A month-old baby wailed at the top of his lungs as a pen-size laser focused its beam into his mouth.
“I love you baby, yes I love my baby,” Dr. Hamed Rezakhan cooed as he deftly severed and cauterized two membranes in the infant’s mouth. “I love you my sweet baby.”
Within seconds the procedure was done and the baby was back in his mother’s arms.
For Dr. Rez, as he is known to his patients and parents, it’s a normal day at Islands Pediatric Dentistry, 1425 W. Elliot Road, Gilbert, where he performs on average two to three tongue-tie and lip-tie releases or a combination of both daily.
“It’s very close to my heart,” said Rezakhan, who’s been practicing since 2012 and began offering the specialized laser procedure about two years ago. “Because it makes a huge difference for the individual who is suffering from it, whether it’s a nursing or speech issue and most importantly sleep apnea.”
Tongue-tie is when the strip of skin connecting the baby’s tongue to the floor of the mouth is shorter than usual and restricts the tongue’s movement. Typically the skin separates before birth.
When the tongue is unable to rest on the palate, it can cause sleep apnea, a serious disorder that occurs when a person’s breathing is interrupted during deep sleep.
If children don’t sleep well, it affects their ability to learn, Rezakhan said.
Less common is lip-tie, where the tissue behind the upper lip is too thick or too stiff and keeps the upper lip from moving freely. In severe instances, a lip-tie can cause a gap between the two front teeth as they grow in.
In the case involving Gilbert mom Kristen Black’s month-old baby, Rezakhan performed both a tongue- and lip-tie releases.
Black said she was told shortly after her son’s birth he was tongue-tied, but the hospital “didn’t make it sound serious.”
She didn’t know her son had a problem until he had a fever and she brought him to an emergency room.
“They found out he was severely dehydrated,” Black said. “We think he wasn’t getting enough milk.”
Her son was put on an IV and stayed in the hospital for a couple of days.
A lactation consultant determined the baby’s tongue-tied condition hindered him from latching.
“I breastfed him for two weeks,” Black said. “He was not emptying the whole breast and it took a long time and he fell asleep a lot.”
She introduced bottle-feeding where it seemed her son was having an easier time but he was swallowing too much air, leading to reflux problems.
Immediately after the procedure, Black was already seeing an improvement as she breastfed her son.
While some experts estimate up to 10 percent of newborns are tongue-tied, Rezakhan feels the number was much higher from what he’s seen at his practice.
“It’s at least double that,” he said, adding 15 to 20 of every 100 patients he’s treated were diagnosed with the condition. “We recommend treatment only if there are symptoms associated with it. Many times, there are no problems.”
According to a 2018 study in the International Journal of Clinical Pediatrics, tongue-tie cases have surged with a corresponding increase in diagnosis and treatment.
“It’s very undiagnosed,” although the condition is known in the lactation community, said Ronda Finley, office manager for Islands Pediatric.
Rezakhan is a big proponent of breastfeeding and educating the community about the condition and the practice has partnered with hospital lactation specialists.
Tongue-tie was something Chandler resident Manoj Kumar Panchapakesan never heard about until his daughter, Vaiynu, was born with it in January.
“She was not taking milk and was crying because she was hungry” as a result of insufficient latching, he said
The hospital recommended the family go see Rezakhan, who performed the procedure on Vaiynu.
“I was scared at first,” Panchapakesan said. “It took less than five minutes. Even for a 4-day-old baby, she cooperated well. With the procedure on her tongue we were able to feed in a few hours after the surgery.”
“The baby is perfectly normal now and she is completely fine,” he added.
Although the condition can be hard to spot in babies, Rezakhan can easily detect it in infants, according to Finley.
Rezakhan said he knows of only two other pediatric dentists in the Valley who offer the procedure.
All three use the minimally invasive laser technology rather than blades, which cause heavy bleeding and have a longer healing process. Due to the lack of dentists who do this procedure, Islands Pediatric has patients coming from as far as Avondale and Paradise Valley, Finely said.
Rezakhan himself is tongue-tie. He was diagnosed at 3 years old when he was having trouble pronouncing his “r’s” but his mother opted not to have the surgery, which was done with a blade at that time.
The Scottsdale resident took speech therapy classes and learned to live with it but as an adult, he has neck tension and some sleep apnea, he said. “I’m looking for me to get treated for sure,” he said.
Generally, tongue-tie is discovered when a baby is unable to breastfeed or the mom feels pain from breastfeeding because the baby bites down attempting to latch on, Finley said.
Sometimes the problem isn’t caught until the child begins school and is assigned to a speech therapist, she added.
Tongue-tie can interfere with the ability to make certain sounds — such as “t,” “d,” “z,” “s,” “th,” “r” and “l.”
“The counselor or nurses will tell parents to have the child checked out because it’s an anatomy issue,” Finley said.
Although the bulk of Rezakhan’s patients for the tongue- and lip-release procedures are on average infants to 6 years old, they did have a 21-year-old patient, Finley said.
A mother whose young child was diagnosed with tongue-tie while listening to the symptoms remarked, “that’s my 21-year-old son,” Finley said.
Turned out the young man was tongue-tie and spoke with a lisp.
Rezakhan said not all tongue-tie cases require surgery but if the procedure is done, proper aftercare such as using coconut oil and massaging the area is vital, otherwise, the membrane will grow back and reattach.
Mesa mom Kysa Murdock learned that the hard way.
She said her oldest son Kaspian Deihl, 4, underwent a tongue-tie release while 4-days-old in the hospital. Before the surgery, Kaspian couldn’t eat and turned blue twice after he choked on milk, Murdock said, adding that after the procedure, they went home with no aftercare instructions.
When Kaspian turned 2.5 years old, Murdock suspected a problem. He was basically non-verbal, she said.
“He would not attempt to copy sounds and words,” she recalled. “It made him distant and unhappy. He would scream constantly and get frustrated.”
He also was waking up cranky and agitated because he wasn’t sleeping well.
Murdock took Kaspian to three different adult dentists who she said didn’t look for tongue-tie and one didn’t even bother to look in his mouth. “That would have been me two years ago. If I had not been trained to look for it,” Rezakhan.
Murdock said Kaspian was considered autistic and placed in a special-needs preschool. A year of speech therapy yields little progress for Kaspian, which prompted Murdock to do research.
She eventually found Islands Pediatric and her son at 3.5-years-old underwent his second tongue-tie release.
“The day after his procedure, he said a three-word sentence – ‘balloon is stuck,’” Murdock said. “It seemed so small but my family cried. Within a month and a half, he learned every letter of the alphabet and its sounds and could count to 10. He’s made tremendous progress.”
Murdock is hopeful because Kaspian starts kindergarten next year.
“He’s got a meeting next month about his educational future,” she said. “His teacher before this was concerned. But he starts regular education class, which is huge for him.”
Information: 602-491-1818 or IslandsPediatricDentistry.com