Tongue tie is one of the more common concerns parents bring to a dental or lactation appointment. It affects an estimated 4 to 11% of newborns, though reported rates vary depending on how it is defined and diagnosed.
For some babies, tongue tie causes feeding difficulties that need early intervention. For others, it may have no noticeable effect. Understanding what tongue tie is, how it is assessed, and when treatment is appropriate can help parents make confident decisions.
What tongue tie is
Tongue tie (the clinical term is ankyloglossia) occurs when the lingual frenulum, the thin strip of tissue connecting the underside of the tongue to the floor of the mouth, is shorter, tighter, or thicker than typical. This restricts the tongue's range of movement.
Every person has a lingual frenulum. Tongue tie is not the presence of this tissue but rather a variation that limits function. The severity varies widely. Some children have a tight band that anchors the tongue tip to the floor of the mouth. Others have a less obvious restriction that still affects how the tongue moves during feeding, swallowing, or speech.
Tongue tie is sometimes categorised by type (anterior or posterior), but what matters most clinically is whether it is causing functional problems.
Signs of tongue tie in babies
Tongue tie is most commonly identified in the newborn period, often because of feeding difficulties. Signs in breastfed babies may include difficulty achieving or maintaining a deep latch, frequent unlatching and relatching during feeds, clicking or smacking sounds during feeding, prolonged feeding sessions with the baby still appearing hungry, poor weight gain despite frequent feeding, and nipple pain or damage for the breastfeeding parent despite correct positioning.
Bottle-fed babies with tongue tie may also have difficulty. Signs include slow feeding, dribbling milk, excessive air intake, and fussiness during feeds.
Not all feeding difficulties are caused by tongue tie. Latch problems can result from positioning, supply issues, or other factors. A thorough assessment by a qualified practitioner is important before attributing feeding problems to tongue tie alone.
Signs of tongue tie in older children
Some children are not diagnosed until they are older. In toddlers and school-age children, tongue tie may present as difficulty with certain speech sounds (particularly "l", "r", "t", "d", "n", "th", and "s"), trouble licking the lips or reaching the upper teeth with the tongue, difficulty eating certain foods (especially licking ice cream or clearing food from around the mouth), a notched or heart-shaped tongue tip when the child tries to poke their tongue out, and gap between the lower front teeth caused by the frenulum pulling on the gum.
Speech concerns are the most common reason parents of older children seek assessment. However, tongue tie is not the cause of all speech delays. A speech pathologist can help determine whether restricted tongue movement is contributing to articulation issues.
How tongue tie is assessed
Assessment involves a physical examination of the frenulum and an evaluation of tongue function. Your dentist or specialist will look at the length and attachment point of the frenulum, the tongue's ability to lift, extend, and move side to side, and in babies, feeding behaviour (ideally with input from a lactation consultant).
At Ivy Dental, our team assesses tongue tie as part of our children's dental services. For newborns with feeding difficulties, we recommend coordinating with your midwife, child health nurse, or lactation consultant so the full picture is considered.
There is no single score or test that definitively diagnoses tongue tie. The decision to treat is based on whether the restriction is causing measurable functional problems, not on the appearance of the frenulum alone.
Treatment options
When to wait
Not every tongue tie requires treatment. If a baby is feeding well, gaining weight, and the breastfeeding parent is comfortable, treatment may not be needed even if a frenulum appears short. Similarly, older children with tongue tie who have clear speech and no functional issues may not need intervention.
Your dentist or specialist will discuss whether a "watch and wait" approach is reasonable for your child's situation.
Frenectomy (tongue tie release)
When tongue tie is causing functional problems, the standard treatment is a frenectomy. This involves cutting or releasing the tight frenulum to allow greater tongue movement.
In newborns and young babies, the procedure is brief. The frenulum is thin and has limited blood supply at this age. The release can often be done with sterile scissors or a laser in a matter of seconds. Bleeding is minimal. Most babies can feed immediately afterward, and many parents report an improvement in latch within the first few feeds.
In older babies and children, the frenulum is thicker and has more blood supply. Local anaesthetic is used, and the release may be done with a laser or surgical scissors. Dissolvable sutures may be placed depending on the technique. Recovery takes a few days, and stretching exercises are usually prescribed to prevent the tissue from reattaching.
Post-procedure care
After a frenectomy, your dentist will provide specific aftercare instructions. For babies, this typically includes feeding soon after the procedure (breastfeeding is encouraged as it provides comfort and gentle stretching) and performing gentle stretching exercises under the tongue several times a day for 2 to 4 weeks to prevent reattachment.
For older children, aftercare may include pain relief as needed (usually paracetamol), soft foods for a day or two, tongue stretching exercises as prescribed, and a follow-up appointment to check healing.
Who to see for tongue tie assessment
Several practitioners can assess and treat tongue tie, including dentists with training in paediatric oral assessment, paediatric dentists, ear nose and throat (ENT) specialists, and some lactation consultants (for initial screening in newborns).
At Ivy Dental, we see children of all ages at our Everton Park and Nundah locations. If your child needs assessment, we can examine the frenulum, discuss functional concerns, and recommend a path forward. For very young babies, we work alongside lactation consultants and maternal health professionals to ensure a coordinated approach.
If your child's tongue tie is beyond our scope, we will refer to the appropriate specialist. Our goal is the right outcome for your child, whether that involves treatment at our practice or a referral elsewhere.
For guidance on when to bring your child in for their first dental visit, see our guide on what age kids should see the dentist.
Book a tongue tie assessment
If you are concerned about tongue tie in your baby or child, whether because of feeding difficulties, speech concerns, or something a health professional has flagged, we can help with an assessment.
Book a children's dental appointment at Ivy Dental. Call (07) 3266 7120 or request an appointment online.
