources

Sleeping Tongue Posture Hold

While your baby is sleeping, you can help improve their tongue posture by placing gentle pressure under the chin. This allows for the tongue to suction to the hard palate. Improved tongue posture will allow for expansion and shaping of the palate. Check out this video for a demonstration.

Tiny Teeth, Big Special

$175 for your child’s first exam!

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