At Lighthouse Kids Dental, we evaluate an infant or toddler for tongue tie and lip tie through a gentle, hands-on examination. This evaluation is typically quick and minimally uncomfortable, designed to be as stress-free as possible for little ones and their parents. We begin by asking the parents about any breast- or bottle-feeding difficulties, speech delays, or other symptoms that might indicate these issues are affecting the child's daily activities.
To check for tongue tie, we visually inspect the frenulum (the thin tissue connecting the tongue to the floor of the mouth) to see if it's unusually thick, tight, or attached too close to the tip of the tongue. We'll also observe how well the child can move their tongue by watching them try to lift it, stick it out, or move it from side to side. For infants, we might gently lift the tongue with a clean finger to get a better look, while toddlers might be asked to perform simple movements like trying to lick their lips or make certain sounds.
Although lip tie is not as common as tongue tie, this issue occurs when the tissue connecting the upper lip to the gums (called the labial frenulum) is too tight or thick. Assessing a child for lip tie is also simple. We gently lift the upper lip to see if the frenulum restricts the lip's movement or creates a gap between the front teeth. In infants, a tight lip tie might make it difficult for them to flange their upper lip properly during breastfeeding, while in toddlers, it could affect speech development or make it hard to clean the upper teeth properly.
If treatment is needed, our office may recommend a simple laser procedure called a frenectomy to release the tongue tie or lip tie. This minimally invasive treatment uses a soft tissue laser to gently cut the restrictive tissue, typically taking just a few minutes to complete. The laser procedure often requires little to no anesthesia, causes minimal bleeding, and heals quickly, allowing infants to breastfeed immediately afterward and helping toddlers regain full tongue and lip mobility for better eating, speaking, and oral hygiene.
Tongue-tie (ankyloglossia) and lip-tie are conditions in which the frenulum, a small band of tissue in the mouth, is unusually short, tight, or thick. Tongue-tie affects the tissue that connects the tongue to the floor of the mouth and can limit tongue mobility, while lip-tie involves the labial frenulum that connects the upper lip to the gums. Both conditions exist on a spectrum, and the degree of restriction varies from mild to functionally significant.
Not every tight frenulum requires treatment; the concern is whether the restriction interferes with feeding, speech, oral hygiene, or dental development. Clinicians assess both appearance and function to determine if a restriction is clinically important. A careful, hands-on evaluation helps distinguish a normal anatomic variant from a problem that warrants intervention.
In infants, common signs include breastfeeding difficulties such as poor latch, nipple pain for the parent, frequent popping off the breast, slow weight gain, or colic-like fussiness during feeds. Bottle-fed infants may struggle with efficient sucking or show prolonged feeding times and frequent air swallowing. For older children, symptoms can include speech sound disorders, difficulty sticking out or elevating the tongue, trouble licking lips, or challenges with oral hygiene that contribute to early gum recession or decay.
Because symptoms can be subtle, parents who notice persistent feeding or speech concerns should seek an evaluation rather than waiting. Early assessment allows the care team to identify whether the frenulum is contributing to the problem or if another issue is responsible. The evaluation can also connect families with supportive services such as lactation consultants or speech-language pathologists when appropriate.
At Lighthouse Kids Dental we perform a gentle, hands-on assessment that focuses on both anatomy and function. The clinician visually inspects the frenulum and observes how the child uses the tongue and lips during tasks like feeding, making specific mouth shapes, or producing certain sounds, and may gently assist movement for a clearer view. For infants, we often observe a feeding session or ask parents about breastfeeding or bottle-feeding challenges to understand functional impact.
The evaluation is typically quick and designed to minimize stress for both child and family, and the findings are discussed clearly with parents. If a restriction appears to be affecting feeding, speech, or oral health, we explain the options, expected outcomes, and the recommended next steps. When appropriate, we coordinate with lactation consultants or speech professionals to provide a comprehensive plan tailored to the child’s needs.
A frenectomy may be recommended when a frenulum restriction demonstrably interferes with feeding, speech, oral hygiene, or dental development and when conservative measures alone are insufficient. Indications in infants most commonly relate to persistent breastfeeding problems despite lactation support, while in older children the decision is based on functional limitations or speech articulation concerns. The clinician weighs the child’s age, severity of restriction, and the presence of related issues before recommending a procedure.
Shared decision-making with the family is central to the process, and recommendations are individualized rather than reflexive. When appropriate, we discuss non-surgical options, timing considerations, and the potential benefits and risks of a frenectomy. If the decision is made to proceed, we provide clear instructions on pre- and post-procedure care and coordinate any necessary multidisciplinary follow-up.
