Lip tie and tongue tie are conditions in which the tissue connecting the lip or tongue restricts normal movement. These conditions can affect feeding in infants, speech and oral function in children and adults, and a range of related concerns including jaw tension, sleep, and oral hygiene. Dr. Karen Davis Dentistry provides assessment and laser treatment for lip tie and tongue tie for patients of all ages in Sarnia and across Lambton County.
What Is a Tongue Tie?
A tongue tie (medically referred to as ankyloglossia) occurs when the lingual frenulum — the band of tissue connecting the underside of the tongue to the floor of the mouth — is unusually short, thick, or tight. This restricts the range of motion of the tongue.
The tongue plays a central role in feeding, swallowing, speech, and the natural cleansing of the mouth. When tongue movement is restricted, these functions can be affected.
What Is a Lip Tie?
A lip tie occurs when the labial frenulum — the band of tissue connecting the upper lip to the gums above the front teeth — is tight or restrictive. This can limit how freely the upper lip can move and flange outward.
A restricted upper lip can affect feeding in infants and may contribute to gaps between the upper front teeth or difficulty maintaining oral hygiene around the upper front teeth.
How Lip Tie and Tongue Tie Affect Infants
In infants, lip tie and tongue tie are most often identified because of feeding difficulties. Effective feeding — whether at the breast or with a bottle — depends on the infant's ability to seal the lips and use the tongue to draw and swallow milk.
Signs that may indicate a lip tie or tongue tie in an infant include:
- Difficulty latching during breastfeeding
- Long or frequent feeding sessions
- Falling asleep at the breast without finishing
- Clicking sounds while feeding
- Gassiness, reflux, or excessive spit-up
- Slow weight gain
- Persistent maternal nipple pain or damage during nursing
- Difficulty with bottle nipples or pacifiers
Not every feeding difficulty is caused by a tie, and not every tie causes feeding problems. A functional assessment by a clinician familiar with infant oral function helps identify whether treatment is appropriate.
How Lip Tie and Tongue Tie Affect Children and Adults
Lip and tongue ties do not always resolve on their own. Older children, adolescents, and adults may experience effects that have not been previously connected to a tie:
- Speech articulation difficulties (particularly with sounds like t, d, l, r, s, z)
- Difficulty cleaning around the upper front teeth
- Gum recession near the upper front teeth
- Gaps between the upper central incisors
- Jaw tension or temporomandibular joint discomfort
- Chronic mouth breathing
- Snoring or sleep-disordered breathing
- Headaches or neck tension
- Difficulty with certain foods or eating efficiently
Many of these concerns can have multiple causes. A comprehensive functional evaluation helps determine whether a tie is contributing.
How Lip Tie and Tongue Tie Are Diagnosed
Diagnosis at Dr. Karen Davis Dentistry begins with a clinical examination focused on function rather than appearance alone.
The evaluation looks at:
- Range of motion of the tongue and lip
- The shape and elevation of the tongue at rest and during movement
- The position and tension of the frenulum
- The function being affected (feeding, speech, hygiene, breathing)
- Related symptoms
Some ties appear visually mild but cause significant functional restriction, while others appear prominent but cause little restriction. Function — not appearance — guides treatment decisions.
For infant cases, assessment often involves observation of feeding and may include collaboration with a lactation consultant. For older children and adults, collaboration with a speech-language pathologist or myofunctional therapist may be part of the evaluation and treatment planning.
Laser Frenectomy at Dr. Karen Davis Dentistry
When treatment is appropriate, the procedure to release the restrictive tissue is called a frenectomy. At Dr. Karen Davis Dentistry, frenectomy is performed using a CO₂ dental laser.
The CO₂ laser is a soft tissue laser that uses focused light energy to release the restrictive tissue with precision. The procedure is brief — typically completed in a few minutes — and is generally well tolerated by infants, children, and adults.
Compared to traditional surgical methods using scissors or a scalpel, laser frenectomy offers:
- Precision targeting of the restrictive tissue
- Reduced bleeding due to the laser's coagulation effect
- Often little or no need for sutures
- Reduced risk of infection due to the sterilizing effect of the laser
- Generally faster healing
For infants, the procedure is performed in a few minutes with topical or local anaesthesia. For older children and adults, local anaesthesia is used, with sedation options available if needed.
