Am I The Only One That Thinks Worm Looks Like a Gap Tooth Bill Murray Here?

One of the topics in the imaginary book “100 Things No One Tells New Parents” is that of the gap toothed baby.  I don’t yet own a copy, so when my little Worm started filling his mouth with his first set of pearly whites, I wasn’t prepared.   A huge space formed between tooth E and tooth F.  (That’s medical speak for the top two front teeth!)  I asked myself for the 15th time “Is Worm actually my son?” I don’t have a gap and neither does Steph.  So why would the Worm have such a prominent one?  The only sensible answer is that we accidentally picked up Michael Strahan and Lauren Hutton‘s love child from the hospital (and in exchange, our real child is having the champagne wishes and caviar dreams the rest of us only see on TV).

Upon closer inspection, Steph and I found that our boy’s maxillary frenulum (or frenum) is quite low on the gums.  Worm’s upper labial tie (not to be confused with a neck tie, or cravat) attaches very near the bottom of his gums at the edge of the hard palate.  This gives me good reason to assume that Worm’s teeth are gapped due to the thick (about 3mm) frenulum that sits between his front choppers.  Other possible gap teeth causes for Worm (besides the theory that he isn’t mine) are:  his teeth are small, his jaw is big, he may have extra teeth in the gums that prevent correct positioning, etc.

Bad Frenulum! Bad, bad!

To be on the safe side, we made a special visit to our pediatrician.  The kid doctor had a look and told us not to worry about the teeth or frenulum just yet.  And to have it evaluated at the dentist when he turns two (Worm, not the dentist).  She also said that since the teeth and gums change as more teeth emerge, it may be less of a problem, or go away completely as his adult teeth come in.

Having never before seen a living frenum like Worm’s, I decided to get a second opinion from our other doctor, the internet.  I researched a few articles reassuring me that my son was not a mutant lifeform and that other children also suffer from different levels of lip-tie.  Worm’s frenum looks to be between a class III and IV, which are the most tightly attached.  I don’t know if it was because he was our first child, or because we didn’t pay close enough attention to him, but we missed catching it early and it’s most likely Obama’s fault in some way.  I felt slightly better when I read that plenty of “tight frenulum” issues go undetected because many babies adapt well enough to overcome some of the associated problems.  Worm’s workarounds worked right around us.  Scouring the internet, I found many parents’ stories that share a lot of our fears and concerns about the frenulum fracas.  Because sharing is caring, here is a summary of our story, small enough to fit in a pocket of your mind:

When Worm was an infant, he was fussy.  Early on, I spent many hours sleepwalking through the house trying to bounce and squeeze the extra air out of him.  We thought he was a little colicky but normal, as we also didn’t have any prior parenting experience to compare him to.  He was our first child.  After being introduced to solid foods, Worm quickly lost his desire to breastfeed.  That never bothered us, because it gave us an excuse to use our brand new baby food processor earlier than anticipated.  We figured that his personality was the driving factor in his desire to switch to solid foods, so no red flags arose.  During the first year of his life, we didn’t really look inside his mouth for longer than the amount of time it took him to yawn.  An occasional peek showed us a tongue, pink gums, and a couple of cobwebs in the back corner…nothing out of the ordinary.  Then he got old enough to belt out a hearty laugh (from one of my horrible jokes) and his upper lip only curled slightly. Voila!  We noticed a thick flap of skin holding onto Worm’s upper lip and gums and the wife and I started pointing fingers.  “That’s not from my side of the family!” we each exclaimed.

(We’re still trying to locate the family member that passed this gene down so we can bill them for the dental procedures.)

So to make other new parents aware of this ‘more common than you think’ issue, I’ve provided a list of upper labial frenulum complications below.  I tried to gather a concise list of signs and symptoms I’ve found that make sense of the upper lip frenulum fuss:

• Baby may have problems latching, make clicking sounds during feeding, or take in excess air during feeding
• Breastfeeding may be painful for the mother (and cause cracking and bleeding of the nipple)
• Baby may fail to gain weight during first year of life
• Bottle feeding may also pose a problem
• Colicky baby or symptoms of colic
• GERD and indigestion
• Poor lip movement that can affect smiling and talking
• Diastema (or gap teeth) that carries on through adulthood
• Accelerated upper teeth decay
• The need for orthodontics, such as braces later on

So now the question is:  What do we do?

I’m not into waiting for the frenulum to fix itself.  I know there are a few dental websites that say to wait, but I don’t want this to turn into thousands of dollars worth of braces and teeth realignment down the road.  (I want a new mountain bike and I’m not spending good money on useless sillyness like teeth…)  We don’t want general anesthesia for Worm, so anything requiring it is placed at the bottom of the list as a last resort.  (The only things putting Worm to sleep are my boring childhood stories.)  I could snip it myself, but my gag reflex kicked in after only seeing pictures online.  I’m not going to do it.  The best option I see right now is an erbium laser treatment.  We will start heading in that direction and gather more information.  It uses local anesthetic, is timely, and involves obliteration of tissue and burning of flesh… but in a nice, humane and painless way.  Besides, anything involving lasers should be nothing short of awesome!

We’re going to look into the cost of the procedure and if there is insurance coverage for any of it.  Pics and updates to come.  Stay tuned.

I wonder if Smush could have the same problem…hmm.

Related Links:

Oral Diagnosis of Abnormal Frenum Attachments in Neonates and Infants – Classification of maxillary frenulum attachment and examines a laser treatment solution.

Frenums, Tongue-tie, Ankyloglossia – Excellent presentation discussing sublingual and maxillary frenula complications.  Surgical procedures and before/after pictures.  Very interesting.

Breastfeeding and Frenulums – website with excellent information for breastfeeding mothers as well as a presentation HERE.  Brian Palmer is the dentist and he put together the Frenums, Tongue-tie, and Ankyloglossia presentation above as well.  Excellent.

Blog Posts:

Frenectomy Today Frenum, Frenulum and Frenectomy – How to Effectively Deal With Them in 21st Century America –  Great blog post on one woman’s struggle with finding help for her child’s maxillary labial frenulum problem.  Other articles

The funny-shaped woman – Here’s a blog post that got me started on my internet hunt to find out more.  It’s a real life breastfeeding woman’s experience with maxillary labial tie.

The Mommypotamus Lip Tie Q & A – Great blog post on questions that you may have about lip-tie.

The Mommypotamus How to Spot Tongue/Lip Ties & Get FREE Expert Advice – Another great blog post on lip and tongue tie and how to start looking for it on your children.

Tempest Beauty Maxillary Labial Frenum and Tongue Tie – Mom’s experience with feeding and later, laser treatment for upper lip tie at Dr. Kotlow office.