Lip & Tongue Tie FAQ

How can you tell if a baby has tongue tie or lip tie?

Nearly all babies have a tissue attachment under their upper lip and under their tongue that naturally forms during development. Tissue that is overly restrictive is identified during a clinical exam based on the physical appearance and the limitation or restriction of natural movement. These restrictions must also cause symptoms, such as difficulty eating or speaking, in order for treatment to be recommended.

What causes tongue tie?

A tongue tie is a restrictive oral tissue that naturally forms during development in utero. It has previously been thought that an increase in folic acid usage during pregnancy may contribute to tongue ties, as folic acid helps midline tissues close, and tongue and tissue ties are strong midline tissues. While folic acid is highly recommended in pregnancy to prevent devastating conditions like spina bifida, a tongue or lip tie may develop as the midlines close securely. However, there are currently no research papers demonstrating a true link between folic acid supplementation and tongue ties, so these restrictive oral tissues may instead be genetically linked or simply a small consequence that occurs during normal development. It is highly recommended to take prenatal vitamins with folic acid before, during, and after pregnancy (while breastfeeding).

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How do you fix tongue tie or lip tie?

There are several ways to fix a tongue or lip tie. Centuries ago, midwives used their fingernail to quickly cut the restrictive tissue! Even today, some doctors use scissors or simple diode lasers, which do not allow for a full release or appropriate healing. At Richmond Smile Design, we have invested in top-of-the-line laser technology that was developed to treat restrictive oral tissues in a conservative, effective way and that improves results and healing time.

Does a lip tie need to be corrected?

Lip and tongue ties only need to corrected in the presence of symptoms related to the tie. For example, speech difficulty, feeding troubles (bottle/breast with infants or solid foods in older babies/children), neck and back muscular issues, etc. can all be signs of tethered oral tissues, and the lip and tongue should be evaluated to determine if they could be contributing to the symptoms the patient is experiencing.

Can a lip tie correct itself?

A lip tie can correct itself only through physical trauma to the area. For example, a child may fall down stairs or fall off a bicycle, hitting the face in a way that causes that tissue to tear. A full tear of a lip tie is rare, and oftentimes without appropriate follow-up care while healing, the scar tissue that can form can be more restrictive than the original tie. Waiting for trauma to occur to correct a physical limitation is inappropriate, so in the presence of symptoms a laser frenectomy is the preferred treatment of a lip tie.

What is the tongue tie surgery cost? What about lip tie surgery cost?

We have several options available for patients who need a tongue or lip tie procedure. We are in network with several dental insurance companies, and have an additional discount for patients with Medicaid. During your consultation appointment, we will determine which procedures are needed, and will check your insurance to get an accurate idea of cost before we proceed with the treatment. It is our goal to keep the procedure affordable for all families.

What is the relationship between a lip tie/tongue tie and speech?

It isn’t hard to fathom that tight and restricted tissues in the mouth, holding back the motors of the mouth (the lips and tongue) can interfere with speech. Most often, our patients having trouble with speech have already been under the care of a licensed Speech Language Pathologist (SLP) and come to us as a referral from the SLP. We cherish these valuable working relationships and the small role we are able to play to help a child (or adult!) improve speech. If you are a parent concerned that a tongue or lip tie may be contributing to delayed speech in your child, give us a call for a consultation. We will likely refer you to a local SLP to utilize a team approach to get your child the absolute best care possible.

Can you get tongue tie as an adult?

Some adults have had a tongue tie throughout their entire lives, but have not made the connection between any symptoms or difficulty in function and the tongue tie. The most common issues related to a tongue in adults difficulty with speech and neck/upper back pain secondary to significant tension in this area. After seeing a specialist to address any tension prior to the release, we can see some incredible (and even unexpected!) positive results after releasing a tie in an adult.

What are lip tie problems in adults?

Lip ties in adults are most often diagnosed in conjunction with a gap between the two upper front teeth. A low tissue attachment, or a lip tie, in this area can cause the front teeth to develop and maintain a gap between them. Releasing the tie, sometimes along with orthodontic treatment, can close the gap and prevent any further issues from arising.

My child has already had a tongue tie correction, but now they need the procedure again. Why?

There are two main reasons why a tongue tie correction would need to be performed for a second time. The first is related to the type of release that was previously performed. Scissors and similar tools have been shown to very inadequately release the tie. In fact, inadequate release can cause the tie to return (or even worsen!) as thick scar tissue forms during healing. The second is related to aftercare performed after the procedure. In some cases, parents are either not taught or are unable to perform the necessary stretches after the first release, so the tie can recur as the area heals. Second procedures are rarely necessary when the release is performed with a laser, as it is at RSD, and when the patient has follow-up appointments to monitor healing.