If your baby struggles to latch, clicks while nursing, or seems frustrated at every feed, you may have heard the words "tongue tie." Tongue and lip ties are common, and they're also often misunderstood. Here's what they are, the signs to watch for at different ages, and how they're treated.
What is a tongue or lip tie?
Everyone has small bands of tissue called frena (one is a frenum) that connect the tongue to the floor of the mouth and the lips to the gums. In some children, these bands are unusually short, tight or thick. That can limit how well the tongue or lip moves.
When that restriction causes problems with feeding, speech, eating or sleep, it's called a tongue tie or lip tie. Together these are known as tethered oral tissues.
A tongue tie affects the band under the tongue. It can limit lifting and extending the tongue.
A lip tie affects the band between the upper lip and the gums. It can limit how far the lip lifts and flares.
Not every visible frenum is a problem. What matters is function: whether the tissue is actually getting in the way of what your child needs to do.
Signs in infants
Feeding is usually where tongue and lip ties show up first. Signs include:
Difficulty latching or staying latched, at the breast or bottle
Clicking or smacking sounds while nursing
Long feeds, or a baby who seems hungry again soon after
Poor weight gain
Reflux or colic-like symptoms
Excessive gas or fussiness
Nursing parents may notice sore or damaged nipples, or pain that doesn't improve with latch help.
Signs in older children
Some ties aren't noticed until later, when they can affect eating, speech and sleep:
Speech: difficulty with sounds like S, Z, T, D, L and R, or speech that's hard to understand
Eating: slow or picky eating, food packing in the cheeks, gagging or choking on some textures
Sleep: snoring, mouth breathing, restless sleep or nighttime teeth grinding
These signs can have other causes too, which is why a careful exam matters.
How tongue and lip ties are treated
When a tie is causing real problems, the usual treatment is a frenectomy: a quick procedure to release the tight tissue.
At First Smile we use a CO2 laser for frenectomies. Compared with traditional methods, a laser release typically means:
Minimal discomfort after the procedure
Less bleeding and swelling
Faster healing
A quick visit that usually doesn't need sedation
After a release, we'll show you simple stretching exercises to do at home while the area heals. These help keep the tissue from reattaching as it heals. For feeding or speech concerns, we may also suggest working with a lactation consultant, feeding therapist or speech-language pathologist so your child gets the full benefit.
When to have your child evaluated
Consider an evaluation if:
Feeding is painful or difficult and hasn't improved with lactation support
Your baby isn't gaining weight as expected
A speech therapist, pediatrician or lactation consultant has mentioned a possible tie
Your older child has ongoing speech, eating or sleep concerns
An exam doesn't commit you to treatment. Dr. Morrow will look at how your child's tongue and lips move, talk through what you're seeing at home, and give you an honest recommendation. Sometimes that's a release, and sometimes it's simply watching and waiting.
Frenectomy in Middletown and Dover
First Smile Pediatric Dentistry offers gentle laser frenectomy for infants and children at both of our Delaware offices. Learn more on our frenectomy page, or request an appointment. You can also call Middletown (302) 376-3750 or West Dover (302) 734-0330.