What are Tongue and Lip Ties?

Tongue ties are a small band of tissue that connects the tongue too tightly to the floor of the mouth. Nursing issues are by far the most common problem caused by tongue ties. In infants, tongue ties can hinder the tongue from reaching their palate which is necessary for proper latch while breast feeding. If a child’s tongue is not able to function properly and causes issues with swallowing, nursing may become very frustrating and/or painful for both child and mother.

Lip ties occur most commonly the upper lip and have to do with a band of tissue that tethers the lip. If the connection is too tight it will limit proper flange which can hinder a proper latch. For older patients with a tongue tie, hindrance of speech and proper oral hygiene is common. Only ties that limit normal function require treatment. We work with an excellent team of lactation consultants before and after the procedure. For older children, we recommend scheduling follow-up care with speech therapists.

When Dr. Wright and others (pediatricians, lactation consultants, speech therapists) diagnose a tongue or lip tie that is causing a functional problem a short one minute procedure with a soft tissue laser is performed to completely remove the tethered tissue.

What are the Symptoms?

Baby's Symptoms

Difficulty eating
Poor weight gain
Reflux or frequent spitting up
Frequent gassiness and fussiness
Clicking or smacking noises when eating
Dribbling milk out of mouth
Frustration when eating
Inability to hold a pacifier
Prolonged nursing or bottle-feeding sessions

Mother's Symptoms

Painful nursing
Creased or flattened nipples
Blistered or cut nipples
Incomplete breast drainage
Plugged ducts or mastitis
Inability to nurse without using a nipple shield
Decreased milk supply

Other Symptoms

Frustration with communication
Difficulty being understood by others
Difficulty getting words out (groping for words)
Trouble with sounds
Speech Delay, Stuttering, or Speech Therapy
Speech harder to understand with longer sentences
“Baby talk” or Mumbling
Neck or shoulder pain/tension
TMJ Pain, clicking, or popping
Headaches or Migraines
Strong Gag reflex
Mouth open/ Mouth breathing throughout the day
Tonsils or adenoids removed
Ear Tubes previously

Treatment for Children and Adolescents

There are many children who have difficulties related to tongue-ties and lip-ties, but unfortunately, these conditions are often not identified until later in life. They can cause speech and feeding difficulties, sleep issues, and a wide-range of other concerns.

If your child is unable to touch the roof of the mouth with his or her tongue when opening widely, is struggling with speech delay, or speech issues that aren’t resolving, has difficulty eating or getting a good night’s sleep, consider getting a complimentary evaluation.

Speech

A tongue restriction affects speech differently in each individual. Some children with a to-the-tip tie can articulate well (but may struggle with increased effort when speaking). Other children, with a less visible or posterior tie, may have a speech delay or difficulty producing the sounds for L, R, T, D, N, TH, SH, and Z. We have seen that many tongue-tied children begin saying new words even just hours or days after the release! Not every child will have immediate results, but we often see drastic improvement.

Sleep

A tongue-tied child will often grind his or her teeth at night, snore, or experience other sleep-disordered breathing problems. Releasing a tongue-tie can help a child to sleep more soundly because the tongue will be able to rest on the palate, as it was designed to do, rather than falling back to narrow or block the child’s airway. Sleep-disordered breathing can cause frequent waking, restlessness, bed-wetting, failure to feel refreshed upon waking and accompanying difficulty focusing (which is sometimes misdiagnosed as ADD or ADHD).

Sometimes a child will be seen by multiple specialists to try to remedy a problem that could actually be quickly solved with a quick tie release treatment. In addition, children with tongue-ties often have a history of multiple ear infections and needing ear tubes. They may have had tonsils and adenoids removed. All of these can be complicated by the mouth-breathing that frequently occurs in tongue-tied individuals. We have found that when a tongue-tie is treated, sleep can improve dramatically.

How the Procedure Works

Review

A consultation will indicate whether your child will benefit from a tongue or lip tie treatment. We don’t perform unnecessary procedures. We take the time to talk it through together and explain why we feel your child does or does not need a procedure.

Release

Using a state-of-the-art Light Scalpel CO2 dental laser, we easily release ties in a 10-15 second procedure, usually with minimal to no bleeding. Babies are usually gone from mom no longer than 7-10 minutes. You’ll be surprised how quick and easy it is.

Recover

Babies are able to go to mom immediately following the procedure and nurse if needed. The recovery only takes minutes and children can resume normal functioning almost immediately.

The Results

It is important to understand that improvement will not always be immediate. Even so, many nursing moms see and feel the difference right away. Since the tongue is just like any other muscle in the body, it takes time to adjust and adapt to a new way of functioning. Most to all muscle memory will be lost and it will take time for your child’s brain to create it again. As this process of relearning takes place, there may be some regression in sucking for a few days.

In a similar manner, some older patients that suffer from speech impediments will need time and continued speech therapy to help reestablish proper muscle memory, but many others experience almost immediate improvement.