What Is Tongue Tie & Lip Tie?
Tongue tie (ankyloglossia) and lip tie are conditions in which the small bands of tissue called the frenulum — which connect the tongue to the floor of the mouth, or the upper lip to the gum — are shorter, thicker, or tighter than normal. This restricted tissue limits the natural range of motion needed for feeding, speaking, swallowing, and breathing.
When the tongue or lip cannot move freely, it creates a chain of functional challenges that ripple across a person's life — from difficulty latching at birth, to dental spacing issues in childhood, to jaw tension and airway concerns in adulthood. Recognizing a tie early and understanding its impact is the first step toward effective treatment.
Two Types, One Spectrum
Tongue tie and lip tie often occur together and exist on a spectrum from mild to severe. A thorough functional assessment — not just a visual check — is needed to determine whether a tie is truly restrictive and affecting quality of life.
- Anterior tongue tie: visible tethering near the tip of the tongue
- Posterior tongue tie: deeper, beneath the tongue, often missed on casual exam
- Lip tie: upper lip frenulum attachment restricts lip flanging during feeding
Recognizing the Signs at Every Stage.
Tongue tie and lip tie can look very different depending on age. Here's what to watch for — from birth through adulthood.
Newborns & Infants
- Poor or shallow latch during breastfeeding
- Clicking or slipping off the breast or bottle
- Excessive gas, colic, or reflux
- Slow weight gain or failure to thrive
- Fatiguing quickly during feeds
- Nipple pain, compression, or damage for nursing mothers
Toddlers & Children
- Delayed or unclear speech; difficulty with sounds like l, r, t, d, n, th
- Mouth breathing or open-mouth posture
- Dental spacing, crowding, or high palatal arch
- Difficulty eating certain textures; picky eating habits
- Dental decay linked to inability to clear food with the tongue
- Snoring or restless sleep
Teenagers
- Chronic jaw tension, TMJ pain, or neck/shoulder tightness
- Sleep-disordered breathing or snoring
- Difficulty swallowing or chewing certain foods
- Speech articulation challenges
- Dental crowding or recession
- History of unresolved breastfeeding difficulty as an infant
How Tongue & Lip Tie Affects Breastfeeding.
Breastfeeding is one of the most demanding functions a newborn's oral structure must perform — and a tongue or lip tie is one of the most common reasons it becomes painful or impossible. When the tongue cannot elevate and cup the breast, or the upper lip cannot flange outward to create a seal, the latch is shallow, inefficient, and damaging for both mother and baby.
Signs in the Nursing Infant
- Cannot sustain a deep latch; slips or clicks repeatedly
- Takes in excess air, leading to gas and fussiness
- Falls asleep at the breast before getting adequate milk
- Gains weight slowly or below expected milestones
- Appears frustrated or refuses the breast after early feeds
Signs in the Nursing Mother
- Nipple pain, pinching, blistering, or compression
- Recurrent plugged ducts, mastitis, or low milk supply
- Feeding sessions that feel endless without satisfaction
- Feeling that milk supply is decreasing despite frequent feeding
- Emotional distress or early weaning due to pain
These challenges are not a personal failure — they are mechanical, and they are treatable. A functional evaluation at the Arkansas Tongue and Lip Tie Center can identify whether a tie is contributing to your breastfeeding difficulties and whether a frenectomy would help.
How We Diagnose Tongue & Lip Tie.
A tongue or lip tie diagnosis at the Arkansas Tongue and Lip Tie Center is never based on appearance alone. Our evaluation process is thorough, functional, and family-centered — designed to give you confident, clear answers.
01 / Intake & History
We begin with a detailed health and feeding history — birth story, feeding patterns, symptoms, and any prior evaluations. Understanding the full picture before examining the mouth is essential to an accurate assessment.
02 / Visual Examination
Our provider visually assesses the appearance and attachment point of the lingual (tongue) and labial (lip) frenula, noting length, thickness, and insertion depth on the gum or tongue floor.
03 / Functional Assessment
We evaluate how the tongue and lip actually move — elevation, lateralization, cupping, and lip flanging. A tie that looks mild visually can have a significant functional restriction. This step is what separates a complete diagnosis from a superficial one.
04 / Care Team Coordination
We discuss findings with you in plain language, answer your questions, and coordinate with your lactation consultant, pediatrician, or speech therapist as needed. Our goal is a diagnosis you fully understand — and a clear next step.
Common Questions About Tongue & Lip Tie.
If you're wondering whether your child's tie is significant, whether treatment is necessary, or what the risk of waiting looks like — these answers are for you.
Is every tongue tie or lip tie a problem that needs treatment?
No — not every tie causes significant functional issues. The goal of evaluation is to determine whether YOUR child's tie is restrictive enough to be causing real problems. Ties are treated based on functional impact, not appearance alone. Many mild ties are monitored rather than treated immediately.
My baby has a tie. How do I know if it's significant?
The key indicators are feeding difficulty, pain for the nursing mother, poor weight gain, and infant frustration during feeds. If you or your baby are struggling — even if a previous provider said "it looks mild" — a functional evaluation is the only way to know for certain whether restriction is the cause.
What happens if a tongue or lip tie goes untreated?
The consequences depend on severity. In infants, untreated ties can lead to feeding failure, low milk supply, and early weaning. In toddlers, they may contribute to speech delays and dental development issues. In older children and adults, the effects often shift to airway function, jaw posture, and chronic muscle tension. Early treatment generally leads to better outcomes — but treatment is always a decision made together with the family.
Can teenagers have tongue tie treated?
Yes. Teenagers increasingly seek evaluation for long-standing symptoms — speech articulation, jaw pain, sleep-disordered breathing, or difficulty eating. Laser frenectomy is performed for teenagers as well as infants, and outcomes can be meaningful even when the tie has been present for years.
Will my child need to see other specialists too?
For many patients, yes. Tongue and lip tie treatment works best as part of a coordinated care approach. We work closely with lactation consultants, pediatric dentists, speech-language pathologists, and myofunctional therapists to support outcomes before and after the procedure.
Think Your Child May Have a Tongue or Lip Tie?
You don't have to guess. A thorough functional evaluation at the Arkansas Tongue and Lip Tie Center gives you clear answers — and a confident path forward. Most families leave their first visit with a diagnosis and a plan.