Janet Simpson, here's how Dr. Greg Notestine DDS does a frenotomy:
He examines baby with gloved fingers and has mom describe what's going on.
Then he scores the baby using Alison Hazelbaker's assessment tool, which he
says just confirms what he's already decided clinically. If mom agrees to the
procedure, he goes ahead.

Mom reclines in the dental chair with baby on her chest facing the same way
she is. Mom holds baby's hands/arms and body. Someone holds baby's head. Greg
lifts and stabilizes the tongue with his left hand. He takes a sterile
scissors with his right hand and clips the frenulum, usually in the middle.
Mom immediately sits upright and puts the baby to breast.  That's all. The
exam takes about 15-30 minutes, the clip takes less than 5 minutes, rarely is
there any bleeding, and some babies sleep through it. Sometimes he uses a
curved scissors, sometimes straight. I have personally observed (and
sometines videotaped) babies ranging from 4 days to 2 years old being
treated. Boys outnumber girls by a wide margin - I recall 2/3 to 1/3 but
don't quote me on that.

Usually the babies nurse well immediately, and mom notices the difference
which can be dramatic. One mom said "Wow - no more sandpaper!" On a very few
occasions, the baby's suck will still need some work which a LC supervises.

Linda Smith, Dayton OH private practice