Instructions Following Functional Frenuloplasty

Myofunctional Therapy

The success of our practice is based on our ability to provide a complete and effective release of tethered oral tissues with a functional frenuloplasty approach for children and adults. We use a multidisciplinary protocol that integrates myofunctional therapy (and sometimes physical therapy) before, during and after surgery.

Our tongue-tie release procedure is based on precision, releasing only the appropriate extent of tissues for maximal relief; not too much, and not too little. We are often asked whether we use a laser or scissors. We use a scissors and suture technique which promotes healing by primary intention which is the body’s fastest and most efficient type of wound healing. Our technique offers a more predictable healing sequence and lessens the possibility of partial tissue reattachment and scarring. The tongue is one of the most critical organs in the human body, with the ability to regulate and shape orofacial structure and musculature. Our functional frenuloplasty approach honors the changes that occur during a tongue-tie release and prepares the body for acceptance and optimal healing post-treatment.

Our group is highly active in clinical research and committed to promoting optimal outcomes after surgery. In addition, we are delighted by the opportunity to share our knowledge and experience to help inspire the field to move towards higher standards in the delivery of tongue-tie release surgery.


Patients can expect some mild swelling, pain and/or discomfort as a normal process of wound healing. Generally, this is fairly mild and can be controlled with over-the-counter pain medications. Possible (but very rare) complications of frenuloplasty may include anesthesia complications, bleeding, pain, numbness, failure of procedure, voice and swallowing changes, infection, injury to adjacent structures and scarring. Be gentle with exercises for the first 4-6 days (do not begin exercises until day 4) Stretching exercises are better than strain.

At any time, call our practice if you experience any of the following: Severe pain that does not improve with medication, Brisk bleeding, Severe Swelling at the site of surgery, difficulty breathing or a Fever higher than 102℉


1. Bleeding: It is normal to experience some bloody oozing during the first 1-2 days. If steady bleeding occurs, place gauze under the tongue to hold pressure and call Dr. Coats cell phone. (817.944.5900) If heavy bleeding persists, please go to your local ER.

2. Wound care: you will be provided with presoaked gauze that will contain 2% viscous lidocaine. Place the gauze on surgical site. Leave the gauze in place for as long as you can for the first 24-48 hours. Replace the gauze as needed

3. Lypo-spheric Vitamin C: Gently apply package of vitamin C onto wound (entire packet) 3 x day for 10 days. Saliva will mix with this and you are to swallow the excess vitamin C. Use all packets. (You are sent home with box of 30 packets)

4. Sutures (Stitches): We use absorbable sutures that will fall out on their own with a week after surgery. After sutures come out, we then encourage you to brush the surgical site (2X/Day) with a soft toothbrush. (hold brush as you would hold a pen to keep you from pressing to hard), lift tongue up and hold, then swipe brush upwards from base to tip of tongue- do 3 gentle swipes- We recommend the Curaprox Surgical Megasoft brush (found on Amazon)

5. Oral hygiene: We recommend rinsing with saltwater and/or Colgate Peroxyl mouthwash (see photo of recommended rinse) 2X/day times a day to keep the wound clean and reduce the risk of infection. Colloidal silver spray is an excellent antimicrobial option. Rinsing is not swishing. Gently roll your head around/back and forth to move the rinse around.

6. Myofunctional Therapy Exercises: Beginning on day 4- It is EXTREMELY important to perform the stretches and exercises as prescribed by your therapist to obtain the most optimal results. We especially encourage waggle spot, flat tongue (aka puppy tongue), skinny tongue (aka pointy tongue or snake), light clicks and caves (aka suction).

Also, hold tip of tongue with washcloth (or gauze) stretch tongue out, with a straight pull and hold for 20 seconds. Relax, then pull/stretch to right side and hold for 20 seconds and repeat to left side. (Discomfort is normal, and you will feel deep stretching through chin and neck) Exercises 3X/ Daily

7. Pain medications: We recommend using Tylenol and/or Ibuprofen as needed for pain.

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