Trained SL dentist solves breastfeeding issue for family

Pearl Lorentzen

Local Journalism Initiative Reporter

A Slave Lake baby has been able to breastfeed thanks to a partnership between Slave Lake Dental and a public nurse/lactation consultant at Alberta Health Services in Slave Lake.

Carter Coutts was born in early December. His mom Alex Coutts had planned on breastfeeding, but he wouldn’t latch.

“We weren’t really prepared for it,” says Coutts.

She had a small breast pump, but that was it. When she left the hospital in Edmonton, she was encouraged to keep trying.

The day after she arrived back home, the public health nurse stopped by to see how things were going. She lent Coutts a larger breast pump and connected Coutts with another public health nurse, Katherine Owen, who is a lactation consultant.

“We were trying around the clock,” says Coutts.

Owen thought the baby might have a lip tie and a tongue tie, says Coutts. She mentioned that a new dentist in Slave Lake was trained to deal with these.

Dr. Dallin Evanson is the dentist at Slave Lake Dental who did the procedure.

A tongue or lip tie happens when the small piece of tissue connecting the tongue or lip to the mouth is too thick or too tight, says Evanson. Both happen at the front of the mouth.

If you put your tongue between your teeth and your upper lip you can feel the tissue in the middle that connects it. The lip tie makes it so the baby can’t open their mouth wide enough to latch on, says Evanson. The tongue tie makes it hard for the baby to suck the milk.

“Moms don’t realize that the reason they’re struggling with breastfeeding it’s because the lip and the tongue are tied,” says Evanson.

The dentist found a 75 per cent constriction, says Coutts. He was able to do the procedure right then and there. It was very quick, with very little bleeding. Christmas Eve was 10 days after the procedure. That day, Carter latched for the first time, but didn’t eat. The next time he latched, he ate for 30 minutes.

Now Carter is “totally breast fed,” says Coutts. The whole process had “lots of tears, but it was totally worth it.”

Coutts encourages any mom who wants to breastfeed but is having trouble to reach out for help. She is a paramedic, but wasn’t aware about lip ties and tongue ties and figures many other mothers might not be either.

Coutts has been very impressed by the support she received from public health. When she was struggling, she could stop by the Slave Lake Family Care Clinic whenever she needed to weigh her baby.

In an article posted on albertahealthservices.ca about baby Carter, Owens says, “By providing a patient-centred, holistic approach, families can receive the support they need, close to home.” 

The procedure takes about five minutes, says Evanson, but parents and the child will be at the dentist for about an hour. The dentist checks to see if the baby has a tongue or lip tie. If they do, the dentist explains the procedure and any risks, which takes about half an hour. The procedure can be done the same day. The dentist does a follow-up to make sure that the tissue hasn’t grown back and that they are still able to move their lips and tongue.

Dr. Evanson started practicing in Slave Lake about a year ago. He’s done 100s of them in Edmonton and two in Slave Lake.

Carter was the first one. The other one was in mid-March. In the first instance, the mother was referred to the dental clinic by a lactation consultant.

This falls within the dentists purview, because it has to do with the mouth, says Evanson. He’s not sure how many dentists in Alberta do the procedure.

“When I’ve gone to courses on it,” he says, “there’s usually 10 or so taking the course.”

In Edmonton, he knows of about six who do it regularly. As far as he knows, he’s the only dentist in Slave Lake that does the procedure.

The second time, the mother was still in hospital, says Lund. She was told the baby needed the procedure, and as a patient of Slave Lake Dental, contacted them to find out if they did it.

Doctors use scissors, says Evanson. Dentists use lasers, which means they can cut deeper.

Evanson also teaches the parents some easy stretches to makes sure the tissue doesn’t scar or grow back. These have to be done every three to four hours for a month, but only take a few minutes.

The process is a partnership between the dentist and the lactation consultant, says Evanson. He frees the tissue. The lactation consultant teaches the mother positions and other ways to encourage the baby to breast feed.

Considering how serious Carter’s tongue and lip ties were, Evanson was pleased and surprised that Carter was able to breastfeed so quickly.

Long term
If untreated, lip and tongue ties sometimes cause issues later in life.

“The tongue is the bigger issue,” says Evanson, “when it comes to long-term airway and breathing.”

The child can’t touch the roof of their mouth with their tongue, he adds. This can cause issues with airway and jaw development. It can also cause issues with speech.

With the lip tie, he adds, the child may end up with a gap between their front teeth.

Cost
The procedures are called infant frenectomy and labial tongue release. When done by a dentist, these aren’t covered by provincial health coverage.

“Some insurances are starting to cover it,” says Ashley.

Health spending accounts can be another way to cover the cost.