Labial Frenulum Injury
Lip ties are a structure in the form of a membrane or fibrotic band, which is located between the inner surface of the lip and the gingiva and can sometimes reach up to the hard palate, restricting lip movements. The piece of tissue behind your upper lip is called the frenulum. In calves with a taut labial frenulum, they may prevent the upper lip from moving freely when the frenulum is too thick or too rigid. Babies with a tight tongue tie or severe lip tie may have trouble gaining weight. It makes it difficult for the upper lip to turn outwards and upwards, making it difficult for the upper lip. While suckling, it can prevent the baby from placing the breast deeply into the mouth, keep the lips and teeth close to each other, cause dead space, and cause tooth decay or tartar. In the later period, gingival opening in the upper gingival line may cause separation of the teeth (diastema) in Yin babies. Generally, in infants and children, the labial frenulum may rupture when the upper lip is pulled suddenly after a fall.
The photos above are of a baby whose upper lip was torn traumatically. In the photos below, it can be seen that the lip tie has completely healed after 1 week.
In the healed upper lip ties, rough areas can remain for life and do not cause any health problems. Sometimes adult patients mistakenly think it is a wart (papilloma) and apply to a ENT specialist. The photos below show the photos taken 1 week after the labial frenulum rupture. The tartar on the upper parts of the baby's upper teeth is striking.
Tear of the lip tie in infants can occur spontaneously, although rarely.
Causes of Lip Tie Tear
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| The photo above belongs to a child whose upper lip ligament was torn after falling. The bleeding has stopped on its own and the lip tie looks torn as if a surgical procedure was performed. No intervention was made on the patient and follow-up was planned. On this page, you can find another photo of the same patient below. |
Conditions that may cause rupture of the upper lip tie in infants:
- Strong nutrition
- Forced insertion of a pacifier
- Retention or stretching of the lip
- Strong rubbing of the lip
- Having a direct blow to the lip
Due to frequent falls and unstable movements in toddlers, the upper lip can hit the table, the floor or any hard object in the environment and can be easily torn. Most of the above reasons are situations that small babies cannot easily do on their own, and it is emphasized in some forensic medicine books that there may be a finding that needs attention about child abuse.
Causes of upper lip tie rupture in adults usually include direct traumas and accidents. The upper lip can be torn in traffic accidents, occupational injuries, sports games and falls.
Patient Evaluation in Infants and Children Presenting with Tear of the Lip Tie
First of all, the trauma history should be carefully examined and it should be evaluated whether the tear of the lip tie is an intraoral injury and whether there is injury in other parts of the mouth. Small babies are less likely to tear their lip ties with their hands. In older children and adults, the patient may need to be evaluated for general trauma.
Usually the Treatment of Labial Frenulum Tears is Simple
In babies who come with an upper lip tie tear or injury, it is usually sufficient to stop the bleeding by applying pressure alone. Rarely, cauterization or suturing is required.
How Can Pressure Be Used to Stop Bleeding?
In babies presenting with a ruptured upper lip, it is usually sufficient to press the upper lip from the outside for 5-10 minutes. Apart from this, it is important to press with a natural compress and to keep the patient upright. A lip tie tear is not usually a life-threatening injury on its own. In infants and adult patients whose lip tie is torn, waiting by applying a small amount of pressure on the upper lip is usually sufficient to stop the bleeding. If the bleeding is excessive or the tear is long, it is usually sufficient to apply cold compress to the upper lip from the outside (a clean cloth can be placed on the lip, ice can be contacted in the bag, compress for 10-20 minutes). In rare cases, stitches may be required in cases where the bleeding does not stop. Once the bleeding from inside the lip has stopped, it is ideal not to pull the lip out again to look at it (the bleeding may start again!). It is safer to look after 3 days😊
It is appropriate not to lift the lip for 3 days when the bleeding stops after the first intervention. No additional treatment is usually necessary in breastfed infants. In older children and adults, it is appropriate to avoid extremely hot, salty and spicy foods. Generally, the wound in the lip tie heals completely within 2 weeks. Touching the wound with an unwashed finger may lead to the onset of local infection. In this case, local antiseptic spray and epithelial products
In the two photographs above, there are photographs taken 3 days later of the child whose upper lip tie accidentally ruptured 3 days ago. The natural healing process and the swollen area in the wound area are remarkable.
How to Feed After Upper Lip Tie Tear?
Babies who are exclusively breastfed do not need any additional nutrients. However, it is appropriate to avoid extremely hot, extremely salty and spicy foods in infants and older children who take solid foods.
Source links >> What to know about a labial frenulum tear?
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon
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Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
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