Thursday, March 27, 2014

Implications For Tongue-tied Newborns

We know that breast-fed babies are healthier. We know that they are less likely than formula-fed babies to have health issues throughout infancy, adolescence and into adulthood. I know there are plenty of anti-breast feeding people out there that will dispute this fact. It doesn't change facts though.

So, when parents decide they want to primarily feed their infants with breast milk, it is necessary that the infant be able to latch on properly to the mother's nipple. Unfortunately, some children cannot properly latch on due to their tongue being tied.  This can make nursing incredibly difficult for the infant and very uncomfortable for the mom.  Often tongue-tied infants will have a heart shaped tongue when they try to stick it out, or not be able to stick the tongue out past the lips.  Also, some mothers will notice a clicking sound as their infant nurses.  Nursing will also often be very painful, and babies will not seemed satisfied even after nursing for a long period of time.  If you have any of these signs or symptoms you need to contact a dentist to have your infant evaluated.   

The condition of being tongue-tied is called Ankyloglossia. The word is derived from the Greek words Ankylo and Glossus. Ankylo means fused or stuck together. Glossus is the Greek word for tongue.  Sometimes you may hear it called a short frenulum, too. 

The problem with ankyloglossia is the inability to latch on to the nipple properly. Take a look at the diagram below. It illustrates what happens when an infant's tongue prevents them from latching properly.

The tongue isn't always the culprit. These tissue attachments can also occur on the upper or lower lips resulting in the same issue of being unable to latch properly. Infants' lips need to be able to flange in order to create proper suckling.  

Fortunately, this condition is rather easy to correct with modern surgical procedures. I perform the surgery with a laser. It is relatively quick, easy and painless.  Often the only comfort measures needed is to latch the baby on immediately following the procedure.  Nursing will help comfort the baby and will also apply pressure that will help with any minimal bleeding that may occur.  Often the fear of the procedure is more scary for mothers than the actual procedure, and the benefits of comfortable nursing for both the mother and infant is so great, it is worth it to have the procedure done. 

Before and After correction

If your baby is tongue-tied and you wish to breast feed, then find a dentist that can make this simple correction for you. Not all dentists perform this procedure, or use a laser.  A laser is necessary as this helps to minimize bleeding and accelerate healing time. You may need to call around and ask if they offer this service.  

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Co-written by Dr. Martin Cisneros and Carrie Owens

Thursday, March 20, 2014

Therapeutic Botox

Most people have heard of Botox. It is best known for it's cosmetic application in the removal of wrinkles. When it was developed, it was used for other reasons not related to cosmetics. The purpose of this blog is to describe a few uses that people aren't well aware of.

Botox is a medicine that is derived from the toxin produced by the bacterium Clostridium Botulinum. The way it works is that the toxin prevents muscular contractions and glandular secretions. Therefore, when medical issues arise that are caused primarily from excessive muscular contractions (or excessive glandular secretions), simply decreasing the intensity of the muscular contractions (or glandular secretions) will resolve the problems.

Chronic Headaches

Up to 90 % of headaches are muscle tension headaches. If we get the muscles to relax, then the symptoms will be alleviated. Botox will alleviate the problems that occur from overuse of muscles in the head and neck.

Some believe that all headache types can be treated with Botox. Many medical sites including the Botox website state that chronic migraines can be treated with Botox.

I discussed headaches in my most recent blog. There is much misinformation even amongst medical professionals. I'm not entirely convinced Botox can alleviate the symptoms of migraines. The cause of migraines has nothing to do with the musculature. You can relax the muscles all you want, but since the pain has nothing to do with the musculature, the symptoms will not be relieved in this manner.

Blepharospasms and Strabismus

The muscles of the eyes or eyelids can sometimes be overworked and may spasm. Again, simply getting the muscles to relax will resolve the problems associated with these muscles.

Cervical Dystonia

This condition is also called Spasmodic Torticollis. This is a movement disorder where there is uncontrollable muscle contractions with repetitive movements and abnormal postures. There is no cure for the disorder. In the past, treatment has been palliative and has proven to be difficult. Now, Botox appears to be an excellent treatment option and has shown remarkable results.


The ability to sweat is important in regulating the body's temperature. Some people however suffer from excessive sweating of certain parts of their bodies such as the hands, feet, forehead and armpits. We call this condition "Hyperhidrosis".

Administering Botox just under the skin will reduce the signals for the sweat glands to excrete sweat.

Bladder Dysfunction

Many people suffer from a strong urge to urinate. The urge may occur frequently.  There may be leaking or wetting accidents on occasion. In these cases, Botox can be injected into the muscles of the bladder in adults with an overactive bladder.

Cerebral Palsy

The spastic muscles in children suffering from Cerebral Palsy have been successfully treated long before Botox was ever even used cosmetically.


I only mentioned a few conditions that could be treated successfully with Botox. In reality, there are hundreds of potential conditions that can be treated with Botox. If a problem arises from a muscle that is overstimulated or over-utilized, then the solution is simple......get the muscle to relax. Botox has proven to be incredibly safe and effective in therapeutic doses.

If you believe you suffer from an issue arising from excessive muscular contractions (or glandular secretions), see your healthcare professional and ask if Botox may benefit your condition.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit


Tuesday, March 11, 2014


There is so much confusion on the topic of headaches. There are different ways to classify headaches. Some ways are considered outdated and incorrect. Many headaches are often misdiagnosed. The National Institutes of Health published a nice synopsis. There are many other reputable sources of information regarding this topic.

Generally speaking, there are two types. Within each of these types, there are subtypes. The first type of headache is vascular (from blood vessels). The most common within this type is a Migraine. The second type of headache is muscular. These account for approximately 90% of all headaches.

Migraine Headache

Since this is the most common type of vascular headache, let's discuss migraines.

Migraine headaches can be differentiated from muscle tension headaches in several ways:
  • In many cases, there is a prodromal stage. This is were there is a sensation that it is about to start.
  • Pain is often described as intense and presents as a pulsing or throbbing sensation. The pain may be severe enough to incapacitate a person which may keep them from carrying out daily responsibilities.
  • The area of pain is most often on one side of the head (but can be on both sides).
  • There may be light or sound hypersensitivity.
  • The vast majority of migraine headache sufferers are women.
Muscle Tension Headache

As previously mentioned, most headaches (approximately 90%) are tension headaches. Many people misdiagnose themselves and incorrectly classify their headaches as migraines.

Tension headaches develop when excessive muscular contraction occurs in any of the muscles of the head and neck. This is primarily in the muscles associated with chewing. Check out the blog on clenching and grinding for additional insight. Head position or posture can cause prolonged and chronic contraction as well. The pain will then originate from a different set of overworked muscles.

I often tell my patients that if they were to exercise a muscle group for an hour each day, then that would be just fine. However, if they were to exercise for 10, 15, 20 or more hours each day, we can see why there would be pain associated with the involved muscles. Chronic muscle contraction from either clenching of the jaw or because of compromised posture, will predictably lead to chronic pain of the involved muscles. 

Other Headaches

There are other types of headaches such as cluster headaches, toxic headaches and sinus headaches. If you are suffering from chronic headaches or from intense headaches, then a consultation with your physician is indicated.  Your physician can diagnose the type of headache and the appropriate treatment can be rendered.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit