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The Second Lip-Tie Consultation

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I’m finally getting around to posting the update on L’s second lip-tie consultation with pediatric dentist #2. You can read about my whirlwind of a week here, but the short version goes like this:

I was feeling deer caught in headlights about the second consult. Hubby couldn’t take off work to go with me, and I was taken aback by the possibility of the frenectomy being done that same day. Then there was the feeling of sticker shock over the possible $1600 it would cost to get the frenectomy completed.

Friday morning I packed the boys and a ton of gear into my car and we drove to my parent’s house to drop G off. My sister met us there and she came with L and I to the dentist. She wanted to provide moral support, though I wasn’t sure I would need it.

This dentist office was awesome! Huge! Modern! Complete opposite of the dentist office the boys go to here at home.

I’m sure my sister and I looked and sounded like the little kids coming in for their check-ups as we told each other in wide-eyed amazement, “Look at that!” and “How neat is this?”

There was a play area in the shape of a tree. There were bean bags in the middle of the floor. Tons of books that weren’t falling apart. Huge stuffed animals to cuddle with. An air hockey table. Video games. And a room with amphitheater seating where you could watch a movie of your choice. The receptionist offered us water and coffee.

We didn’t have to wait long before a dental assistant came out and introduced herself. Then she offered to carry my diaper bag and push the stroller for me.

Between that and being offered something to drink, I felt like a princess.

As we walked out of the reception area, the assistant said we’d be going to a room in the back. I half-jokingly told L that we were being put in the back so no one could hear his screams. Sure enough, we were taken to a room (with a door) in the very back.

The dental assistant asked me a bunch of questions about why I was there, L’s birth, and how was nursing going for both of us. She seemed impressed that I had done my homework on lip-ties and knew the reasons why the revision with a laser was better. Then she explained how they would perform the frenectomy: swaddle L up and another staff member would hold him while the dentist used the laser to cut the tie. She asked if I was willing to perform exercises on L to prevent the tie from forming again, stating that if I wasn’t then there was no point to getting the frenectomy done. I told her I didn’t really have a choice; I knew he needed the lip tie revised. Then she got another dental assistant (she called him a “friend” — I’m sure to keep things from being too scary for their little patients) who took pictures of L’s gums and tongue while the first dental assistant and I held him down. L was pretty compliant having his gums photographed, but wanted nothing to do with his tongue being lifted for it to be photographed.

After the pictures were taken, the first dental assistant put her notes into a computer and told us she was going to get the dentist. On her way out she told me not to nurse, just in case they could perform the surgery after our consult. I was glad she told me that because L was getting hungry and I would have nursed him while we waited for the dentist to come in.

As soon as the dentist walked through the door, L flashed her a huge smile. This took me by surprise because L never does this to people he doesn’t know. The dentist and L spent a few minutes getting acquainted (mostly L patting hitting her face while she got down on his level to make small talk) and then she asked some of the same questions the dental assistant asked me.

Then she inspected L’s gums and tongue. She rattled off numbers to the dental assistant who typed them into the computer. Again, L was okay with having his gums checked, but hated having his tongue played with. While she was doing her exam, the dentist commented on how wiggly and strong L was.

Once she completed the exam, she gave me her diagnosis. L had a Class 4 lip-tie on his upper lip (out of 4), a Class 4 tongue tie (posterior), and a class 2 lip-tie on his lower lip (out of 4). I knew from my readings L’s upper lip-tie was bad, so I felt better knowing the dentist agreed with me. I had read about posterior tongue ties and learned they were hard to diagnose, and were often misdiagnosed if found at all. I had to do some research later to find out what a Class 4 tongue tie was, and thankfully it had nothing to do with how bad it is, just the part of the tongue it is found. I never thought about L having a lower lip tie, but was glad that wasn’t too bad.

Kotlow classification of lip ties
source

The dentist also went over why it would be good for L to get the revision on his lips and tongue and how she would perform the frenectomy, saying they’d do both in the same visit, and there would be two follow up appointments after that.

