A tongue tie happens when the band of tissue under the tongue, the lingual frenulum, is short or tight enough to restrict movement. It is present from birth. Many are mild and never cause a problem; some interfere with feeding, speech or oral hygiene.
Signs in babies
- Difficulty latching, or a latch that keeps slipping
- Feeds that take a long time, or the baby tiring quickly and feeding again soon after
- Clicking sounds during feeding
- Poor weight gain despite frequent feeding
- Reflux-like symptoms from swallowing air
- For the mother: persistent nipple pain, damage, or recurrent blocked ducts and mastitis
Feeding difficulty has many causes and a tongue tie is only one of them. Positioning, latch technique and other factors are assessed first.
Signs in older children and adults
- Difficulty lifting the tongue to the roof of the mouth, or sticking it out past the lower lip
- A heart-shaped or notched appearance at the tip when the tongue is extended
- Trouble clearing food from around the teeth with the tongue
- Some speech sounds being harder to form, particularly those needing tongue elevation
- A gap developing between the lower front teeth
Lip ties
A lip tie is a tight band between the upper lip and the gum. It can restrict how far the lip flanges during feeding and, in older children, can be associated with a gap between the upper front teeth. Lip and tongue ties often occur together, and an assessment looks at both.
How an assessment works
An assessment looks at the appearance of the frenulum and, more importantly, at function: how far the tongue lifts and extends, and whether the restriction explains the symptoms. Appearance alone does not determine whether treatment is needed. A visible frenulum with normal function generally needs nothing done.
For babies, assessment often involves a feeding history and sometimes input from a lactation consultant, because treating a tie without addressing feeding technique rarely resolves things on its own.
If treatment is recommended
A frenotomy releases the restrictive tissue. It is a short procedure. Aftercare, including stretches and continued feeding support, is part of the treatment rather than an optional extra, and is explained at the time.
Related treatment
Read more about lip and tongue tie assessment in Bendigo.
This article is general information only and is not a substitute for an individual assessment.