Tongue tie & lip tie
Tongue tie & lip tie (ankyloglossia)
Understanding their role in airway health, feeding, speech and dental development.
Why tongue and lip function matter
Tongue tie and lip tie are often associated with feeding and speech difficulties, but they can also influence breathing, swallowing, jaw development and overall oral function.
At Align Dental Surgery, we take a function-first, airway-focused approach. Rather than assessing the frenulum alone, we evaluate how tongue and lip mobility affect breathing, oral posture and development, recommending treatment only when it is likely to improve function.
The three pillars of healthy oral function
Healthy oral development depends on three habits working together.
When one or more of these habits is disrupted, whether by tongue tie, lip tie or other factors, it may influence oral function and development over time.
Lips gently closed
Supports comfortable nasal breathing.
Tongue resting on the palate
Encourages healthy jaw growth and balanced facial development.
Breathing through the nose
Supports healthy breathing, oral function and facial development.
What are tongue tie and lip tie?
A tongue tie (ankyloglossia) occurs when the band of tissue beneath the tongue (lingual frenulum) is unusually short, thick or tight, restricting tongue movement.
A lip tie occurs when the band of tissue connecting the upper lip to the gums (upper labial frenulum) restricts movement of the upper lip.
Both conditions are present from birth and vary in severity. While many people have no symptoms, others may experience difficulties with feeding, speech, oral hygiene, dental development or overall oral function.
At Align Dental Surgery, we recommend treatment only when the restriction is affecting function.
Tongue tie vs lip tie
Although tongue tie and lip tie are often diagnosed together, they affect different parts of the mouth and may cause different concerns.
Tongue tie
- Restricts tongue movement
- May affect tongue posture, feeding, swallowing and speech
- May influence jaw development and mouth breathing in some individuals
- May affect overall oral function
Lip tie
- Restricts upper lip movement
- May affect lip seal, feeding and oral hygiene
- Most commonly associated with a persistent gap between the upper front teeth
- Primarily affects dental development and lip mobility
Each condition is assessed individually based on its impact on oral function.
Why tongue position matters
The tongue plays an important role in healthy jaw development, swallowing and breathing.
At rest, the tongue should sit gently against the roof of the mouth with the lips closed and breathing taking place through the nose. This natural posture supports healthy jaw growth, nasal breathing and overall oral function.
When tongue movement is significantly restricted, maintaining this position may become more difficult, which may influence jaw development and oral function in some individuals.
How tongue tie and lip tie may affect oral function
Tongue tie and lip tie affect oral function in different ways.
A tongue tie may make it more difficult for the tongue to rest against the roof of the mouth, which can influence swallowing, breathing and jaw development. In some individuals, this may contribute to mouth breathing, altered jaw growth or sleep-related breathing concerns.
A lip tie is less likely to affect breathing directly. Instead, it more commonly affects feeding, lip mobility and dental development. It may contribute to a persistent gap between the upper front teeth (midline diastema), make orthodontic space closure more challenging or increase the chance of the gap reopening after braces or Invisalign.
A restrictive lip tie may also make it more difficult to maintain a comfortable lip seal. When combined with other factors such as tongue tie, enlarged tonsils or nasal obstruction, this may contribute to open-mouth posture and altered oral function.
Not everyone with a tongue tie or lip tie will experience these problems, and treatment is recommended only when the restriction is contributing to functional concerns.
Signs and symptoms
The effects of tongue tie and lip tie vary depending on age. While some people have no symptoms, others may experience difficulties with feeding, speech, breathing or dental development.
Infants
- Difficulty latching during breastfeeding or bottle feeding
- Clicking sounds during feeding
- Poor milk transfer
- Maternal nipple pain
- Reflux or excessive wind
- Long feeding sessions
- Poor weight gain
Children
- Mouth breathing
- Restless sleep
- Speech concerns
- Narrow palate
- Crowded teeth
- Persistent gap between the upper front teeth
- Tongue thrust swallowing
Teenagers & adults
- Snoring or poor-quality sleep
- Daytime fatigue
- Jaw or neck tension
- TMJ discomfort
- Difficulty maintaining tongue posture
- Mouth breathing
- Teeth grinding (bruxism)
Not every patient experiences these symptoms, and many tongue ties or lip ties remain completely asymptomatic. A comprehensive assessment helps determine whether the frenulum is contributing to the concerns being experienced.