A laser frenectomy is a minimally invasive procedure that uses a soft-tissue laser to release the restrictive frenulum. The laser allows precise removal or modification of tissue with minimal bleeding, reduced swelling, and often a shorter procedure time compared with traditional scissors, which can be particularly advantageous for infants and young children. The procedure is usually brief and can be performed in the office setting when clinically appropriate.
Following the release, immediate improvements in tongue and lip mobility are common, and many infants are able to breastfeed right away, though responses vary. The practice provides clear aftercare guidance and follow-up to monitor healing and functional progress. Laser use is one tool among several, and the choice of technique is based on the individual child’s anatomy and the clinician’s experience.
Anesthesia needs vary by age and by the child’s comfort and medical needs; many infants undergo a frenectomy with topical numbing and gentle restraint, whereas older toddlers may require local anesthesia or conscious sedation. The treatment team discusses anesthesia options with parents and tailors a plan that prioritizes safety and comfort, taking into account the child’s medical history and anxiety level. For children with special health care needs or significant anxiety, additional sedation options or referral for treatment under general anesthesia may be considered.
Pain after a frenectomy is generally mild and can be managed with recommended nonprescription analgesics as directed by the clinician, along with supportive measures such as cold compresses and soft, soothing feeds. We provide explicit post-procedure instructions and follow-up to ensure comfort and appropriate healing. Any unexpected pain or signs of infection should prompt a prompt clinical contact for assessment.
Recovery from a frenectomy is typically quick, with most children returning to normal feeding and activities within a few days to weeks depending on age and individual healing. Aftercare commonly includes short nerve-sparing stretching or mobility exercises to prevent reattachment and to encourage full range of motion, and these exercises are demonstrated to parents before discharge. Maintaining good oral hygiene and observing the healing site for excessive swelling or redness is part of routine care.
Follow-up appointments are scheduled to monitor healing, assess function, and adjust home exercises as needed. The practice provides written aftercare instructions and will coordinate with any allied professionals such as lactation consultants or speech therapists for continued support. If parents notice persistent difficulty with feeding, speech, or unusual symptoms, they should contact the office for timely evaluation.
Many infants are able to breastfeed immediately or within a few hours after a frenectomy because the tongue gains increased mobility right away, allowing for a more effective latch. Improvements often include less nipple pain for the parent, better latch mechanics, reduced air swallowing, and more efficient milk transfer, though individual responses vary and some infants require time and additional lactation support to relearn effective feeding patterns. Close collaboration with a lactation consultant before and after the procedure helps maximize the feeding outcome.
Parents should expect gradual functional gains rather than instant perfection in every case, and ongoing support can help address lingering challenges. The clinician and lactation team monitor weight gain, feeding efficiency, and comfort during follow-up visits. If feeding difficulties persist despite an adequate release, the care team evaluates for other contributing factors such as tongue tone, oral hypersensitivity, or anatomical issues unrelated to the frenulum.
In older children, a restrictive frenulum can contribute to articulation errors, difficulty producing certain sounds, limited tongue elevation, and challenges with oral hygiene that may affect dental development. A frenectomy can improve tongue and lip mobility, which may facilitate clearer speech production and make brushing and flossing easier. Speech improvement often depends on a combination of increased mobility and targeted speech therapy to retrain oral motor patterns.
Following a frenectomy, coordination with a speech-language pathologist is beneficial when speech concerns exist, and the clinician provides referrals when appropriate. Dental monitoring also helps assess changes in tooth spacing, gum health, and eruption patterns after release. The multidisciplinary approach ensures that surgical release is coupled with functional rehabilitation for the best long-term outcomes.
Optimal care for tongue-tie and lip-tie often involves a multidisciplinary team that may include the pediatric dentist or pediatrician, a lactation consultant for feeding concerns, a speech-language pathologist for speech and oral motor therapy, and occasionally an otolaryngologist or orthodontist for complex cases. Collaboration among these professionals ensures that both structural issues and functional needs are addressed, and it helps families receive coordinated, evidence-based recommendations. The practice works with local specialists and therapists to facilitate timely referrals and comprehensive care when needed.
Parents benefit from a clear plan that outlines roles, expected timelines, and follow-up steps so progress can be measured and adjustments made as necessary. Communication between providers and with the family is emphasized to support recovery and functional improvement. If you have questions about which specialists might be helpful for your child, the office staff can guide you to experienced local resources and coordinate referrals.
