Dr. Hisaw is an honors graduate of dental school and attended his pediatric residency at Baylor, one of the premier pediatric programs in America. He is a two-time national award winning pediatric dentist, who scored first in the nation for his Pediatric Board Certification Exam. He continues to exceed the continuing education requirements required by American Board of Pediatric Dentistry and has twenty years of experience caring for children. Throughout his career Dr. Hisaw has taken additional courses on infant and adolescent laser frenectomy. He has also received a certificate of achievement for passing the Academy of Laser Dentistry proficiency and safety course. To advance his skills and to gain even more experience, Dr. Hisaw completed additional on-site training with two of the world’s leading experts on infant and adolescent laser frenectomy. He has successfully treated many infants and children in North Carolina. Dr. Hisaw enjoys working alongside lactation consultants and pediatricians, and also enjoys providing TT and LT education to the medical community.

Dr. Hisaw is the most experienced laser frenctomy provider in Greensboro, having been the first provider in the Piedmont Triad to be trained using Light Scalpel.

A Note from

 Dr. Thane Hisaw

5 stars from our patients!

“Great experience! Feels like I am nursing a different baby.”

 - Elizabeth J.

What is Tongue-Tie and Lip-Tie?

The tongue and lips are complex groups of muscles that are very important for all oral functions. Hidden under our tongue and lips are strong connective tissue bands called frenums or frenulums. These normal structures help the tongue and lips function properly. When these tissues are found to be unusually short, excessively thick, or attached in the wrong position then it is highly possible that the tongue and lip will function abnormally. A Tongue-Tie (TT) is a non-medical term for “ankyloglossia”, which is diagnosed as a frenum that did not develop ideally and now restricts the tongue from normal movement. The failure of the tongue to move freely  can cause complications with nursing, sometimes with speech, and occasionally with chewing and swallowing food.  Lip-Tie (LT) is also a non-medical term for an upper lip frenum that due to its abnormal development tethers the lip too tightly. A LT regularly prevents the lip from curling and moving in normal directions. Just as a TT can contribute to breastfeeding difficulties for a mother and baby, an upper LT is often a contributing factor to painful breastfeeding because the lip is not able to invert itself outward for proper latching. Upper LT also may increase the risk of cavities on front teeth, contribute to gaps between front teeth for children and adults, and lastly they are often at increase risk for injury when toddlers trip and fall.

 

Not everyone with an abnormal TT and LT requires treatment, but many infants and children experience significant benefits after having this problem corrected. Treatment of problematic TT and LT is not a "fad" treatment, but rather it has been recommended by the American Academy of Pediatrics (AAP) for many years. Current evidence based research completed by physicians, ENT specialists, and pediatric dentists has continued to further prove that the AAP recommendation is more correct than ever! When TT and LT treatment is the cause for complications with breastfeeding, speech, and/or swallowing then removal of pathologic TT and LT is best completed early as possible. This is especially true for breastfed infants and their mothers. Traditional treatments used to involve sedation, scissors and sutures, and were accompanied by post-operative bleeding. Advances in technology and training allow Dr. Hisaw to conservatively treat his patients with a soft-tissue CO2 laser. This safe and efficient technique is completed in the office and does not require sedation or sutures, and causes little to no bleeding.

 

“The experience was very stress free and went well.”

 - Jessica R.

Feeding Difficulties

If a baby has restricted movement of the tongue and lip due to tongue and LT, they may not be able to latch deep enough or seal on the nipple during feeding. This can lead to swallowing of air which is called “aerophagia”. This ingestion of air increases risk of causing colic symptoms, reflux and gas production for the baby. You may also hear clicking noises when the baby is feeding which is another sign that the child has not latched properly during feeding.

 

It is likely that your pediatrician and/or lactation specialist will have diagnosed this problem for you when your child was first born. The Anterior Tongue-Tie (ATT) is much easier to diagnose as the tongue is tethered to the floor of the mouth at the tip of the tongue. The Posterior Tongue-Tie (PTT) is more difficult to diagnose, and can often be “hidden” under the tongue due to its retracted position. Both PTT and the more visible ATT can cause the same problems with breast feeding. The ability of the tongue to elevate upward is essential to proper breastfeeding and swallowing. In the photos below you can see the difference in the sucessfully treated TT, because the tongue is now free to move upwards and function normally.  An infant or child with a PTT maybe able to move their tongue out but not up, and this is a common reason that PTT conditions remain overlooked.

