Tongue-tie and lip-tie: breastfeeding in babies, speech in children and the gap between front teeth
The thin band of tissue under the tongue is the lingual frenum, and the band joining the upper lip to the gum is the labial frenum. Everyone has them; in some babies and children they are short, thick or attach very close to the teeth. A short tongue-tie (ankyloglossia) can make breastfeeding difficult in babies and some sounds harder for older children; a prominent lip-tie may be linked to a gap between the upper front teeth. Not every short frenum needs treatment; the decision depends on how the tongue and lip function.
When does tongue-tie cause problems?
- In babies: Difficulty latching, slow weight gain despite frequent long feeds, clicking during feeds; nipple pain and sores for the mother.
- In children: The tongue can't stick out past the lips or forms a heart shape when it does, can't reach the palate, and some sounds (especially r, l, t, d) are difficult.
- In adults: Restricted tongue movement, difficulty cleaning under the tongue, sometimes problems with denture fit.
Breastfeeding difficulties have many other possible causes; assessment should involve the paediatrician and a lactation consultant.
Lip-tie and a gap between the front teeth
A gap between the upper front teeth as they come in is normal in children and usually closes by itself when the permanent canines erupt (age 11–13). If the lip-tie extends between the teeth and the gap persists after the canines are through, a lip-tie procedure may be considered along with orthodontic treatment. It's usually done after the gap has been closed orthodontically. For gaps in adults, see bonding and closing gaps between teeth.
Assessment
What matters is less how the frenum looks than how freely the tongue and lip move: the tongue's movement forwards, upwards and sideways, and its function during sucking or speech. Observing a feed in babies and a speech assessment in children are important. If a frenum looks short but doesn't affect function, no treatment is needed.
If treatment is needed, how is it done?
- Frenotomy (newborns and young babies): A quick snip that releases a thin frenum; it takes seconds, usually needs no stitches and the baby can feed straight afterwards.
- Frenectomy / frenuloplasty (older children and adults): Releasing the frenum under local anaesthetic, with stitches if needed. Some centres use a laser.
- Afterwards: Tongue and lip exercises are advised to stop the tissue reattaching; speech therapy may be added for speech problems.
Depending on the child's age, these procedures may be done by paediatric surgeons, ear, nose and throat surgeons or dentists. Don't decide on the basis of appearance alone.
Quick notes for parents
- A short tongue-tie is not on its own a reason for late talking; late talkers need assessment by a paediatrician and speech therapist.
- If there are breastfeeding problems, get support from a lactation consultant first.
- Keep under the tongue and the front teeth clean; for brushing from the first teeth, see teething in babies.
- Thumb-sucking and dummy habits can also affect how teeth line up. See dummies and thumb-sucking.
Assessment in Beylikdüzü
At Dent32 we assess the tongue and lip frenum at children's and adults' examinations, explain any functional restriction to the family and refer to the relevant doctor when needed. For children's check-ups, see dental care for children in Beylikdüzü.
Dent32 Ağız ve Diş Sağlığı Polikliniği (Dent32 Dental Polyclinic) is at Barış Mah., Ginza Lavinya, E-5 Yanyolu No:30 D:179, 34520 Beylikdüzü, Istanbul and is open seven days a week. To book, call or WhatsApp +90 555 011 33 68, or use our contact page. At the examination we share the findings, the options and the approximate cost in writing; you are under no obligation to start treatment afterwards.
For clinic details, our dentists and the full list of treatments, visit Dent32, our dental practice in Beylikdüzü.
Frequently asked questions
What happens if a tongue-tie isn't cut?
A tongue-tie that doesn't affect function causes no problems and needn't be cut. Treatment is considered if it clearly restricts feeding, speech or tongue movement.
Does tongue-tie delay speech?
A short tongue-tie can make some sounds harder but isn't on its own a cause of late talking. Late talkers need assessment by a paediatrician and a speech therapist.
Is the gap between the front teeth caused by a lip-tie?
In children it's usually part of normal development and closes when the canines come in. If it persists, an orthodontic assessment and, if needed, a lip-tie procedure are considered.
