A lip tie, or upper lip tie, happens when the tissue connecting your baby’s upper lip to the gums limits how freely the lip can move. A tongue tie happens when the tissue under the tongue restricts its movement. In some infants, these restrictions can make feeding more difficult. If you’re concerned about a tongue or lip tie, we can assess your child and help determine whether treatment may be needed..
Often midwives and lactation consultants will identify the problem and refer your child to us. This is critical, because if left untreated either condition can lead to difficulties with breastfeeding, bottle feeding and eventually speech development.
If your infant has a tongue or lip tie, they may have difficulty latching during breastfeeding. Your baby may struggle to get a comfortable latch or have difficulty remaining latched.
When your baby has difficulty latching and staying on during breastfeeding they may not empty the breast or a bottle. In some cases, difficulty transferring enough milk may contribute to poor weight gain. If feeding difficulties are present, a tongue tie may be one of several possible factors to assess.
Difficulty sticking out the tongue or using it freely while eating can be signs of tongue tie. In older children, difficulty articulating certain speech sounds, such as “T”, “D” and “N”, may also be associated with restricted tongue movement.
An upper lip tie may sometimes be associated with a gap between the two upper front teeth, known as a diastema. Because spacing can also be a normal part of dental development in children, our pediatric dentists can assess the frenulum and determine whether it is affecting your child’s oral development.
Midwives and lactation consultants are often among the first healthcare professionals to notice signs of a possible tongue or lip tie, particularly when a baby is experiencing feeding difficulties. They may refer your child to us for further assessment. Early evaluation can help determine whether restricted tongue or lip movement is contributing to breastfeeding, bottle-feeding or other functional concerns and whether treatment is appropriate.
We assess the location and appearance of the frenulum along with how well your child’s tongue or lip is functioning. The Kotlow classification may also be used as part of this assessment.
If treatment is recommended, a laser may be used to release the restrictive frenulum and improve its range of movement. The appropriate treatment depends on your child’s age, anatomy, symptoms and functional needs..
It’s a simple and quick procedure.
Depending on the age, we may or may not use numbing gel or freezing. For a newborn lip tie or tongue tie, a medical condition called methemoglobinemia, which is triggered by exposure to local anesthetics, is a concern so we may not use numbing to prevent this medical emergency. Most babies just need lots of feeding and cuddling to control pain after the treatment. Some may need infant acetaminophen (Tylenol).
The open surgical site can take two to three weeks for full healing. We will see your child for a post-operative visit to confirm normal healing.
At Playtime Pediatric Dentistry, we take a careful, child-focused approach to tongue and lip tie assessment. We look at both the frenulum and how your child is feeding and functioning before recommending treatment. If a revision is appropriate, our pediatric dental team will explain the options, answer your questions and help make the experience as comfortable as possible for both you and your child.
Dr. Ella Choi
