Tongue-Tie and Lip-Tie Assessment & Laser Treatment in Infants, Children and Adults
What Is Tongue-Tie (Ankyloglossia)?
Tongue-tie, also known as ankyloglossia, is a congenital condition present at birth. In this condition, the band of tissue under the tongue (called the lingual frenulum) is unusually tight, thick, or short. As a result, the tongue may not move freely.
Because normal tongue movement plays an important role in feeding, speech, and breathing, restricted tongue mobility can interfere with function, particularly in infants. However, the severity and impact vary from person to person.
What Is a Lip-Tie?
A lip-tie occurs when the band of tissue connecting the upper lip to the gum is tight or restrictive. This can limit how well the upper lip flanges during feeding.
Because the tongue and upper lip develop from related embryological tissues early in pregnancy, tongue-tie and lip-tie are commonly seen together in clinical practice. However, not all patients have both conditions. For this reason, each child requires an individual clinical assessment.
Why Tongue Function Is Important
The tongue plays a critical role in many everyday functions. For example, a healthy, mobile tongue supports:
Breastfeeding and bottle-feeding, including latching, sucking, and swallowing
Chewing and swallowing solid foods
Clear speech articulation
Normal oral and facial development during growth
Healthy breathing patterns and airway support, particularly during sleep
When tongue mobility is restricted, these functions may be affected to different degrees. Over time, some individuals develop compensatory habits that place additional strain on the jaws, muscles, and airway.
Signs and Symptoms of Tongue-Tie and Lip-Tie in Infants
Some infants with tongue-tie or lip-tie may experience feeding difficulties. Common signs include:
Difficulty achieving or maintaining a latch
Slipping off the nipple during feeding
Long or inefficient feeding sessions
Clicking noises while feeding
Milk leaking from the mouth
Poor or slow weight gain
Fatigue or sleepiness during feeds
Irritability during feeding
In addition, mothers may notice:
Nipple pain or trauma
Recurrent blocked ducts or mastitis
Reduced milk supply due to ineffective milk removal
Importantly, not all infants with tongue-tie or lip-tie experience feeding problems. Therefore, functional assessment is essential.
Tongue-Tie and Lip-Tie in Children
As children grow, restricted tongue function may be one contributing factor to a range of concerns. These can include:
Mouth breathing
Speech clarity issues
Abnormal swallowing patterns
Narrow or underdeveloped upper jaw
Dental crowding or bite irregularities
Sleep-disordered breathing
Because these issues often have multiple contributing factors, tongue-tie is not considered the sole cause. Early assessment may help reduce long-term compensatory patterns in some children.
Possible Long-Term Associations
In susceptible individuals, ongoing oral dysfunction may contribute to longer-term concerns such as:
Snoring
Sleep-disordered breathing or obstructive sleep apnoea
Daytime tiredness and reduced concentration
Recurrent ear infections
Enlarged tonsils
Bed-wetting in some children
These conditions are multifactorial, and a comprehensive evaluation is always required.
Tongue-Tie and Lip-Tie in Adults
Adults with untreated tongue-tie often develop compensatory patterns over many years. As a result, some adults may experience:
Chronic jaw, head, or neck discomfort
Sleep-disordered breathing or sleep apnoea
Ongoing fatigue related to poor sleep quality
For this reason, adult assessment focuses on current function and symptoms, rather than anatomy alone.
Tongue-Tie and Lip-Tie Treatment: Laser Frenectomy
When clinically indicated, a frenectomy releases the restrictive frenulum under the tongue or upper lip.
At our practices, we perform laser frenectomy using the Waterlase dental laser.
Potential Advantages of Laser Frenectomy
Compared with traditional scissors or scalpel techniques, laser frenectomy may offer several advantages:
High precision
Minimal trauma to surrounding tissues
Reduced bleeding
Lower bacterial load at the treatment site
Less post-operative discomfort
Minimal swelling and faster healing
Because outcomes vary between individuals, post-procedure exercises and follow-up care are essential. In some cases, we may also recommend collaboration with lactation consultants or speech therapists.
Tongue-Tie and Lip-Tie Assessment in NSW
Our assessment process considers:
Tongue and lip anatomy
Range and quality of movement
Feeding, speech, or breathing concerns
Age-appropriate function
Medical and developmental history
Based on these findings, we discuss whether treatment is appropriate. Importantly, treatment decisions are always made on a case-by-case basis.
Learn More About Tongue-Tie and Lip-Tie Release
To learn more, please visit our frequently asked questions page on tongue-tie and lip-tie release in infants.
Dr Nathan Le provides laser frenectomy using Waterlase technology at:
Best Western Dental Centre