Does tongue-tie need to be treated?
Not always. Tongue-tie means the band of tissue under the tongue (the frenulum) is shorter or tighter than usual. The NHS notes it often causes no problems, and treatment is not usually needed unless it affects feeding or, in older children, function. When it does, a short release procedure may be considered after assessment. At Creative Arts in Dubai our dentists can check the frenulum at a children's visit and explain who assesses feeding or speech.
Who treats you here Dr. Duaa Ameen General Dentist · Dr. Julia General Dentist
Every dentist’s licence can be checked on the DHA Sheryan medical directory.
What are tongue-tie and lip-tie?
Everyone has small folds of tissue called frenula. One runs from the underside of the tongue to the floor of the mouth (the lingual frenulum). Another joins the inside of the upper lip to the gum above the front teeth (the upper labial frenulum), and there is a smaller one under the lower lip.
Tongue-tie, medically called ankyloglossia, is the term used when the lingual frenulum is short, thick or attached close to the tip of the tongue, so the tongue cannot lift or stick out as freely as usual. The NHS describes it as skin connecting the tongue to the floor of the mouth that is shorter or tighter than usual, most common in babies, and often causing no problems at all.
Lip-tie describes an upper lip frenulum that is thick or attaches low on the gum, sometimes reaching between the two front teeth. The term is used loosely online. In babies a low, thick upper frenulum is very common and is not a diagnosis by itself, because the attachment often changes as the jaw grows and the teeth come through.
The appearance of the band matters far less than what the tongue or lip can do. Two babies with similar-looking frenula can have very different feeding experiences, which is why assessment focuses on function.
Signs that a tie may matter, and signs that it probably does not
A general guide for parents. None of these signs is proof on its own; feeding and speech problems have many other causes.
| Area | Worth having it assessed | Often no treatment needed |
|---|---|---|
| Breastfeeding | Baby struggles to latch or stay on, feeds are very long, clicking sounds, poor weight gain, or the mother has persistent nipple pain or damage | Feeding is comfortable and the baby gains weight as expected, even if the frenulum looks short |
| Bottle feeding | Milk leaks from the mouth, frequent choking or very slow feeds that do not improve with a different teat or position | Feeds are steady once the right teat and position are found |
| Tongue movement | The tongue tip cannot reach the upper gum or lips, or looks heart-shaped when the child pokes it out | The tongue lifts, moves side to side and pokes out past the lips |
| Speech (older children) | A speech and language therapist links specific sound errors to restricted tongue movement | Speech is developing normally, or difficulties are explained by other causes |
| Teeth and gums | A thick upper frenulum that keeps a wide gap between the front teeth after the adult canines erupt, or pulls on the gum and makes brushing hard | A gap between baby front teeth or new adult incisors, which often narrows naturally as other teeth come in |
If a baby is not feeding well or not gaining weight, see your paediatrician promptly, whatever the cause.
How does tongue-tie affect breastfeeding?
To breastfeed well, a baby lifts and extends the tongue over the lower gum and uses wave-like tongue movements to draw milk. A tight frenulum can limit that movement. The NHS lists difficulty latching onto the breast or bottle, and sore nipples for the mother, among the problems tongue-tie can cause.
Many latch problems, however, have nothing to do with the frenulum. Positioning, prematurity, jaundice, a sleepy baby or the mother's anatomy can all play a part. That is why the first step is usually a feeding assessment by someone trained in infant feeding, such as a lactation consultant, a midwife or your paediatrician, rather than looking at the frenulum alone.
If the feeding assessment and examination point to tongue-tie as the cause, a release (frenotomy) may be offered. If not, improving position and attachment is often enough. Either way, a baby who is not feeding well should be seen soon, not left to see whether it improves.
Can tongue-tie affect speech, eating or teeth later on?
Speech. Most children with a tongue-tie learn to speak normally. Tongue movement is only one part of speech, and the evidence linking tongue-tie to speech delay is limited. If you are worried about how your child speaks, the right first step is a speech and language therapist, who can tell whether a sound difficulty is linked to restricted tongue movement or to something else.
