Lip tie and tongue tie are two different conditions involving the tissues that connect the lips and tongue to the mouth. While they often occur together, they affect babies differently. A tongue tie (ankyloglossia) restricts tongue movement because the lingual frenulum is unusually tight or short.
A lip tie involves the upper labial frenulum, making it difficult for the upper lip to lift normally. Both conditions can affect breastfeeding, but not every baby with a lip tie or tongue tie needs treatment. A proper assessment by a pediatric dentist, ENT specialist, or lactation consultant is the best way to determine whether intervention is necessary.
What Is a Tongue Tie?
A tongue tie, also called ankyloglossia, occurs when the lingual frenulum is too short, thick, or tight, limiting normal tongue movement.
The tongue may have difficulty:
- Lifting toward the roof of the mouth.
- Moving from side to side.
- Extending beyond the lower gums.
Some babies with tongue tie breastfeed normally, while others develop significant feeding difficulties.
Tongue tie affects an estimated 4% to 11% of newborns, making it one of the most common oral conditions seen during infancy.
What Is a Lip Tie?
A lip tie occurs when the tissue connecting the upper lip to the upper gum is unusually tight or thick.
This may make it difficult for a baby to:
- Flange the upper lip outward during feeding.
- Maintain a deep latch.
- Create an effective seal while breastfeeding or bottle-feeding.
Unlike tongue tie, lip tie affects the movement of the upper lip rather than the tongue.
Lip Tie vs Tongue Tie: What’s the Difference?
| Feature | Tongue Tie | Lip Tie |
| Affected tissue | Lingual frenulum | Upper labial frenulum |
| Restricts | Tongue movement | Upper lip movement |
| Main feeding issue | Poor latch and weak suction | Difficulty flanging the upper lip |
| Common signs | Heart-shaped tongue, clicking, nipple pain | Poor lip seal, feeding fatigue |
| Long-term concerns | Speech, swallowing, jaw development | Gap between front teeth, oral hygiene challenges |
| Treatment | Frenotomy, frenectomy, or observation | Frenectomy only when clinically indicated |
How Common Are Lip Tie and Tongue Tie?
Tongue tie is relatively common in newborns.
Lip ties are also frequently seen and may occur alongside tongue tie, although they are separate conditions. Many babies have visible frenulum attachments that are completely normal and never require treatment.
Treatment decisions should always be based on symptoms and function, not simply appearance.
Signs and Symptoms to Watch For
Clicking Sounds During Feeding
A clicking sound often means your baby is losing suction during breastfeeding or bottle-feeding.
Although clicking can occur for several reasons, tongue tie is one possible cause.
Poor Latch
Babies with tongue tie or significant lip tie may struggle to maintain a deep latch, causing:
- Frequent slipping off the breast.
- Short feeding sessions.
- Constant feeding.
- Difficulty transferring milk.
Nipple Pain for Mothers
A shallow latch may lead to:
- Painful breastfeeding.
- Cracked or bleeding nipples.
- Ongoing nipple damage.
- Reduced milk transfer.
Slow Weight Gain
If feeding remains inefficient, babies may:
- Feed for long periods.
- Fall asleep while feeding.
- Become fussy during feeds.
- Gain weight slowly.
Physical Signs
Parents may notice:
- A heart-shaped tongue when crying.
- Difficulty sticking out the tongue.
- Limited tongue elevation.
- A tight upper lip that does not lift easily.
- Classification and Severity
Not all tongue ties are the same.
Coryllos Classification
Tongue ties are commonly classified according to where the frenulum attaches.
- Type I: Near the tongue tip.
- Type II: Slightly behind the tip.
- Type III: Middle of the tongue.
- Type IV: Hidden or posterior tongue tie beneath the surface.
Kotlow Classification
Another system measures the length of the tongue that can move freely.
Greater restriction generally indicates a more severe tongue tie, but treatment decisions depend on symptoms rather than classification alone.
How Are Lip Tie and Tongue Tie Diagnosed?
Diagnosis involves more than simply looking inside the mouth.
A pediatric dentist or ENT specialist will evaluate:
- Tongue mobility.
