TONGUE AND LIP TIE FAQ:
What is a tongue-tie? What is a lip-tie?
A tongue-tie is a web of thickened tissue in the middle and undersurface of the tongue. A lip-tie is a
web of thickened tissue in the middle and undersurface of the upper lip. Ties vary in thickness, length,
and position and can restrict proper mobility of the tongue and lip. As a result, ties negatively impact
eating, swallowing, speech, and sleep.
What can happen if we don’t treat the tongue tie?
Untreated tongue ties make speaking, eating, swallowing, and sleeping difficult. The longer someone
goes with untreated ties, the more compensations their body produces. Bad habits become harder
and harder to remove with age.
What are compensations?
Compensations are negative habits that come as a result of a tongue tie. Examples are forward
posturing, grinding teeth, tongue thrusts, and open mouth breathing to open the airway. In addition,
we see flattened gums or blistered lips in infants, because when feeding, the baby uses their gums and
lips to make a seal instead of the tongue.
I’ve seen a speech therapist for years, and no one caught this. Why now, and why not leave it?
Sadly, I hear this too often! Unfortunately, knowledge of tongue and lip ties varies among providers,
resulting in long-term therapy with little to no progress.
In my opinion, if treatment is not improving the condition after six months, there is something deeper
that needs attention. The longer someone lives with a tongue tie, the more bad habits (i.e.,
compensations) form. So, the quicker it is addressed, the easier it is to remove the compensations.
Why do you work with therapists?
I work with therapists because we are both pieces of a giant puzzle. Therapy is essential to long-term
success after a release. Think about having surgery to repair your torn ACL and the importance of
physical therapy is to rebuild strength. The same goes for a tongue release: therapy is needed before
and after treatment to strengthen and lengthen the tongue muscles.
THE PROCEDURE FAQ:
How do you release the tongue? How long does the procedure take?
I use a laser to gently erase this excess tissue in the midline of the lip or tongue. A lip-tie release takes
less than 1 minute, while a tongue-tie release can take 5 minutes. When stitches are placed, this can
add 15 minutes. Anyone over the age of 5 receives stitches to improve healing
Is the procedure painful?
I make sure every patient is comfortable by using numbing cream on all ties before release. For an
older child or adult, I will also add local anesthesia. Once I confirm the patient is comfortably numb, I
begin the quick procedure; it takes less than 5 minutes!
Can parents come back for the procedure?
Parents are welcome to bring the child to the room at the beginning of the appointment. After
comfortably positioning the child, the parents will be escorted to the reception area while we perform
the quick procedure. Immediately afterward, the parents return to demonstrate the stretching
Are there potential complications after a release?
Bleeding or infection are possible but extremely rare. In my personal experience, no patient has ever
had a bleeding-related complication. The treated area immediately stops bleeding with nursing or
bottle feeding in infants. I’ve only seen one child experience an infection that required antibiotics and
no further treatment.
What happens after the procedure? How long is recovery?
After the procedure, you’ll return home with detailed instructions on aftercare stretches. To manage
any discomfort, most patients do best with Tylenol or Motrin for three days following the procedure.
The tongue and lips are most sensitive the first three days when stretching and exercising, so these
medications are beneficial during this period.
After the first week, there is minimal to no discomfort when stretching, and I will see you back at this
time to check progress and healing. After that, oral exercises will continue for a total of four weeks.
How long will it take to see results?
There is variation in how quickly we see results. Results depend on age and the impact the tongue tie
had on the function of the individual patient. For instance, we see more immediate (some even same
day) results in infants who came with latching difficulties. However, older children and adults who
experience speech delays or sleep apnea may take longer to see results because it takes extra time to
retrain the tongue.
Can you get same-day treatment, or do we have to schedule back?
When the patient comes to the consultation with a referral from a preferred provider (e.g., oral
myofunctional therapist, lactation consultant, speech therapist), there is the option to release the
frenum the same day. We recognize that bringing an infant or toddler to appointments can be
challenging, so we try to accommodate as much as possible in one visit. However, in cases where
sedation is the best treatment option, we will schedule the procedure for another day.