Eating and cleaning. A tight tongue can make it harder to clear food from the back teeth and the cheeks, and some children dislike lumpy textures for longer. These are rarely reasons for treatment on their own, but they are worth mentioning at check-ups.
Teeth and gums. A thick upper lip frenulum is often blamed for a gap between the front teeth. In young children such gaps are normal and frequently close as the adult canines come in. A dentist or orthodontist usually waits for that stage before deciding whether the frenulum is part of the problem. See our guide to gaps between teeth for the other causes of spacing. A low lower frenulum that pulls on thin gum can occasionally contribute to gum recession in adults, which is assessed by a dentist on its own merits.
Who assesses a tongue-tie or lip-tie?
Different professionals look at different parts of the picture. For babies the starting point is usually the feeding team; for older children it depends on the concern.
| Concern | Usually the first person to see | What they look at |
|---|---|---|
| Feeding difficulties in a newborn | Paediatrician, midwife or lactation consultant | Latch, sucking pattern, weight gain, the mother's comfort and the baby's tongue movement |
| Release in a baby | A health professional trained in infant frenotomy, after a feeding assessment | Whether the tie is the likely cause and whether a release is appropriate |
| Speech concerns | Speech and language therapist | Which sounds are affected and whether tongue movement is the reason |
| Gap between front teeth, gum pulling | Dentist, and an orthodontist when the adult teeth are coming in | Tooth development, the frenulum attachment, the gum and the bite |
| Release in an older child | Surgeon or dental professional experienced in the procedure | Function, age, cooperation and the right setting and anaesthetic |
Creative Arts does not present tongue-tie or lip-tie release as a service on this site. Our dentists can examine the frenulum during a children's visit and explain whether a referral is worth considering.
What happens in a tongue-tie or lip-tie release?
A release, called a frenotomy or frenectomy, divides or removes part of the tight band so the tongue or lip can move more freely. In general terms:
- Young babies: the NHS explains that the procedure is usually done without anaesthetic. It is quick, and feeding is usually checked again soon afterwards.
- Older babies, children and adults: the NHS notes that it is usually carried out under general anaesthetic, because the tissue is thicker and the person needs to keep still. Some clinicians use local anaesthetic for older, cooperative patients; the choice depends on the case.
- Instruments: scissors, a scalpel or a soft-tissue laser may be used. The method matters less than an accurate diagnosis and the clinician's experience.
- After a release: a little bleeding and soreness are expected. Some clinicians suggest exercises or feeding support afterwards; follow the advice of whoever carries out the procedure.
A release is not a cure-all. If feeding or speech problems have another cause, cutting the frenulum will not fix them, which is why a careful assessment beforehand matters so much.
Be cautious with diagnoses made from photos
Lip-tie and tongue-tie are often 'diagnosed' online from a picture of a baby's mouth. A short-looking frenulum is common and frequently harmless. Before agreeing to any procedure, ask what problem it is expected to solve, what the alternatives are, and whether a feeding or speech assessment has been done first.
Questions about your child's frenulum, a gap between the front teeth or how the teeth are coming in? Our dentists in Dubai examine children gently and explain what needs watching and what does not.
See children's dentistryWhat can a dental check-up add?
A dentist sees children's mouths at every stage, so a routine visit is a good moment to ask about a frenulum. At a children's appointment at Creative Arts, Dr. Duaa Ameen or Dr. Julia can:
- look at how the tongue and lips move and where the frenula attach;
- check whether a gap between the front teeth is the normal spacing of childhood or something to monitor;
- look for areas that are hard to clean because a lip or tongue frenulum gets in the way, and show you how to brush them;
- tell you whether a referral to a paediatrician, lactation consultant, speech and language therapist or orthodontist could help.
For a baby's first visit and what happens at it, read our guide to a baby's first dental visit. If your child breathes through the mouth or snores, mouth breathing in children explains why that deserves its own assessment, and thumb-sucking covers another common habit that affects how front teeth line up.