Frequently Asked Questions about Tongue-Tie & Lip-Tie

A tongue-tie is a condition where the thin strip of tissue under the tongue (the frenulum) is unusually short or tight. Every baby has a frenulum, but in the case of a tongue-tie this tissue keeps the tongue tethered close to the floor of the mouth. You might notice that your child’s tongue doesn’t move freely – for example, they may not be able to stick their tongue out past their lower lip or lift it up very high. Visually, you may see a band of tissue when they lift their tongue or cry, and the tongue might even look heart-shaped at the tip because the frenulum is pulling it down. In short, a tongue-tie often appears as if the tongue is “tied” to the bottom of the mouth by a small cord-like tissue.

No – not every baby is born with a tongue-tie. While all infants have a frenulum under the tongue, only a relatively small percentage have one that is tight or thick enough to cause problems. In those cases, we call it a tongue-tie. It’s estimated that roughly 5% to 10% of babies are born with a significant tongue-tie. Most newborns do not have this issue. Tongue-ties tend to occur unpredictably (sometimes they run in families), but it isn’t something that happens to all children.

Tongue-ties can lead to noticeable symptoms, especially when the child tries to eat or speak. Here are some common signs to watch for:

• Feeding difficulties in infants: Babies with a tongue-tie may have trouble breastfeeding or bottle-feeding. They might struggle to latch deeply, slip off the nipple frequently, or make a clicking sound while nursing. Feeding can be prolonged, and the baby may seem fussy or get tired during meals. (Mothers may also experience pain or sore nipples due to a shallow latch.)
• Poor weight gain: Because of feeding challenges, some infants with a tongue-tie may not gain weight as expected or may seem unsatisfied even after long feedings.
• Speech development issues: As the child grows, a tongue-tie can sometimes affect speech. Toddlers or older children might have difficulty with certain sounds (like “t,” “d,” “r,” or “l”) or their speech may be unclear if the tongue’s movement is restricted. Not all tongue-tied children have speech problems, but it can be a concern if the tie is severe.
• Limited tongue movement: You might notice your child can’t stick their tongue out very far, or they can’t lift it to touch the roof of their mouth. They may not be able to lick their lips or ice cream easily. Often, the tongue may look notched or heart-shaped at the tip when they try to stick it out – this is a telltale sign of a tight frenulum.
• Difficulty with oral hygiene or eating older foods: In some cases, a tongue-tie can make it harder for a child to sweep food debris from their teeth or chew certain foods comfortably. They might be picky eaters or avoid foods that are hard to manipulate in the mouth.

(If you suspect a tongue-tie based on these signs, it’s a good idea to have your child evaluated. Our dental team can quickly tell if a tongue-tie or lip-tie is present and discuss whether treatment is needed.)

Not always. Treatment is recommended only when the tongue-tie is causing problems. If your child’s tongue-tie is mild and isn’t interfering with feeding, speech, or oral health, we may take a conservative “wait-and-see” approach. Many children with minor tongue-ties grow and adapt without any issues, so an immediate procedure wouldn’t be necessary in those cases. However, if the tongue-tie is causing significant challenges – for instance, your baby can’t nurse properly, or an older child has speech difficulties – then treating it can greatly improve their quality of life. Our team will carefully evaluate your child’s specific situation. We work with parents (and often pediatricians, lactation consultants, or speech therapists) to determine if a procedure is needed. Remember, the goal is to ensure your child can eat, speak, and thrive comfortably, so we only recommend treatment when it’s truly beneficial.