david, It just so happens that just this evening I was speaking with a local dentist husband & wife team (she is a pediatric dental specialist in Troy Michigan, I spoke about in a earlier post) he is a local dentist of the future in Fraser Michigan, They has clipped tounge ties in some of my very young (week old or less) patients, as well as my 7 year old daughter, (I wish they were around when she was nursing) The best part is that baby is allowed (encouraged) to be put to breast right after the procedure if mom wants to. I have gotten permission to post their AOL address ( I have also warned them about the volume of questions they might get) : Dr David Apsey DDS & Dr Carol Beckert can be contacted via aol at [log in to unmask] The laser procedure usually takes less than 3 minutes (using a infared laser) there is virtually "no" blood it can be done with a local anestetic solution, but since it is so quick, it is not normally needed -- more trouble than its worth (you could ask my daughter about pain, she thought is was SO cool to be able to stick her tounge out at her sister a few minutes after the procedure). Mom or dad can help hold the baby still during the procedure and a few pulses of light later its done. Since the laser cauterizes the area while it cuts, the frenulum doesn't grow back together as readily as it might if it was clipped by another means, infection rates should be very low as well. As a side note it is a "really" neat procedure to be able to watch. In most cases the fee is around $100 or less depending on the time involved (this is reasonable for our area the "old" pedi who use to do clips in our area used to charge $75 three years ago, he retired, of course.) The procedure is asked to be paid for up front since insurance reimbersment is lacking in most cases, however, Dr Apsey has informed me that the rate of reimbursement is improving and in some cases its up from 15% to nearly 75% so the 3rd party payors may be starting to come around. Dr Carol Beckert is our local expert on Nursing caries and tounge ties, she did a very interesting and informative talk for our lactation professional organization. She would be the one to talk to about blaming caries on long term nursing. I happen to know she is advocate of the benefits of long term nursing. I am forwarding them copies of all the posts we have had in the last month about these two problems to bring them up to speed. Take care Anne Norton-Krawciw, RPh, IBCLC (the druggie - as my other half likes to call me - he is a pharmacist too.) [log in to unmask] PS: I am trying to interest Dr Carol to talk about one or both of these issues at our next ILCA conference, what do you all think of this idea.