Breastfeeding Complications

Commonly Caused by TT and LT

Baby:

poor latch

poor weight gain

chewing the nipple

reflux/spitting up often

gassy or fussy often

unable to hold a pacifier

slides of the nipple easily

frequent eating

 

Mother:

painful latch

continued painful breastfeeding

prolonged nursing sessions

creased or flattened nipples

blistered or cut nipples

incomplete breast drainage

plugged ducts or mastitis

feels like a full-time job

“It has only been one week since the operation,

 but we have already seen significant improvements.

The entire staff has been wonderful to work with.”

 - Krystal C.

Improving Speech

Many children that have a tongue-tie do not experience any speech impediments because they are able to adapt adequately as they grow and mature. Conversely, other children do not adapt well and do experience impediments with their speech.  By the age of three the sounds of L, R, T, D, N, TH, SH, and Z are beginning to be articulated by children. By the age of four, if a child’s speech is struggling with the sounds mentioned, or if other non-family members find it difficult to understand them, it is usually necessary to get a speech evaluation. A child with a tongue-tie may have a lisp, talk slowly and/or softly, and have a difficult time talking when speaking fast or when they are tired. Treatment of tongue-tie for speech related concerns should always be in conjunction with prior speech pathology evaluation and postoperative speech therapy.  Many children improve in their articulation on the same day of treatment, and others need a little more time to retrain their tongue to function properly. Follow-up speech therapy after treatment is always recommended for best results.

Classic Signs of a TT

Tongue does not extend past the lip

Heart shaped appearance at tip of tongue

Tongue won’t touch roof of mouth

Tongue does not move well side to side

Thick or tight band of tissue under the tongue

“Dr. Hisaw and his team are awesome.”

 - Shannon L.

Frenectomy Treatment Options

 

The procedure to treat tongue-tie and lip-tie is called a “frenectomy”. When babies experience nursing difficulties related to their TT and LT, the frenectomy treatment is usually performed within the first two weeks after they are born. The procedure can also be completed when children are older. However, once a problematic TT or LT has been diagnosed it is advantageous to treat it earlier rather than later, so they can learn to use their tongue and lips properly at the youngest possible age. During the procedure, which usually takes just a few minutes, parents are asked to wait in the waiting room. At the end of the procedure the baby and mother are encouraged to attempt breastfeeding in our private recovery room. Most mothers notice a significant difference immediately and see marked improvement on the very first feeding!

Benefits of Carbon Dioxide (CO2) Laser Treatment

Utilizing the highest quality state-of-the-art equipment,  Dr. Hisaw can safely perform this procedure in his office in just a few minutes.  Not all lasers are the same. The CO2  laser Dr. Hisaw uses is about 5 to 10 times cooler in temperature than a more commonly used “diode laser.” It is our belief that the lower temperature of a CO2 laser provides the best opportunity for ideal treatment outcomes.

Myths Related to

Breast Feeding and TT/LT

 •TT and LT do not affect breastfeeding

 

All TT’s need treatment

 

All TT's  are tethered and easy to see

 

Reflux and aerophagia are never related to TT

 

Anesthesia and sedation is required to treat

 

Breastfeeding is supposed to be painful

 

Some infants struggling to nurse are “lazy eaters”

Parent Reviews of TT and LT Laser Treatments

“It has only been one week since the operation, but we have already seen significant improvements. The entire staff has been wonderful to work with.

 - Shannon L.

Schedule a Visit

Ways to Make an Appointment...

 

Call our office at 336.378.1421

 

Email us at   smile@ChildrensDentistryofGreensboro.com

 

Or stop by our office at

504-j east cornwallis drive, greensboro, nc 27405
[google directions]

 

Our office is conveniently located

in the State Street Shopping District at Cornwallis Court.

If you park on State Street our office is street level and wheelchair accessible.

If parking off of Cornwallis, our office is upstairs one flight.

Meet Dr. Thane Hisaw

“As a husband and father of four, I know first hand how important it is for a mother and child to bond through pain-free nursing. Frequently, mothers come to us almost in tears because the breastfeeding experience has become increasingly painful and stressful.  Other times children with speech problems have tried conventional therapy, but still have trouble with the same sounds. Ideal speech development positively contributes to child's overall personal development. If a child's speech is impeded due to a TT, they may lack both confidence and the ability to communicate well because of their fear of sounding different and being misunderstood. For those that require treatment, the post-operative transformation for mother/baby, and adolescents with speech concerns is life changing. On behalf of myself and the team at CDG, I want to say it is a real privilege for us to help those families in our community who need this treatment.”

~ Dr. Hisaw

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Schedule an Appointment 336.378.1421