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