As pediatric dental specialists, we often meet parents who feel concerned about their infant's ability to breastfeed or, as their child grows, about speech development. Lip ties and tongue ties can sometimes cause these challenges. The terms sound similar, but they describe two distinct issues involving small bands of tissue in the mouth called frenula. When you understand the difference, you take the first step toward finding the right solution for your child’s oral development.
Parents often have many questions during the early stages of raising a child, and oral health plays a big part in that journey. We want to provide answers so you feel confident about your child’s health. In this guide, we explain what lip ties and tongue ties are, how you can spot them, and what steps you can take for your child. Our goal is to give you the tools you need to support your child’s health and happiness from day one.
What is a Frenulum?
Everyone has several frenula (the plural of frenulum) in their mouth. These small folds of soft tissue connect and support the movement of different parts of the mouth. You can use your tongue to feel one now; it’s the tissue connecting the underside of your tongue to the floor of your mouth. Another connects your upper lip to the gum right above your front teeth, and you’ll find a similar one for the lower lip. These frenula play a crucial role in speaking, eating, and swallowing.
The Role of Oral Tissues
The frenula keeps the mouth stable without restricting movement. The lingual frenulum (under the tongue) guides tongue growth and movement, while the labial frenula anchor the lips to the jaw. Most of the time, these tissues remain thin and flexible, letting you move your tongue and lips freely.
When a Frenulum Causes Problems
Problems occur when a frenulum grows unusually thick, short, or tight. When a frenulum tethers the tongue or lip too closely, it limits movement. We call this issue a "tie." A lip tie involves the labial frenulum connecting the lip to the gums, while a tongue tie—also known as ankyloglossia—involves the lingual frenulum under the tongue. These restrictions can disrupt vital activities, especially in infants who need precise lip and tongue movements for nursing.
Defining a Tongue Tie (Ankyloglossia)
A tongue tie—ankyloglossia—happens when a shorter or tighter lingual frenulum restricts tongue movement. The band of tissue connects the bottom of the tongue’s tip to the floor of the mouth, which makes it hard for a child to lift the tongue or move it from side to side. Tongue ties range from mild to severe, sometimes causing the tongue to appear joined at the base of the mouth.
Common Signs and Symptoms of a Tongue Tie
Infants with tongue ties show signs most clearly during feeding. Babies who cannot move the tongue freely struggle to latch during breastfeeding and often have a shallow latch. These challenges create problems for both the baby and the mother.
- For the Baby: Signs include poor weight gain, fussiness during and after feedings, clicking sounds during nursing, difficulty staying on the breast, and difficulty clearing milk from the mouth.
- For the Mother: Moms may have nipple pain, cracked or bleeding skin, and sometimes mastitis or blocked milk ducts due to inefficient latching.
As children grow, untreated tongue ties can lead to new difficulties. Toddlers and older children may find speech challenging—mainly when producing sounds that require tongue elevation, such as "t," "d," "l," and "th." Eating presents challenges, too. Children may have trouble moving food around for proper chewing or cleaning their mouths with their tongue.
Defining a Lip Tie
Lip ties happen when a thick or stiff labial frenulum connects the upper lip to the gum line. This tissue limits upper lip movement, making it hard for the lip to curl outward. Everyone has a labial frenulum, but a lip tie occurs when the tissue interferes with movement and function. Experts often classify lip ties based on where the frenulum attaches, and some even extend between the two front teeth.
Common Signs and Symptoms of a Lip Tie
Like tongue ties, significant lip ties affect breastfeeding. For a healthy latch, infants need to open their lips wide and curl them out around the areola. A tight lip tie stops this, causing the upper lip to curl in instead.
- For the Baby: Signs include a poor latch, clicking noises during nursing, milk dribbling from the mouth, and, sometimes, a callus or blister on the upper lip from friction.
- For the Mother: Moms experience nipple pain and pressure due to the baby's inability to create a good seal.
In older children, severe lip ties may create a gap (diastema) between the two top front teeth. Brushing may also become more difficult, as a tight lip makes it harder to reach the teeth and gums for cleaning. Plaque buildup and tooth decay become more likely in that area. Lip and tongue ties often appear together, and their effects can compound feeding problems. Our professionals diagnose these conditions by assessing the function, not just the appearance, of the frenulum. If a frenulum restricts movement and interferes with feeding or speech, a simple and effective treatment, such as frenectomies for lip and tongue tie, can help release the tissue and restore proper function.
How We Can Help
When we diagnose a lip or tongue tie that interferes with movement or feeding, we recommend a frenectomy. In our office, we use a laser for this simple procedure to release the tight tissue. The laser provides a near-painless experience, minimal bleeding, and a shorter recovery compared to older methods. We finish the frenectomy in less than a minute. When we treat infants, we use only local anesthetics and make sure your child stays comfortable every step of the way. We also give you precise, specific aftercare instructions—including stretches to help your child regain their new movement and to keep tissue from reattaching. You can count on our team to guide and support your family from diagnosis to post-procedure care.
Frequently Asked Questions About Frenectomies for Lip and Tongue Tie
How do I know if my baby needs a frenectomy?
Function—not just appearance—guides the decision for a frenectomy. Many babies have visible frenula that do not cause any problems. Schedule a consultation if your baby has difficulty latching, gains weight slowly, makes clicking sounds while feeding, or if you experience nipple pain during nursing. Our pediatric dentists carefully examine your child’s tongue and lips to check the range of motion and decide whether a tie causes feeding problems.
Is a frenectomy painful for an infant?
We make sure your child feels as comfortable as possible. We use a topical anesthetic to numb the area before we begin. The laser frenectomy lasts only a few seconds. Babies may feel a minor, brief discomfort—much like a scraped knee—but most settle quickly and can nurse for comfort right after the procedure. Most infants bounce back rapidly with little fussiness.
At ABQ Pediatric Dentistry, we focus on creating a positive, comfortable dental experience for children in Albuquerque and surrounding communities. Our team tailors care to the unique needs of infants, children, and teens. If you feel concerned about a possible lip or tongue tie, please get in touch with us to schedule a consultation.