Tongue Tie & Revision

Mother, Dentist, Revision Provider

By April 30, 2018 No Comments

Hi everyone. My name is Joanna and I’m a mother and a dentist. And, if people don’t dislike the dentist enough already, I have a confession to make. I also do revision procedures on teeny, tiny babies. Even newborns. Mothers and fathers look to me for reassurance that they are doing the right thing. I know how they feel because I’ve been in their shoes. Allow me to explain…

My first daughter, Stella, was born at 35 weeks due to complications at the end of my pregnancy. Over the course of a few days, I went from having an easy pregnancy to an emergency c-section and a four pound baby in the NICU. Thankfully she was born healthy, albeit small, and we were on our way home after two weeks. During the next several months I struggled to nurse my little girl. The latch was all wrong. There was pain. There was colic. There was reflux and gas. You name it, we had it going on. I was tired and struggled with postpartum depression that was made worse by failing to nurse my tiny baby. After two months of seeking care and still struggling, I gave up breastfeeding and exclusively pumped for ten months.

Fast forward two years later, Fiona was born full term and double the size. Although a lot of things were easier this time around, the similarity was that breastfeeding was difficult and not going as planned . This time though, I was determined that it would work (mostly because I couldn’t imagine pumping and washing that many bottles again) so I sought the care of Katie and her team and went in for an assessment.

After a very thorough first appointment, I finally had an in-depth and comprehensive evaluation. I had a lot of answers and newfound guidance. I finally felt like I wasn’t alone with the uncertainty and stress a mother feels when having difficulty feeding her baby. Over the course of a couple of appointments, Katie concluded that the issues we were having were likely due to restricted range of motion of her tongue and upper lip.

But, to tell you the truth, I had already Googled every cause of every issue we were having. I had definitely Googled tongue-tie and Fiona certainly did not have one. I’m a dentist. The mouth is my specialty…I would have seen it, right? Turns out that even though I had performed frenectomies on teenagers and adults, I didn’t know much about them in babies. What I learned that day and in the following months, is that it takes a lot more than a quick peek and an internet search. It takes an experienced, trained professional that uses objective findings to correctly assess form and function. While this is easily done in children and adults using clinical assessment and verbal guidance, babies are a completely different skill set.

It turned out that Fiona had a lip tie that was prohibiting her upper lip from flaring and a posterior, submucosal tie that restricted elevation of her tongue. Due to her poor latch and inability to move her tongue properly, I was the human buffet for a month. She nursed all the time, for a really long time, and she never seemed satisfied. It was getting old quickly, especially with a two year old running circles around us. So the consultation with the revisionist was scheduled. I was scared. Was I doing the right thing? A million scenarios raced through my mind, but ultimately I knew I was doing the right thing for us. I just had to remind myself of what I went through with Stella and how I wanted it to be different this time around.

So off we went —the revision process was relatively straightforward and was so much faster than I expected. Fiona cried during the procedure and for a couple minutes after and then she was nursing and content. When she nursed I already noticed a difference! I was excited to have it over with and relieved that it went well. Over the next few days she was fussier than normal, but manageable. After the areas healed, she had some relearning to do and it took some time until everything “clicked”. After a few weeks everything normalized and nursing was no longer a full day event. Life was much better for my family

Throughout this time I had second thoughts and a pretty bad case of mom guilt, but in the end I was thankful it was done. Katie was always just an email or a visit away from a helpful trick or some kind of motivational pep talk. I believe there was one email that went along the lines of “well behaved women rarely make history” when I was going through a particularly rough patch.

Seeing Katie and her team at The Birth Center was the best decision I made not only for Fiona, but also for myself. I was able to have a comprehensive and evidenced based assessment and I was able to act on it in order to preserve and maintain the nursing relationship that I wanted. It was a huge learning experience for me as well. It ultimately led me to want to provide this service to others in hopes that I can use both my own experience as a mother and a clinician to give the most thorough and compassionate care possible. For those of you wondering, Yes, it does hurt my heart a little each time I do the revision procedure on a little baby, but I always keep the end in mind.

Working with IBCLCs like Katie, Gywnne, and Corrine allows me to have a top notch, team centered approach to treating babies. The care they offer pre-op, post-op, and through long term follow up is impressive. It’s how this process should always be and I’m beyond thrilled and honored to be a part of this team. Not only does it take a whole village to raise a baby, but it takes a village approach to recognize, diagnose, and ethically treat our most vulnerable patients, our babies.


Dr. Joanna Green is a dentist at Pike Creek Dental in Wilmington, Delaware.

Dr. Green enjoys all aspects of dentistry and provides her patients with individualized and comprehensive care. She attends continuing education programs on various topics and stays abreast of the latest technology and new techniques

She brings her experience as a mother to her work, and the health and comfort of children are always a priority. She prides herself on providing the highest quality of care for all generations of the families in her practice.

A Maryland native who grew up in the Annapolis area, Dr. Green now resides in Hockessin with her husband Kyle and daughters Stella and Fiona. Outside of the office, she enjoys spending time with family and friends, cooking, or running with Murphy, their Irish Setter.

“My philosophy is simple, I believe every patient is entitled to comfort—from the moment you walk in the door, to discussing and planning your oral health needs, and ultimately when in the dental chair. By listening to your needs and wants, I strive to create an atmosphere that changes the way you think about dentistry and puts you at ease. I look forward to taking part in your care to create and maintain a healthy and beautiful smile.”