Tongue- and Lip-Ties

What Is a Lip- or Tongue Tie?

Also called Ankyloglossia or a Tethered Oral Tissue (TOT), a tongue tie is a condition in which the bottom of the tongue is tethered to the floor of the mouth by a membrane (frenulum) that unduly restricts movement of the tongue. Similarly, an upper lip tie is a frenulum attachment that restricts movement of the upper lip.

The condition is present at birth and can result in various oral developmental issues, including feeding, speech, and swallowing, as well as interfering with adequate breastfeeding. About 4% to 10% of all babies are born with tongue-tie. There are degrees of tongue- and lip-ties, depending on where the frenulum attaches to the tongue.

Why Does It Matter?

Tethered oral tissues limit the range of motion of the tongue and lip, which can cause problems with feeding, swallowing, speech, and the formation of the jaw and palate. Babies who are tongue-tied may have problems latching securely to the breast. They will often overcompensate with increased suction or using the jaws, which causes nipple damage and pain in the mother. Once the baby can no longer maintain their latch in this manner, there is often clicking and loss of suction, or even complete detachment from the breast. This could not only cause pain to the mom but also affect the baby's ability to adequately drain the breast, leading to supply issues and/or infections. Some babies may not be able to latch at all.

Infant Symptoms: Mom’s Symptoms:

- Poor or incomplete latch

- Slides off nipple while attempting to latch

- Clicking noises while nursing

- Gumming or chewing on nipple

- Unable to hold pacifier

- Poor weight gain

- Colic or Reflux symptoms

- Short sleep episodes/frequent feedings

- Snoring, heavy breathing, or sleep apnea

- Creased, flat, or blanched nipples

- Cracked, bruised, or blistered nipples

- Bleeding nipples

- Severe pain when the infant attempts to latch

- Poor or incomplete breast drainage

- Infected nipples of breasts

- Plugged ducts or mastitis

- Nipple thrush

- Oversupply or diminishing supply

Left untreated, tongue- and lip-ties can cause development or speech problems and oral hygiene issues down the road, not to mention the loss of the breastfeeding relationship between moms and babies.

How Is It Treated?

Tongue- and lip-ties are easily corrected with a simple, safe, and immediately effective procedure called a frenulectomy. Dr. Jordan is one of six preferred providers in the state of Ohio for the revision of a tongue- and lip-tie via dental laser. The dental laser is the safest and least invasive of treatments available for revision.

If your child is diagnosed with a tongue- or lip-tie, it is important to get the right kind of support. Depending on your child’s age and symptoms, your support group may include a Lactation Consultant, Craniosacral Therapist, Speech Therapist, Myofunctional Therapist, and a Chiropractor or Osteopathic Doctor. With the right team of support and care, breastfeeding relationships can be saved.

What to Expect at Your Appointment

When you arrive for your appointment, you will be greeted by one of our friendly staff members and asked to complete some basic paperwork. You will then be welcomed back into one of our exam rooms, where Dr. Jordan will sit down with you and your child. She will first want to discuss any symptoms you and your child have experienced. She will then do an exam to confirm a tongue- and/or lip-tie. From there, recommendations will be made for treatment and/or additional therapies. She will then explain the procedure to you and will be able to answer any questions you may have.

The procedure itself lasts approximately two minutes. For infants, you will be encouraged to feed your baby as soon as treatment is complete. We have a private space available for moms to nurse and comfort their babies. Some moms have reported immediate relief of pain, extended nursing times, and improved infant sleeping.

What Happens After Treatment?

Parents are given postoperative instructions, including stretches of the treatment sites, in order to reduce the risk of reattachment. Stretches are to be done three times per day for three weeks for the best outcomes in infants. Dr. Lawrence Kotlow created a great tutorial that can be viewed below. Active wound management (stretching) is vital to prevent reattachments.

Older children and adults will be instructed to practice myofunctional exercises after revision for two weeks to begin retraining the muscles of the tongue and face.

Additional myofunctional therapy and other support are often required for the best possible outcomes following the procedure. Depending on your child’s age and symptoms, your support group may include a Lactation Consultant, Craniosacral Therapist, Speech Therapist, Myofunctional Therapist, Chiropractor, or Osteopathic Doctor.

Infant Post-Op Instructions

Why Do We Do This?

Dr. Jordan has been personally affected by tethered oral tissues by having not one but two children with tongue ties. Because of her history, she is incredibly passionate about helping other families.

Our office is committed to continuing to educate ourselves and our patients about this important topic while providing a safe and loving environment for all families affected by tongue- and lip-ties. Parents are given postoperative instructions, including stretches of the treatment sites, in order to reduce the risk of reattachment.