What to Expect After Treatment
Healing following a laser frenectomy is typically straightforward.
For infants, many parents notice changes in feeding within a few days, though improvements may continue over the following weeks. Post-procedure exercises (active wound management) are typically recommended to support healing and reduce the chance of reattachment. Specific instructions are provided after the procedure.
For older children and adults, mild tenderness in the treated area is common for a few days. Soft foods are recommended for the first day. Stretching exercises may be recommended to maintain mobility during healing.
Myofunctional therapy — exercises to retrain the muscles of the tongue and face — is often recommended for older children and adults to maximize the benefit of the release and support proper oral function. We may collaborate with myofunctional therapists or speech-language pathologists as part of treatment planning.
Reattachment can occur during healing and is one reason post-procedure exercises are recommended. Following the prescribed aftercare protocol reduces this risk.
Who Is a Candidate for Treatment?
Treatment may be appropriate for:
- Infants with feeding difficulties associated with restricted oral function
- Children with speech articulation concerns linked to tongue mobility
- Children or adolescents with oral hygiene difficulties around the upper front teeth
- Adults with persistent jaw tension, headaches, sleep concerns, or speech difficulties potentially linked to a tie
- Patients of any age with documented functional restriction affecting daily life
Not every lip or tongue tie requires treatment. The decision depends on the degree of functional restriction, related symptoms, and the patient's goals. A thorough functional assessment guides the recommendation.
Frequently Asked Questions About Lip and Tongue Tie Treatment
At what age can a tongue tie be treated? Tongue tie can be treated at any age, from a few days old through adulthood. Many infant releases are performed within the first few weeks of life when feeding difficulties are identified. Older children, teens, and adults can also benefit from treatment when functional concerns are present.
Does the procedure hurt? The procedure is performed with topical anaesthesia for infants and local anaesthesia for older children and adults. The CO₂ laser causes minimal discomfort during the procedure itself. Some tenderness is normal in the days following treatment.
How long does the procedure take? The frenectomy itself is typically completed in a few minutes. The full appointment, including assessment and aftercare instructions, generally takes 30 to 60 minutes.
Will my baby's feeding improve immediately? Some infants show improvement in feeding within a few feeds after the procedure. For others, improvement is gradual over the following days or weeks as the baby learns new patterns of tongue movement. Working with a lactation consultant during this period is often recommended.
Will I need stretching exercises after the procedure? Post-procedure exercises (sometimes called active wound management) are typically recommended to support healing and reduce the risk of reattachment. Specific exercises are provided based on the patient's age and the procedure performed.
Can a tongue tie come back after treatment? Reattachment can occur during healing if scar tissue forms across the released area. Following the recommended post-procedure exercises significantly reduces this risk. If reattachment occurs, a revision procedure may be considered.
Will treatment fix my child's speech? A frenectomy can address one contributing factor to speech difficulties — restricted tongue movement — but speech development depends on multiple factors. Speech improvements after treatment often require working with a speech-language pathologist to retrain articulation patterns.
Does insurance cover frenectomy? Coverage varies by insurance plan. Many plans cover frenectomy when there is documented functional restriction. Coverage for cosmetic-only cases may be limited. Our office can submit a predetermination to clarify your coverage.
Is laser frenectomy safer than traditional surgery? Laser frenectomy has a different clinical profile than traditional surgical frenectomy. The laser's coagulation effect generally reduces bleeding, sutures are often not needed, and the sterilizing effect reduces infection risk. Both methods are accepted clinical approaches when performed by an experienced clinician.
Lip and Tongue Tie Treatment at Dr. Karen Davis Dentistry in Sarnia
Dr. Karen Davis Dentistry provides functional assessment and laser frenectomy for infants, children, and adults in Sarnia, Bright's Grove, Point Edward, Corunna, and across Lambton County. Offering laser frenectomy locally allows many families to receive evaluation and treatment in Sarnia rather than travelling to London for assessment.
If you suspect a lip tie or tongue tie in yourself, your child, or your infant, contact Dr. Karen Davis Dentistry in Sarnia, Ontario to schedule a functional evaluation.