Tongue And Lip Ties

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Tongue Ties and Lip Ties

What are tethered oral tissues?

The mouth naturally has frenum attachments, which are small bands of tissue attaching from one location to another. Some of these oral tissue attachments can be too tight and restrictive, and therefore adversely affect function (such as feeding, swallowing, proper tongue position), dental development, and oral-facial growth. When these frenum attachments are too tight, they are called tethered oral tissues. They are also called lip ties, tongueties, and buccal ties. A frenum can also be called a frenulum, and those names can be used interchangeably. Research has determined that 5-20% of the population has a tongue tie.

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What is a lip tie?

A tight upper lip frenum may compromise lip flanging during latching on a breast or bottle, making it more difficult to feed well. The lip may appear tense during nursing, and cause shallow latch. When teeth are present, a tight upper lip may trap milk, resulting in enamel decalcification (weakening) and tooth decay. If the frenum attaches close to the gum tissue ridge and is thick, a future diastema (gap between front teeth) can occur.

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Upper Lip Tie

What is a tongue tie?

A tongue tie (ankyloglossia) is an embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal movement such as elevation, protrusion, lateralization, and cupping during latch on a bottle or breast. This can result in an inability of the tongue to function correctly for feeding. Long term, a tongue tie may result in speech or feeding problems. A tongue tie may hinder the development of proper adult swallow, and be associated with a high palate, narrow dental arches, crowded teeth, and mouthbreathing.

What is an anterior tongue tie?

An anterior tongue tie is when the frenum attaches to, or very close to, the anterior tip of the tongue. The tongue tip then is sometimes “heart shaped”. This type of tongue-tie is easily recognized by parents and medical providers.

anterior tongue tie

Anterior Tongue Tie

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Posterior Tongue Tie

What is a posterior tongue tie?

A posterior tongue tie is when the frenum attachment is restrictive, but the frenum attachment is further from the tip of the tongue (more posterior) and sometimes submucosal. These types of tongue ties require a hands-on assessment from an experience provider in order to find and feel the restriction. During the functional assessment, the medical provider will also note the tongue may be limited in elevation, protrusion, lateralization and cupping.

What is a buccal tie?

A buccal (pronounced like “buckle”) tie is a restrictive frenum attachment from the cheek area to the gum tissue on the side of the dental arch. This area is where the baby molar teeth or adult premolar teeth are, or will be, located.

When tongue ties and lip ties cause a functional problem, how are they treated?

Laser Frenectomy

A laser frenectomy is a treatment option for babieschildren, or adults with a restrictive frenum (also called a frenulum). A frenum is a band of tissue extending under the lip and/or cheek to the gumline, or a band of tissue under the tongue extending to the floor of the mouth. Oftentimes frenum attachments are normal, but a restricted frenum may not function normally and lead to other problems with feeding, speaking, swallowing, growth and/or development.

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Dr. Kristen Berning uses a LightScalpel CO2 laser to remove the tight frenum attachment, release the restriction, and allow for improved range of motion. Topical and/or local anesthesia may be used. There is minimal bleeding and the area will heal over the course of 1-3 weeks.

For both adults and children, a restrictive frenum can lead to gum recession, a large gap between the teeth, difficulties with eating or speech, mouthbreathing, improper swallow or other functional concerns. In babies, these restrictive frenums are called lip ties and tongue ties, and can contribute to difficulties with breastfeeding or bottlefeeding.

One of our dentists, Dr. Kristen Berning, experienced the difficulty herself with breastfeeding her own tongue tied babies. Please read about her experience on our blog. Dr. Berning provides support for breastfeeding moms who have babies with tongue ties or lip ties. She uses laser technology to release restrictive frenums, including posterior tongue ties. She performs this laser procedure routinely, often as much as 1-5 times per week.

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Please contact our Dubuque laser dentist today by calling 563-556-2711 or complete the form on this page to request your consultation. Exceptional Dentistry serves Iowa communities such as Dyersville and Davenport. Families often travel from Cedar Falls, Waterloo, Cedar Rapids, Iowa City, northwest Iowa, southwest Wisconsin and northwest Illinois to see Dr. Kristen Berning for infant tongue tie appointments.

See What Our Patients Are Saying

"Took my 4 week old son to get looked at for lip and tongue ties, and the dentist was so knowledgeable about the problems she was seeing in him. All of the staff was so accommodating to us and our needs. They had a separate room to have him in that was perfect for feeding him afterwards. Very clean and nice place. Highly recommend for any tongue or lip releases."


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