Tongue and Lip Ties

Tongue and Lip Ties (ankyloglossia and aberrant frenum)

Tongue and Lip Tie Symptoms

Everyone has a lip and tongue frenum, but only those that restrict normal movement and/or cause symptoms are considered “tied”. The following symptoms may indicate the presence of a tongue or lip tie, but a full in-person assessment is required to diagnose. Many symptoms can also have other causes, so it is important to have a complete functional exam.

Possible symptoms for breastfeeding parents

  • cracked, blistered or bleeding nipples
  • pinched or “lip stick” shaped nipples after nursing
  • plugged ducts or mastitis
  • pain or discomfort while nursing
  • baby slips off during feeding
  • thrush
  • low milk supply

Possible symptoms for baby

  • reflux or colic
  • difficulty latching
  • gumming or chewing nipples or bottles
  • gassiness
  • poor weight gain
  • clicking while nursing
  • excessively long nursing sessions

Possible symptoms in children or adults

  • difficulty pronouncing L, T, D, N, Sh, Th, or S
  • inability to touch tongue to roof of the mouth
  • problems moving tongue side to side or clearing food from the teeth
  • snoring or sleep disturbances
  • dental problems- cavities, recession, gaps

Preparing for your visit

Before the procedure:

All breastfeeding infants/children should be seen by a qualified International Board Certified Lactation Consultant (IBCLC) prior to the release procedure and non-breastfeeding babies/children and all adults should be seen by an IBCLC, qualified Speech Language Pathologist (SLP), feeding specialist or Oral Myofunctional Therapist (OMT) prior to release. Please ask your provider to send a report to us prior to your appointment date.

For your convenience, we are pleased to offer Myofunctional Therapy in our office with Cindy, our Certified Orofacial Myologist.

Most patients begin oral exercises given to them by their IBCLC/SLP/OMT prior to being seen in our office and most patients require bodywork from a skilled provider (Chiropractor, CST, PT, OT) to address tensions throughout their system both before and after release.

Please bring any pain management remedies you plan to use to your appointment. These may include homeopathy, Tylenol, Ibuprofen, or other remedies. Please discuss your plan for pain management with your primary care providers prior to your appointment with us. We ask that infants refrain from feeding for 1 hour prior to their appointment.

Paperwork (click for links to pdf printable forms):

During the procedure:

The release itself is a simple procedure performed in-office without the need for general anesthesia (being put to sleep). Toddlers and some very strong infants may require the use of sedation which is not available in this office. We can provide these children with a referral.

Unfortunately, parents or visitors are not allowed in the room during the procedure due to office safety regulations, but babies are typically only separated from caregivers for 3-5 minutes or less.

We start by using a specially compounded topical anesthetic (“numbing jelly”) on the frenum. After the numbing jelly is placed, babies are swaddled and stabilized in our dental chair by an assistant to minimize movement during the procedure. Older children may receive an injection of local anesthetic.

A LASER is used to complete the release procedure which takes about 15-20 seconds or less per site. Babies do cry during the procedure, but they are typically soothed very quickly afterward.

After the procedure:

Babies are returned to their family to nurse or soothe immediately following treatment and are welcome to stay as long as needed. Dr. Wehmeyer will assist with initial feeding/nursing and soothing.

Post-procedure wound care is very important for patients of all ages to help prevent the sticky edges of the wound from reattaching back to where they started. Please read and follow wound care instructions from Dr. Wehmeyer and other providers carefully. In addition, Dr. Wehmeyer and your IBCLC or OMT may recommend specific oral exercises to help your child gain proper function.

Home Care Instructions (click title for link to printable pdf):

Dr. Wehmeyer generally sees patients back for 1 or 2 follow up visits to check on wound healing and improvement in function. These can sometimes be completed via Zoom.

Careful follow up with your IBCLC, bodyworker and other referring providers is critical to success.

Would you like to learn more?