Tongue-Ties and Lip-Ties: What Parents Need to Know

Understanding oral restrictions, function, therapy, and your treatment options 

By Dr. Kelly Betts

If your child has been diagnosed with a tongue-tie or lip-tie, you probably have questions. Can it affect feeding? Does it need to be treated? Will it cause speech problems? Will my child outgrow it? 

You are not alone in asking these questions, and you do not have to figure out the answers by yourself. At Integrative Dental Wellness in Eldersburg, Maryland, we take time to evaluate each child individually and help families understand whether treatment is truly needed or whether observation is the better path. 

Here is what every parent should understand about tongue-ties and lip-ties. 

What Is a Tongue-Tie? 

Every child has a lingual frenulum. That is the small band of tissue connecting the underside of the tongue to the floor of the mouth. It is normal anatomy. 

A tongue-tie, also called ankyloglossia, occurs when this tissue is unusually tight or short and restricts the tongue is normal movement. When that happens, it can affect feeding, swallowing, and in some cases, speech development. 

The key question is not whether the frenulum looks prominent. The key question is whether it is restricting function. 

What Is a Lip-Tie? 

The labial frenulum connects the inside of the upper lip to the gums. Its size and attachment vary widely from child to child, and nearly everyone has one. 

A lip-tie is the term used when this tissue is thought to restrict upper lip mobility or contribute to a feeding or dental concern, like causing a gap between teeth or limiting your ability to brush along the gumline. Like tongue-ties, the decision to treat a lip-tie should be based on whether it is causing a real functional problem, not just how it looks. 

How Is a Tongue-Tie or Lip-Tie Diagnosed? 

A thorough evaluation looks at both structure and function. Depending on your child is age, this may include observing tongue and lip movement, feeding patterns, swallowing, and overall oral posture. 

For infants, a feeding evaluation with a lactation consultant or feeding specialist is an important part of the process. Many breastfeeding difficulties have causes unrelated to tongue-tie, and a proper feeding assessment helps distinguish what is actually going on. 

For older children and adults, diagnosis may involve collaboration among a dentist, speech-language pathologist, orofacial myofunctional therapist, and other specialists. 

What Problems Can a Tongue-Tie Cause? 

Effects vary widely. Some children have obvious restrictions but function perfectly well. Others compensate in subtle ways and develop difficulties over time. Problems may include: 

Infants: 

• Difficulty latching onto the breast or bottle 

• Poor milk transfer or long, difficult feedings 

• Excessive gas 

• Nipple pain for breastfeeding parents 

• Fussiness during feeding or falling asleep before finishing 

Children and teens: 

• Difficulty with certain speech sounds 

• Chewing and swallowing challenges 

• Food frequently getting stuck in the teeth 

• Mouth breathing or poor lip seal at rest 

• Acid reflux or gagging 

• Clenching or grinding teeth 

• Poor sleep quality or signs of sleep-disordered breathing 

It is important not to assume that every feeding, speech, sleep, or developmental concern is caused by a tongue-tie. A careful, whole-child evaluation is the only way to know for sure. 

What Role Does Therapy Play? 

Increasing the range of motion in the tongue does not automatically teach the tongue how to use that new movement correctly. That is what therapy is for. 

Orofacial myofunctional therapy, often called OMT, works like physical therapy for the tongue and swallowing muscles. It helps children and adults learn better oral patterns involving the tongue, lips, jaw, and face. Depending on the individual, therapy may address tongue awareness, lip seal, swallowing patterns, and appropriate tongue posture at rest. 

For some children, therapy alone is enough to resolve functional concerns. For others, therapy before a frenectomy helps establish good movement patterns that make the outcome more successful. 

Does My Child Need Treatment? 

Not every tongue-tie or lip-tie requires intervention. Many children have visible restrictions with no symptoms at all. In those cases, observation is often the right approach. 

When treatment is genuinely indicated, it should be based on three things: 

• A real anatomical restriction is present 

• A meaningful functional problem exists 

• There is a reasonable expectation that improving mobility will help 

The goal of treatment is not simply to cut tissue. The goal is to improve a specific function that matters to the child and family. 

Surgery should never be performed solely to prevent hypothetical future problems. And it should never be based on appearance alone. Current guidance from the American Academy of Pediatrics does not support frenotomy in infants solely to prevent future speech or sleep concerns. 

A Team Approach Works Best 

Oral restrictions rarely involve anatomy alone. Feeding, speech, swallowing, muscle patterns, and dental development often all play a role. The right care team might include a pediatric dentist, pediatrician, ENT, lactation consultant, speech-language pathologist, or orofacial myofunctional therapist. 

At Integrative Dental Wellness, we help families navigate these decisions with clarity and without pressure. We will never recommend treatment that is not truly needed, and we will make sure you understand all of your options before deciding anything. 

Ready to Talk About Your Child? 

If you have questions about tongue-ties, lip-ties, or your child is overall oral health, we welcome you to schedule a consultation. We serve families in Eldersburg, Sykesville, Marriottsville, and the greater Carroll County area. 

Book online: dentalwellnessmd.com 

Call: (443) 776-1836 

Location: 1330 Liberty Rd Suite C, Eldersburg, MD 21784 

Disclaimer: This information is for general educational purposes only and is not a substitute for an individualized examination or treatment recommendation. Our team will provide specific guidance based on your child is unique needs.