What Are Tongue-Tie and Lip-Tie?

Tongue-tie (ankyloglossia) and lip-tie happen when the thin band of tissue connecting the tongue to the floor of the mouth, or the lip to the gums, is tighter or shorter than usual. Nearly every baby has this tissue, called a frenum. The question isn’t whether it exists — it’s whether it’s restricting movement enough to interfere with feeding, speech, or oral development.

Tongue-tie and lip-tie are common, affecting an estimated 4-10% of newborns, and they range from mild to severe. A mild tie might never cause a problem. A more restrictive one can make it hard for a baby to latch, transfer milk efficiently, or eventually move the tongue and lips the way they need to for speech and eating.

Signs to Watch For in Newborns

Because babies can’t tell us what’s wrong, parents and pediatric providers have to read the clues. Some of the most common signs of a restrictive tongue-tie or lip-tie during the newborn feeding period include:

• Difficulty latching or staying latched during breastfeeding or bottle-feeding
• Clicking sounds while nursing (a sign the latch keeps breaking)
• Slow weight gain or frequent, marathon feeding sessions
• Milk dribbling out of the corners of the mouth during feeds
• A mother experiencing significant nipple pain, cracking, or a shallow latch
• A baby who seems gassy, colicky, or fussy after eating, often from swallowing extra air

 

Signs in Older Babies and Toddlers

Not every tongue-tie is caught in the newborn nursery. Sometimes it shows up later, once a child is eating solids or starting to talk. In older infants and toddlers, a restrictive tie can look like picky or gaggy eating with textured foods, trouble sticking the tongue out past the lips, a tongue that looks heart-shaped when lifted, mouth breathing, or speech sounds that are hard to form — especially sounds like ‘t,’ ‘d,’ ‘l,’ ‘r,’ and ‘th,’ which all require the tongue tip to lift and move freely.

A lip-tie on its own (without a tongue-tie) is less commonly linked to feeding trouble, but a very tight upper lip frenum can sometimes contribute to a gap between the front teeth later on, or make it harder to keep the front teeth clean, which can raise cavity risk.

How It’s Diagnosed

Diagnosing a tongue-tie or lip-tie isn’t just about how the tissue looks — function matters just as much as appearance. At Big Sky Pediatric Dentistry, our board-certified pediatric dentists evaluate how the tongue and lips actually move: how high the tongue lifts, how far it extends, and whether the restriction is actually the source of the feeding or speech difficulty a family is describing. We also talk with parents (and, when helpful, with a lactation consultant or speech-language pathologist already involved in a baby’s care) to get the full picture before recommending treatment.

Laser Frenectomy: A Gentle, Quick Procedure

When a tongue-tie or lip-tie is significant enough to warrant treatment, a frenectomy — releasing the tight tissue — is a simple, well-established procedure. We use a soft-tissue laser rather than scissors or a scalpel, which offers several advantages for babies specifically: minimal bleeding, less swelling, and a shorter procedure time, often just a few minutes.

Most infants are back to nursing or bottle-feeding within minutes of the procedure, and many parents notice an improvement in latch and feeding comfort right away, though it can take a little time and practice for feeding patterns to fully adjust. We’ll walk you through simple aftercare stretches to do at home for the first couple of weeks, which help the tissue heal in a way that keeps it from reattaching too tightly.

When to Schedule an Evaluation

If breastfeeding is painful, your baby is struggling to gain weight, or your pediatrician, lactation consultant, or your own gut feeling has flagged a possible tongue- or lip-tie, it’s worth having it looked at — the earlier the better for feeding, though older children benefit from treatment too, especially when speech or eating is affected. Big Sky Pediatric Dentistry evaluates and treats tongue-tie and lip-tie at our Kalispell, Whitefish, Polson, and Libby locations, with appointments built around what’s easiest for you and your baby.

Frequently Asked Questions

Does every baby with a tongue-tie need treatment?

No. Many mild tongue-ties never cause a feeding, speech, or dental problem and don’t need to be released. Treatment is recommended when the tie is actually restricting function, not simply because the tissue is present.

Is a laser frenectomy painful for my baby?

The procedure is very quick and most babies tolerate it well, often crying more from being held still than from the treatment itself. We use numbing gel and gentle technique, and babies typically calm down and feed again within minutes.

How do I know if it’s a tongue-tie or just a normal feeding struggle?

Many feeding difficulties aren’t related to a tie at all. That’s exactly why a hands-on evaluation matters — we assess actual tongue and lip movement rather than guessing from symptoms alone.

Can tongue-tie affect speech later even if feeding was fine as a baby?

Yes. Some children feed adequately as infants but develop speech sound difficulties later as more complex tongue movements are needed. This is one reason we also evaluate older children who weren’t diagnosed as newborns.

What does aftercare involve?

We’ll show you simple stretching exercises to do a few times a day for about two weeks, which help the area heal without reattaching. We’re also available to answer questions during recovery.

Do you work with lactation consultants?

Yes, we’re glad to coordinate with your lactation consultant, pediatrician, or speech-language pathologist to make sure treatment fits into your baby’s overall care plan.

This article is provided for general educational purposes and is not a substitute for personalized dental advice. Please contact Big Sky Pediatric Dentistry to discuss your child’s specific needs.