Diagnosing and understanding the maxillary lip-tie (superior labial, the maxillary labial frenum) as it relates to breastfeeding.

Successful breastfeeding is dependent upon an infant's ability to correctly latch onto a mother's breast. If an infant is born with oral soft tissue abnormalities such as tongue-tie or lip-tie, breastfeeding may become challenging or impossible. During the oral evaluation of an infant presenting with breastfeeding problems, one area that is often overlooked and undiagnosed and, thus, untreated is the attachment of the upper lip to the maxillary gingival tissue. Historically, this tissue has been described as the superior labial frenum, median labial frenum, or maxillary labial frenum. These terms all refer to a segment of the mucous membrane in the midline of the upper lip containing loose connective tissue that inserts into the maxillary arch's loose, unattached gingival or tight, attached gingival tissue. There is no muscle contained within this tissue. In severe instances, this tissue may extend into the area behind the upper central incisors and incisive papilla. The author has defined and identified the restrictions of mobility of this tissue as a lip-tie, which reflects the clinical attachment of the upper lip to the maxillary arch. This article discusses the diagnosis and classifications of the lip-tie, as it affects an infant's latch onto the mother's breast. As more and more women choose to breastfeed, lip-ties must be considered as an impediment to breastfeeding, recognizing that they can affect a successful, painless latch and milk transfer.

The influence of the maxillary frenum on the development and pattern of dental caries on anterior teeth in breastfeeding infants: prevention, diagnosis, and treatment.

In breastfeeding infants, an abnormal attachment of maxillary frenum has the potential to become a significant factor in contributing to facial caries formation on the maxillary anterior teeth. This is in part due to the inability of infants to remove residual milk from the area between the lip and facial surfaces of the maxillary central and lateral incisors at the completion of nursing. Early diagnosis and treatment of an abnormal frenum attachment with the simple and quick revision technique using the Erbium: YAG or Diode laser can prevent these from occurring and does not present any significant risks to the infant.

Lasers and pediatric dental care.

There are several types of lasers that will allow pediatric dentists to remove soft tissue (such as diode or Neodynium:Yttrium-Aluminum-Garnet (Nd:YAG) lasers) or remove both hard and soft tissue (such as the Erbium:YAG laser), in addition to photobiostimulation or therapeutic lasers that produce their healing benefits without producing heat. Lasers allow pediatric dentists to provide optimal care without many of the fear factors that result from conventional dental techniques. Lasers are extremely safe and effective when the user has a proper understanding of laser physics. Using lasers for caries removal, bone removal, and soft tissue treatment can reduce postoperative discomfort and infection and make it possible for dentists to provide safe, simple treatments.

Lasers and soft tissue treatments for the pediatric dental patient.

Historically, oral soft tissue surgery on infants and young children was completed in the operating room under a general anesthetic agent. Many children were referred to an oral surgeon and required a physician's physical examination and medical clearance for a hospital admission. potentially placed a child at risk during the use of a general anesthetic for an elective procedure, which may not have insurance benefits. Traditional methods of oral surgery using scalpels or electrosurgery may produce significant postoperative discomfort and require sutures and prolonged healing. Lasers provide a simple and safe in-office alternative for children while at the same time reducing the chances of infection, swelling, discomfort, and scaring.

Lasers in pediatric dentistry.

Pediatric dentistry's mission in delivering care to our young patients is simple: provide optimal preventive, interceptive, and restorative dental care in a stress-free environment. Lasers such as argon, diode, Nd:YAG, CO2, and now the erbium family enable minimally invasive dentistry for hard- and soft-tissue procedures. This article offers an understanding of treatment planning in the pediatric practice and demonstrates the procedures that dental lasers can perform on younger patients.

Using a dental operating microscope in a pediatric dental practice.

It often is suggested that using a dental operating microscope on children cannot work because of their inability to sit still. Not only is this premise incorrect, but also using the microscope can improve the ergonomics of practicing dentistry and, in some cases, reduce the potential for head and neck strain.