This is one of the most common frustrations families face. Most providers - pediatricians, dentists, lactation consultants, ENTs - aren’t trained to fully assess tongue ties or oral function. So even with the best intentions, they often miss what’s really going on.

You’re not imagining things. If feeding is hard, there’s usually a reason. We’re here to look deeper and give you answers that make sense.

Dr. Tara has completed hundreds of hours of advanced training in tongue ties, oral function, and infant feeding - and this is the only thing she does every day.

A tongue tie happens when the tissue under the tongue is too tight or short, limiting movement. This can affect feeding, speech, breathing, and how the face and mouth grow over time.

A lip tie is when the upper lip is held down too tightly by a strip of tissue. This can make it hard for babies to latch well on breast or bottle.

Other reasons to correct a lip tie:

*It's hard to brush your child's top teeth

*Your child is getting cavities around the lip tie

*Your child's adult teeth are in and there is still a gap between them

Baby’s Symptoms

• Slides off the nipple while attempting to latch

• Poor latch

• Falls asleep quickly while attempting to nurse

• Gumming or chewing of the nipples while nursing

• Clicking sounds while nursing

• Milk leaking from the sides of mouth while nursing

• Swallowing problems

• Short sleep episodes requiring feeding every 2-3 hours

• Unable to hold a pacifier in the mouth

• Colic symptoms

• Reflux/vomiting/spitting up

• Gas

• Taking prescribed or over the counter reflux/gas medications

• High gag reflex

• Open mouth breathing

• Breathing sounds (snoring, snorting, general noisy breathing)

• Breathing problems/sleep apnea

• Congestion

• Jaw spasms

• Poor weight gain

Mom’s Symptoms

• Creased, flattened, lipstick shaped, and/or blanched nipples after nursing

• Cracked, bruised, and/or blistered nipples

• Bleeding nipples

• Severe pain when latching or attempting to latch

• Severe pain once latched

• Poor or incomplete breast drainage

• Plugged ducts

• Nipple or breast infections

• Mastitis

• Thrush on nipples

If your baby is struggling to feed well and therapy hasn’t solved the problem, it may be time. We’ll help you decide the best timing based on your baby’s needs and development.

Dr. Tara uses a LightScalpel CO2 laser for tie releases due to its ability for precision, bleeding control, as well as decreased pain. Due to the use of the laser, parents are not allowed back in the surgery room. Dr. Tara will carry your baby back to the surgery room and swaddle them. Before and after pictures will be taken. Specialized laser safety glasses will be placed on your child. The actual surgical portion takes less than 30 seconds. The total time away from your baby is less than 5 minutes. Please be ready to nurse (or bottle feed) your baby after the procedure.

The long term goal of a frenectomy is to allow optimal oral function and prevent oral dysfunction.

It can help a lot - but it's only one part of the process. Releasing the tie gives your baby more movement, but we often need therapy and support after to help retrain feeding, breathing, or speech.

The Three Pillars of Pre- and Post-Frenectomy Care for Babies:

1. Lactation Support

2. Bodywork

3. Oral Motor/Feeding Therapy

Success of a tongue tie release is dependent on addressing ALL THREE PILLARS!

One of the biggest misunderstandings about frenectomies is that the actual procedure is all that is needed to “fix” a baby with tongue tie. The goal when treating ties is to restore optimal oral function; however, in most cases, in addition to the frenectomy, both the parents and the child will need the help of multiple specialists in order to achieve this goal.

Finding the right help is important - the MOST important quality to look for, no matter which type of provider you are searching for, is to make sure that they are educated in the problems related to ties and oral dysfunction - this means they have taken EXTRA education in these areas. Do not assume that these types of providers automatically know about ties and oral dysfunction.

Lactation Support - help with breastfeeding issues, as well as pumping and bottle feeding issues.

Bodywork - if there are oral restrictions, there are whole body restrictions - bodywork allows for full and symmetrical motion of the head and neck which will improve motion in the jaw and mouth. More info: http://www.ankyloglossiabodyworkers.com/benefits-of-bodywork.html

Oral Motor/Feeding Therapy - retraining the tongue and other oral muscles is IMPERATIVE to see good results. In order to have optimal function, baby must be evaluated and treated by a specialized therapist.

Dr. Tara uses a CO2 laser for a quick, precise, and complete frenectomy.

You’ll see a small diamond-shaped wound under the tongue or lip. It might look white or yellow as it heals - that’s normal. We’ll walk you through exactly what to expect and what’s not typical.

Yes - tongue ties can go undiagnosed into adulthood. Some people have learned to work around them, but they may still struggle with speech, tension, jaw pain, sleep, or breathing. Most adults are not aware of how ties are affecting them.

Common complaints from adults with untreated tongue tie:

• Crooked/crowded teeth

• Pain or clicking in the jaws (TMJ issues)

• Migraines and/or chronic headaches

• Chronic neck and upper back pain

• Sleep and breathing issues, for example Obstructive Sleep Apnea

• Inflamed gums and chronic oral health issues

• Inability to speak clearly when talking fast/loud/soft

• Difficulty talking when tired or after even moderate amounts of alcohol

It depends on symptoms and goals. If the tie is causing issues with sleep, speech, tension, or daily function, release may help. We work closely with therapists to make sure it’s done at the right time with the right support.

Adult tongue tie release requires usually months of preparation with both an Orofacial Myofunctional Therapist as well as a bodyworker (for example: massage, chiropractic, physical therapy) Many adults see improvements in their issues after a tongue tie release but only with the proper preparation.

This is a great website from Ear, Nose, and Throat physician Dr. Soroush Zaghi, who pioneered the functional frenuloplasty procedure.

You can find information on all things sleep, breathing, and airway!