Tongue Ties and Lip Ties — When to Clip?

September 17, 2019

Confused? You’ve been told that your child has a tongue or lip tie, and it needs to be clipped.

What is a tongue tie or lip tie? When movement of the tongue or the lip is restricted, it is called a “tongue tie” or “lip tie.”
 

What causes a tongue tie or a lip tie? Understanding what a frenulum is, helps us understand about “tongue tie” or “lip tie.” We all have frenulums. A frenulum is a fold of connective tissue. A lingual (tongue) frenulum connects the tongue to the floor of the mouth. A labial (lip) frenulum connects the lip to the gums. “Tongue tie” or “lip tie” occurs when a frenulum connects tissue in a restrictive way.

Not all tongue or lip ties are equal. Some are very noticeable and some are harder to detect. Some ties are very restrictive, some ties are mildly restrictive, and some ties do not impact a person’s ability at all. The main thing to consider is function. If your child has a tie and it is NOT impacting your child’s ability to function, then it probably does NOT need to be clipped.
 

Here’s some tips to help you decide whether tongue tie or lip tie is impacting your infant/child’s ability to function:

1. Can your infant/child eat without difficulty? If your child has no difficulty eating, then the frenulum may not need to be clipped. If your child DOES have difficulty eating, contact a lactation consultant (for infants)/and or speech-language pathologist to make sure that the cause of difficulty is actually due to a tongue or lip tie. These professionals can give you information that will help you and your dentist or ENT determine whether to perform a frenectomy (clip the frenulum).

2. Can your child use use his/her tongue to clean all the way around the inside and the outside of his/her mouth? If your child has no difficulty, then it may not need to be clipped. If your child CAN’T perform proper oral hygiene, then the function is impacted and you might want to consider having the frenulum clipped. See a speech-language pathologist or other feeding specialist. They will let you know if the function is impacted by tongue or lip tie. This information will help you and your dentist or ENT determine whether to perform a frenectomy.

3. Look at pictures of tongue tie or lip tie. If it looks like your child has a tongue or lip tie and eating and oral hygiene are restricted, you and your dentist or ENT may decide that clipping is a good idea.
    

What about speech? If you notice that your child has a tongue or lip tie and your child is not speaking clearly, talk to your speech-language pathologist to get his/her opinion about whether it is impacting speech. Often children with tongue and lip tie can compensate and speak clearly without having a frenectomy.