Tongue Tie and Lip Tie Release

Tongue Tie Release

Tongue Tie and Lip Tie Release

If you have concerns about a possible tongue or lip tie, we encourage you to explore our sister website, Release and Breathe. There, you’ll find detailed information and the option to schedule an appointment for an assessment. Following the evaluation, we’ll guide you on whether a Laser Frenectomy procedure is suitable for your child.



A frenum, or frenulum, is a small fold of connective tissue that holds and restricts our lips and cheeks with relation to our jaw. We have seven frenums in our mouths, but the most commonly problematic ones are the lingual frenums (under the tongue) and the maxillary labial frenum (upper lip) and upper cheek frenums (called buccal ties).

However, frenums are not always a problem, or every person God created would need a release! Dr. Geisler will discuss with you if the frenum release is medically necessary. The definition of medically necessary treatment is “health-care services needed to prevent, diagnose, or treat an illness, injury, condition, disease or it’s symptoms.”

During the assessment, we discuss symptoms in the baby and the symptoms of the mother (if nursing). We also evaluate the babies function, the appearance and feel of the anatomy of the oral cavity, and do suck evaluating, to determine if a tongue or lip tie release is recommended.

The following are symptoms that may point to ankyloglossia, also known as a tongue-tie, as a problem:

  • difficulty achieving a good latch
  • falls asleep attempting to nurse
  • slides or pops off breast when attempting to nurse
  • clicking, swallowing air or inflated tummy
  • short sleep episodes (needing to feed frequently)
  • strongly pursed lips
  • child appears to have a small mouth
  • child will not open their mouth wide to feed
  • child appears to have a short tongue
  • heavy or noisy breathing
  • snoring (even a little)
  • witnessed events of breathing stopping (apnea)
  • unable to keep pacifier in
  • waking up congested
  • sleeping only in upright position
  • unhappy when laying on back
  • torticollis
  • arches back when put to breast
  • discomfort when upper lip is raised by adult
  • gagging once solid food introduces
  • needing to supplement after a nursing session
  • picky and messy eater once solid food is introduced
  • colic
  • milk leaking out sides of mouth or nose during feedings
  • failure to thrive, not gaining weight
  • falling off the babies growth curve for weight
  • long nursing sessions, baby not satisfied with session
  • swallowing air
  • uncoordinated suck-swallow-breathe pattern
  • excessive gas
  • gulping or just “drinking” a heavier let down
  • clicking sound while nursing
  • cannot keep nipple of a bottle in mouth
  • biting or chomping on bottle nipple instead of sucking
  • blisters on lip(s) and or tongue
  • difficulty swallowing
  • choking on milk
  • unable to move tongue side to side and lift up
  • heart shaped tongue or cleft or notch in tip of tongue
  • can extend tip of tongue over lower ridge only or not even to lower ridge
  • cannot raise tongue
  • high and narrow palate
  • retracted lower jaw
  • plagiocephephy, brachycephaly, or scaphocephaly head shape, or commonly heard is a flat spot on the head
  • a scissors “snip” at birth that did not resolve problem
  • a health professional suggesting a tie may be a problem
  • cracked, creased, misshapen or blanched nipples
  • painful nursing
  • painful latching
  • bleeding, abraded or cut nipples
  • poor or incomplete draining
  • feeling of baby chomping
  • infected nipples or breasts
  • plugged ducts
  • mastitis
  • lipstick shaped nipples
  • breast, areola, or nipple thrush
  • feelings of depression
  • over or under supply of milk
  • knowing “something isn’t right” compared to a previous breastfeeding experience
  • nursing for long periods of time
  • unable to breastfeed so switched to bottles


Dr. Geisler is passionate about helping families with young children who are having difficulty feeding. She has her own story that encouraged her to help other families in the same situation, learn more on our sister website, Release and Breathe Dentistry!

Family Dentist in Plymouth MN


Lip Tie Consequences

  • unable to make proper seal on breast or bottle
  • leaking air
  • leaking milk
  • lip blisters
  • tense jaw from compensating
  • a shallow latch
  • coming off the breast when lip flipped up by mother
  • a space greater than 1.5 mm between upper teeth (some space is normal between baby teeth)
  • an altered smile
  • a high or low upper lip

Buccal Tie (cheek tie) Consequences

  • not as commonly problematic
  • may contribute to poor seal
  • can impede a good latch
  • baby may have preference to nurse only on one side
  • can cause asymmetric smile
  • contributes to muscle tension and jaw tightness
  • can contribute to a pull on cranial bones
  • can contribute to recession

Tongue Tie Consequences

The following are possible short and long term consequences of restricted tongue and to some degree, the upper lip:

  • poor breastfeeding experience, therefore higher chance of switching to formula
  • reduction in milk production
  • speech problems
  • gulping air leading to gassiness
  • sleep apnea
  • snoring
  • narrow dental arches which means crowded and crooked teeth
  • swallowing problems
  • high vaulted palate (roof of mouth)
  • difficulty chewing and swallowing food (creating a slow and picky eater)
  • dental decay on front upper incisors (lip tie)
  • central incisors that are rotated in (tongue tie)
  • malocclusion (poor alignment of teeth)
  • symptoms of gastric reflux
  • breathing through mouth instead of nose (leading to lifetime poor oxygenation)
  • inability to move tongue for licking ice cream cones and other foods
  • affect sexual activity as adult
  • contribute to TMJ or TMD
  • space between front two teeth
  • gum recession
  • head and neck postural problems which leads to pain in neck and back and headaches
  • anxiety

A simple procedure, done early in life, can prevent a lot of health problems. A frenulectomy for a newborn infant, is much easier than when a child is a toddler or preschooler. Please know we work closely with feeding specialists and body workers to obtain the best possible result of tethered oral tissues.

If you suspect a tie in your toddler or preschooler, call us for a name a trusted orofacial myofunctional therapist. Dr. Geisler does exams everyday on little ones who are suspected or known to have ties. We recommend all children have their first dental visit by the age of 1. Our general dentistry practice sees toddlers and preschoolers for exams and cleanings. Contact Us to learn more, or fill out the form for a frenulectomy consultation.


Many parents we see are beyond frustrated with the amount of appointments and time it took them to find someone who would diagnose the tethered oral tissues as a problem and could offer the solution. If you are one of those parents, check out our resources to learn more about how to get your child diagnosed.


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