A tongue tie is a band of tissue under the tongue that limits how far the tongue can move. A lip tie is a similar band connecting the upper lip to the gum. Many children have one and never have a problem. For others, a tie gets in the way of feeding, speech, eating, or sleep. The only way to know which applies to your child is to look at what the tongue and lips can actually do.
This guide covers tongue and lip ties from infancy through the teen years, and how we approach them at Smile Gallery Pediatric Dentistry in Roseville, CA.
The short version
- A tie only matters if it limits function. How it looks matters less than how the tongue moves.
- Ties affect babies, children, and teens, not only newborns.
- Assessment comes before any release, and sometimes the honest answer is that nothing needs doing.
- When a release is needed, the laser procedure takes minutes. The aftercare and the support around it matter just as much.
- The best results usually come from a team: the dentist, plus a lactation consultant, myofunctional therapist, chiropractor, or bodyworker as needed.
What are the signs of a tongue tie in a baby?
In infants, the signs usually show up during feeding. Watch for:
- A shallow or painful latch, or a baby who keeps slipping off
- Clicking sounds or milk leaking from the corners of the mouth
- Very long feeds, very frequent feeds, or falling asleep at the breast or bottle
- Slow weight gain, or a lot of gas and reflux
- Nipple pain, creasing, or damage for a nursing parent
Bottle-fed babies can have similar struggles. None of these signs proves a tie on its own, since feeding trouble has many causes. They are reasons to have it checked.
What are the signs of a tongue tie in an older child or teen?
Plenty of ties are not noticed until a child is older, when speech, eating, or sleep concerns come up. Signs in toddlers, school-age children, and teens include:
- Speech: trouble with sounds that need the tongue tip raised, such as l, r, t, d, n, and th
- Eating: slow or picky eating, gagging on textures, or trouble moving food around the mouth
- Sleep and breathing: mouth breathing, snoring, or restless sleep
- Everyday function: difficulty licking the lips, sticking out the tongue, or cleaning food off the teeth
- Teeth: a gap between the upper front teeth, or plaque that builds up under a tight upper lip
A tie is rarely the only factor in speech or sleep concerns. It is one piece worth ruling in or out.
How is a tongue tie assessed?
At Smile Gallery, Dr. Dan Truong assesses function, not just appearance. The visit starts with your history: feeding, latch, speech, eating, sleep, and what other providers have already found. Then he looks at how your child's tongue lifts, extends, and moves side to side, and how the lips seal.
For babies, that includes how they suck and latch. For older children and teens, it includes speech sounds, chewing, swallowing, tongue resting posture, and signs of mouth breathing. You hear what was found and what it means before you leave.
Many families come to us after hearing different things from different providers. Our job is to give you a straight answer, including when the answer is that a tie is present but is not causing a problem.
What happens on release day?
If a release makes sense, it can often happen the same day as the assessment, but only after you have had time to ask questions. Dr. Truong uses the Solea laser, which works with focused light rather than a blade. It usually means less bleeding, no stitches in most cases, and a faster recovery.
For babies
The release itself takes a few minutes. Protective eyewear is used, and you are back together right away to feed. Most babies are unsettled briefly rather than in lasting pain.
For older children and teens
The area is numbed first, and every step is explained before it happens. Nitrous oxide is available for a child who is nervous. Many older children start myofunctional exercises a few weeks before the release, so the tongue is ready to use its new range of movement.
Before you leave, you are shown the aftercare stretches and given written instructions for your child's age.
What does aftercare involve?
Healing tissue naturally wants to pull back together. Gentle daily stretches during the healing weeks help keep the new range of movement.
- For babies, a parent does short, gentle lifts and sweeps several times a day, as shown at the office.
- Older children and teens usually do their own tongue exercises, often guided by a myofunctional therapist.
- A white or yellowish patch where the release was done is normal healing, not infection, and fades over the following weeks.
- Some fussiness or soreness for the first few days is common.
- A follow-up visit checks healing and adjusts the routine if needed.
Call the office if there is bleeding that does not stop with gentle pressure, a fever, a baby who refuses to feed, or anything else that worries you.
Who else is involved in tongue tie care?
A release changes what the tongue can do. Other providers help your child learn to use it. Depending on your child, we coordinate with:
- Lactation consultants, who help babies and nursing parents with latch and feeding before and after a release
- Myofunctional therapists, who guide exercises for tongue posture, swallowing, and breathing in older children
- Chiropractors and bodyworkers, who some families see for tension in the neck, jaw, and body that can affect feeding
If someone is already part of your child's care, tell us. We would rather work alongside them than start over.
Frequently asked questions
Does every tongue tie need to be released?
No. A tie only needs release if it limits function. Many do not, and those are best left alone.
Is my child too old for a tongue tie release?
Usually not. Children and teens can benefit when a tie is limiting speech, eating, or tongue posture, especially when the release is paired with myofunctional therapy.
Will a release fix my child's speech?
It can remove a physical barrier, but speech is a learned skill. Children often still need speech or myofunctional therapy afterwards to put the new movement to use.
Why use a laser instead of scissors?
The Solea laser treats and seals tissue at the same time, which usually means less bleeding, no stitches in most cases, and faster healing.
Do I need a referral?
No. You can book an assessment directly. If a provider referred you, bring any notes they have shared.
Book a tongue tie assessment in Roseville
If feeding, speech, eating, or sleep has you wondering about a tie, an assessment gives you a clear answer either way. Call (916) 782-5503. Smile Gallery Pediatric Dentistry, 568 N Sunrise Ave STE 350, Roseville, CA 95661.