Comprehensive assessment
Not every tongue tie or lip tie requires treatment.
At Align Dental Surgery, we look beyond the appearance of the frenulum to assess how it affects feeding, speech, tongue posture, lip seal, breathing, swallowing and jaw development. Where appropriate, we also work closely with ENT specialists, myofunctional therapists, speech therapists and lactation consultants to provide coordinated care.
During your assessment, we may use a range of functional tests, including measurements of tongue mobility, to help determine whether treatment is likely to improve oral function.
Management and treatment options
Not every tongue tie or lip tie requires treatment. If oral function is not affected, observation and regular monitoring may be all that is needed.
When treatment is appropriate, your personalised management plan may include the options below. Our goal is always to improve overall oral function, not simply to release the frenulum.
Your plan may include
- Myofunctional therapy
- Frenectomy
- Orthodontic treatment
- Referral to other healthcare professionals where appropriate
Myofunctional therapy
Myofunctional therapy helps retrain healthy tongue posture, lip seal, swallowing and breathing patterns. It may be recommended on its own or before and after a frenectomy to achieve the best long-term results.
Frenectomy
A frenectomy is a minor procedure that releases a restrictive tongue tie or lip tie, allowing the tongue or upper lip to move more freely.
Depending on the patient's age, anatomy and clinical needs, different techniques may be used. We will recommend the most appropriate approach during your consultation.
A frenectomy is most effective when combined with myofunctional therapy. Myofunctional therapy before treatment helps prepare the tongue and oral muscles for improved movement. After treatment, it helps retrain tongue posture, swallowing and oral function while supporting healing and reducing the risk of reattachment.
What a frenectomy may help with
When performed for the right reasons as part of a comprehensive treatment plan, a frenectomy may help improve the areas below.
A frenectomy is not a treatment for every tongue tie, nor is it a standalone solution for breathing or sleep concerns.
A frenectomy may help improve
- Tongue and lip mobility
- Infant feeding
- Tongue posture
- Speech (where appropriate)
- Oral hygiene
- Orthodontic stability
- Overall oral function
Multidisciplinary care
Tongue tie and lip tie can affect several aspects of oral health and development. Depending on your needs, we may work together with the professionals listed here.
This collaborative approach helps ensure every aspect of feeding, breathing, speech and oral development is considered before treatment is recommended.
We may work with
- ENT specialists
- Myofunctional therapists
- Speech therapists
- Lactation consultants
- Orthodontists
- Paediatricians
What to expect
Your journey at Align Dental Surgery typically includes four stages.
- Consultation: we discuss your concerns, symptoms and goals.
- Functional assessment: we assess tongue and lip mobility, oral posture, breathing patterns and jaw development.
- Personalised treatment plan: together, we determine whether observation, myofunctional therapy, frenectomy or a combination of treatments is appropriate.
- Treatment and follow-up: where indicated, treatment is carried out with ongoing review and support to achieve the best long-term outcome.
Why choose Align Dental Surgery?
At Align Dental Surgery, we look beyond the frenulum to understand how the tongue and lips function as part of the entire oral and breathing system.
Rather than recommending treatment based on appearance alone, we recommend treatment only when it is likely to improve function and quality of life.
Our approach focuses on
- Comprehensive functional assessment
- Airway and jaw development
- Personalised treatment planning
- Evidence-based care
- Collaboration with other healthcare professionals
- Long-term support for children and adults
Evidence and further reading
Professional guidelines
- American Academy of Pediatric Dentistry (AAPD)
- American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)
- Academy of Breastfeeding Medicine (ABM)
Key research
- Yoon A, Zaghi S, et al. Toward a Functional Definition of Ankyloglossia: Validating the TRMR Classification
- Zaghi S, et al. Lingual Frenuloplasty Combined with Myofunctional Therapy
- Kotlow LA. Diagnosis and Treatment of Ankyloglossia in Infants and Children
Questions & answers
Tongue tie & lip tie: common questions
Does every tongue tie or lip tie require treatment?
Can a tongue tie or lip tie improve as a child grows?
Is a frenectomy always performed with a laser?
Will a frenectomy improve breathing or sleep?
How long does recovery take?
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