Tongue-Tie & Lip-Tie

What are tongue- and lip-tie and how are they treated?

What causes tongue- and lip-tie?

The thin bands of tissue that connect the upper lip to the upper gums, lower lip to the lower gums and tongue to the base of the mouth are called frenums or frenulums. They provide stability and support for the lips and tongue.

If one or more of the frenums are attached abnormally at birth, conditions known as tongue-tie (ankyloglossia) and/or lip-tie may exist. These conditions may cause problems for infants and developing teeth.

Tongue-tie is when the frenum below the tongue is too thick or stiff. Signs of tongue-tie include:

• Difficulty moving the tongue from side to side or lifting it to the upper front teeth
• Inability to stick the tongue out past the lower front teeth
• Notched or heart-shaped appearance when the tongue is stuck out

Lip-tie is when the frenum that is behind the upper lip keeps the upper lip from moving freely.

Symptoms

The symptoms of tongue- and lip-tie are very similar and are dependent on the degree of tissue attachment. They may include:

• Problems with breastfeeding
• Speech difficulties
• Difficulty eating
• Interference with chewing, speaking and brushing teeth if the frenum is too high or too low
• Disrupted development of the upper two front teeth
• Difficulties swallowing
• Pain and swelling if irritated or injured

The most common indication of a tongue- or lip-tie in an infant is difficulty with breastfeeding, which may appear as:

• Difficulty latching
• Difficulty breathing while nursing
• Becoming tired or falling asleep often during feeding
• Making clicking noises while nursing
• The desire to constantly feed/never seeming full
• Colic
• Weight gain that is slow or lacking

Tongue- and lip-tie are generally harmless. However, when they interfere with breastfeeding or eating from a spoon, a simple procedure may be necessary.

Treatments

Babies who have difficulties nursing should have a feeding evaluation to discover the cause. If the doctor determines that a tongue- or lip-tie is to blame, they can evaluate the severity of the condition and develop a treatment plan.

• Level 1 and Level 2 ties - Less severe ties are typically left alone, although the parent or guardian may be taught some therapy techniques that can be used to loosen the tie.
• Level 3 and Level 4 ties - More severe ties may require a frenectomy to sever the problematic tissue. This procedure causes very little pain or discomfort to the baby and can often be done right in the pediatrician's or pediatric dentist's office (depending on the child's age) without anesthesia.

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Note: The information in this article is not meant to replace the advice of your dentist or another licensed healthcare professional. Talk to your dentist for any specific dental advice.

Sources: https://www.mayoclinic.org/diseases-conditions/tongue-tie/diagnosis-treatment/drc-20378456 https://www.healthline.com/health/lip-tie#symptoms