Lip-tie and tongue-tie are conditions that occur when the tissues connecting the lips or the tongue to the mouth are too tight, short, or thick. Medically known as “ankyloglossia” when involving the tongue, these restrictions can affect a child’s ability to breastfeed, eat, speak, and maintain oral hygiene. In some cases, the tight tissue creates tension that impacts jaw and facial development. At Dentistry for Children and Young Adults in San Jose, CA, Dr. Shawn Taheri, DDS, frequently evaluates children for these conditions, especially those experiencing difficulties in feeding, speech development, or oral health maintenance.
A lip-tie specifically involves the piece of tissue connecting the upper lip to the gum, known as the labial frenulum. A tongue-tie involves the lingual frenulum under the tongue. Although some children may have these attachments without problems, others experience significant functional limitations that require attention. Early diagnosis is important because untreated restrictions can lead to long-term complications.
How Lip and Tongue-Ties Affect Children
The presence of a significant lip or tongue-tie can lead to a range of challenges for infants, toddlers, and older children. In infants, difficulties often include trouble latching during breastfeeding, prolonged feeding times, or inadequate weight gain. Mothers may also experience discomfort during breastfeeding due to poor latch mechanics. As children grow, speech delays, difficulty with certain sounds, and problems with eating solid foods can become more apparent.
Beyond immediate functional concerns, untreated tongue or lip-ties can affect dental development. Tight attachments may pull on the gums, contributing to gaps between the front teeth or affecting how the jaws grow. In children with special needs, these conditions can complicate feeding therapy and speech development even further. Dr. Taheri emphasizes the importance of early evaluation to determine if intervention could improve oral and overall health outcomes.
Signs That May Indicate a Problem
Recognizing the signs of a problematic lip or tongue-tie can help parents and caregivers seek timely care. Some signs to watch for include:
- Difficulty breastfeeding or bottle-feeding
- Speech delays or unclear speech in toddlers and older children
- Inability to lift the tongue freely or touch the roof of the mouth
- Clicking sounds while feeding
- Pain for breastfeeding mothers
- Trouble transitioning to solid foods or picky eating
- Large gap between the front teeth (diastema)
- Frequent gagging, choking, or reflux-like symptoms
While not every child with these signs will require a release procedure, a thorough evaluation by a knowledgeable pediatric dentist like Dr. Taheri is essential in determining the best course of action.
The Treatment Process: What to Expect
If a lip-tie or tongue-tie is diagnosed as problematic, a simple procedure known as a frenectomy may be recommended. A frenectomy involves releasing the tight tissue to allow for greater movement and function. The procedure can often be performed in a pediatric dental office using specialized tools such as soft tissue lasers or surgical scissors, depending on the severity and the dentist’s preferred technique.
The process typically begins with a comprehensive consultation, including an oral exam and possibly imaging if needed. Once a treatment plan is in place, the release itself is usually quick, often taking just a few minutes. Topical anesthetics or local anesthesia help minimize discomfort, and in most cases, there is little to no bleeding. After the procedure, parents are instructed on aftercare, including stretching exercises to prevent reattachment and facilitate healing. Dr. Taheri ensures families are fully supported throughout the recovery process, including personalized follow-up visits.
Benefits of Lip and Tongue-Tie Release
Performing a lip or tongue-tie release at the appropriate time can have immediate and long-lasting benefits for children and their families. In infants, feeding often improves dramatically within a few days, allowing for more effective breastfeeding or bottle-feeding and greater weight gain. Mothers may also find breastfeeding much less painful after the release.
In older children, releasing the restrictive tissue can support clearer speech development and more effective chewing and swallowing patterns. Dental benefits include reduced risk of gum recession, better spacing of teeth, and improved ability to maintain oral hygiene. For children with special needs, resolving these restrictions can remove barriers to therapy progress and contribute to improved daily functioning.
Special Considerations for Children with Special Needs
Children with developmental or medical complexities may experience unique challenges related to lip or tongue-ties. In these cases, careful assessment and a multidisciplinary approach involving speech therapists, feeding specialists, and pediatric dentists are often recommended. Dr. Shawn Taheri, DDS, has extensive experience working with children with special needs and tailors treatment plans based on individual needs and abilities.
Special care may be required during the evaluation and procedure to ensure that the child feels safe and supported. Sensory sensitivities, communication differences, or medical complexities are always considered when planning a frenectomy. Postoperative support may also involve customized stretching techniques or additional therapeutic assistance to maximize the benefits of the release and promote smooth healing.
When a Lip or Tongue-Tie Release May Not Be Necessary
Not all lip or tongue-ties require surgical intervention. Some cases may involve minimal restriction that does not significantly affect function. In these situations, a “watch and wait” approach is often appropriate, with regular monitoring during dental check-ups. If the child is feeding well, speaking clearly, and maintaining good oral hygiene, active treatment may not be necessary.
Parents are encouraged to discuss any concerns with Dr. Taheri during routine dental visits. By carefully monitoring changes and development over time, the dental team can ensure that interventions are only performed when they are clearly beneficial. A personalized approach helps prevent unnecessary procedures while still ensuring children’s oral and overall health needs are met.
Resources:
- Amir, L. H., & James, J. P. (2011). Tongue-tie, breastfeeding difficulties, and the role of frenotomy. Pediatrics.
- Buryk, M., Bloom, D., & Shope, T. (2011). Efficacy of neonatal release of tongue-tie. Pediatrics.
- Knox, I. (2010). Tongue Tie and its impact on breastfeeding. Australian Breastfeeding Association.