Then she gave me news I didn’t really want to hear. Unfortunately, L is too old to be swaddled and held. She mentioned how wiggly and strong he was during her examination of his mouth. That meant they’d need to sedate him; however, he is too young for that.

The dentist went on to explain that the time to relearn how to latch and nurse properly is about half the child’s age. This meant it would take about 4.5 months for L to (hopefully) learn how to suck correctly. This also meant that our last few months of breastfeeding could be stressful. L clearly isn’t failing to thrive and the discomfort I’m feeling while nursing him isn’t unbearable, so the dentist advised it would make more sense to wait until L turned a year before getting his ties revised, that way he could be sedated.

I hate that he needs to be sedated, but I feel better about sedating him after he turns one. By then the pros of the frenectomy will outweigh the con on sedation. The dentist also said that they would perform L’s first routine exam, complete with cleaning and x-rays, during that time since he wouldn’t be able to fight them.

When asked if I had any questions, I only had one: how much is all this going to cost?

Since they would revise both the lip and tongue ties and L would need to be sedated, our grand total was about $2,000. And since this was considered medical, they wouldn’t file it for us. And since we don’t have out of network benefits, we won’t get anything back. Yikes.

I figured we could use next year’s flex spending to cover most of it. However, when I went to schedule L’s surgery the receptionist told me that I needed to put a deposit down to hold the spot. That deposit was nearly $1500.

The room slowly started melting away when I looked at the deposit total. This would put me very close to maxing out my credit card. And it was nearly the entire cost of the frenectomy!

I handed over my credit card. I knew L needed to have this done, and I didn’t want the first appointment of the day to slip through our fingers. The sooner we could get this over with the better. I told myself at least it’s mostly paid for now, even if it will take a long time before it’s paid off.

I think my sister got sticker shock when she heard what I needed to pay. She wanted to know if I would get any of that money back. Unfortunately, I told her, it was a slim chance. We don’t have out of network medical benefits and I wasn’t sure if we could get reimbursed by our dental insurance.

I reviewed all of this with Hubby that night. To my surprise (and complete relief!) he said when I told him it was an expensive procedure, he figured it would be around $5000, so the $2000, while it’s still a lot, didn’t seem too bad to him. Since more than 50% of this has already gone on my credit card, it’s pretty much done. If I get reimbursed, AWESOME! If not, it’s done. It’ll get paid eventually.

I realized on the way home that open enrollment would be coming up. Who knows what our insurance will be like next year. But at least we have a plan of action in place for the lip and tongue ties. I liked this practice, despite it being nearly two hours away, and I felt better cared for there than at the first dentist. They explained things. They took their time with us. They went over the pros and cons of performing the frenectomy now (like the first dentist was willing to do) and waiting. They’re able to perform the procedure with the laser like I want. It should be worth the $2000 to get it done, especially if it means less oral health problems down the road.

L’s frenectomy is scheduled for the end of February. In the mean time I’m wiping up an insane amount of drool, battling eczema around his mouth, and trying not to get bitten while nursing. I’ll be glad when it’s all finally over with.

Did your child have a lip or tongue tie? How was it diagnosed?




10 thoughts on “The Second Lip-Tie Consultation

  1. It sounds like you’ve had a very trying time of it, with a bit more to come. I’m glad that something is able to be done to make everyone feel better and I’ll be hoping that your insurance will give as much back to you as possible!
    It sounds like your little man is a pretty happy guy, hopefully he’ll get even happier after February! Good luck to all of you!
    Cristi G recently posted…Halloween is overMy Profile

  2. Coming in from NaBloPoMo. OK I did not know that was an actual issue as my son was born with that strip between his front teeth. He kind of took care of it himself as a toddler when he fell and bit through his upper lip. 9 stitches later he looked like a baby walrus for a week or so and was leery of drinking or eating. It is ridiculous how expensive things have gotten, even with insurance.
    Southern Angel recently posted…Old to blogging, new to here NaBloPoMoMy Profile

  3. Wow that sounds like one very nice clinic!! Sorry the cost is so high 🙁 What a shame, but definitely worth it for your little guy and the benefits it will mean for him. A shame you have to wait but sounds like the right plan.

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