- Feeding function.
- Latch quality.
- Oral anatomy.
- Weight gain.
- Medical history.
Many babies also benefit from assessment by an IBCLC-certified lactation consultant, who evaluates breastfeeding technique alongside oral function.
When Should You See a Specialist?
Arrange an evaluation if your baby has:
- Difficulty breastfeeding.
- Persistent nipple pain.
- Poor weight gain.
- Frequent clicking during feeds.
- Feeding sessions lasting unusually long.
- Difficulty sticking out the tongue.
Early assessment, ideally during your baby’s first dental visit, often prevents ongoing feeding problems.
Treatment Options
Not every lip tie or tongue tie requires treatment.
When feeding and growth are normal, monitoring may be all that is needed.
Frenotomy
A frenotomy is a quick procedure that releases the tight frenulum.
In newborns, it often takes only a few seconds.
Frenectomy
A frenectomy removes or releases more tissue and may be performed using:
- Surgical instruments.
- Laser technology.
- Radiofrequency devices.
Frenuloplasty
For more complex cases, particularly in older children, a frenuloplasty may be recommended to improve tongue movement while reconstructing the surrounding tissue.
Laser Frenectomy
Many pediatric dental clinics use laser technology because it offers:
- Excellent precision.
- Minimal bleeding.
- Short treatment time.
- Faster healing.
- Less post-operative discomfort.
Radiofrequency Treatment
Some specialists use radiofrequency-assisted treatment, which also provides a minimally invasive approach with rapid healing.
Recovery and Aftercare
Most babies recover quickly after treatment.
Stretching Exercises
Parents are usually instructed to perform gentle stretching exercises several times each day to reduce the risk of the tissue healing back together.
These exercises may continue for two to six weeks, depending on the dentist’s recommendations.
Healing Timeline
Most babies feed soon after the procedure.
Complete healing generally occurs within about one week, although some babies are fussier around days four or five.
What Happens If Lip Tie or Tongue Tie Is Left Untreated?
Some children experience no long-term problems.
Others may develop ongoing issues depending on the severity.
Speech Development
Restricted tongue movement may affect pronunciation of sounds that require the tongue to lift, including:
- T
- D
- N
- L
- R
- S
- Z
- SH
Dental Development
Untreated restriction may contribute to:
- A gap between the upper front teeth (diastema).
- Dental crowding.
- High-arched palate.
- Bite problems.
- Orthodontic concerns.
Feeding and Sleep
Some children continue to experience:
- Feeding difficulties.
- Mouth breathing.
- Poor tongue resting posture.
- Sleep-disordered breathing in selected cases.
Choosing a Specialist in Dubai
If your baby has feeding difficulties, choose a MOHAP or DHA-licensed pediatric dentist or ENT specialist experienced in evaluating infants.
Many children benefit from a team approach involving:
- Pediatric dentist.
- Pediatric ENT specialist.
- IBCLC lactation consultant.
- Speech-language therapist when appropriate.
Families should also ask about:
- Laser treatment availability.
- Experience treating infants.
- Follow-up care.
- Insurance coverage if treatment is medically necessary.
Frequently Asked Questions
Can a baby have both a lip tie and a tongue tie?
Yes. Many babies have both conditions, although each should be assessed independently because one may cause symptoms while the other does not.
Does every tongue tie need treatment?
No. Treatment is only recommended when the tongue tie causes functional problems such as feeding difficulties, poor weight gain, or restricted tongue movement.
Is laser treatment better than traditional surgery?
Both methods can be effective. Laser frenectomy is popular because it is precise, causes minimal bleeding, and usually allows for a quick recovery.
Is the procedure painful?
Newborn frenotomy is typically very quick and causes minimal discomfort. Older children may require local anaesthesia depending on the procedure.
How long does recovery take?
Most babies recover within a few days, with complete healing usually occurring within one week.
Will insurance cover treatment in Dubai?
Coverage varies between insurance providers. If the procedure is considered medically necessary, some plans may provide partial or full coverage. It is best to confirm this with your clinic and insurance provider before treatment.