Maybe, but a tie you can see is not the same as a tie that causes problems. A tongue-tie evaluation looks at how your child’s mouth works, and our Manhattan and Queens pediatric dentists start from function, not looks.
Here’s what parents should know before deciding on treatment.
What Counts as an Oral Tie?
Every child has frenums, the small bands of tissue that connect the tongue, lips and cheeks to the mouth. A tie is a frenum that limits movement enough to get in the way of feeding, eating or speaking.
During an evaluation, the dentist checks four areas: the tongue, the upper lip, the lower lip and the cheeks. Having a visible frenum is normal on its own.
Why Diagnoses Have Climbed
Tongue-tie diagnoses rose sharply in the United States over the past few decades. The American Academy of Pediatrics reports an almost tenfold increase between 1997 and 2012.
The same report encourages pediatricians to try nonsurgical feeding support first. It reserves a release for babies with a significant functional problem.
Signs Worth a Closer Look
For babies, parents often notice a shallow latch, long or painful feeds, clicking sounds or slow weight gain. Older children may struggle to lick, chew certain foods, clear food from their teeth or move the tongue for certain sounds.
Each of these signs has many possible causes. That is why the evaluation looks at the whole picture instead of the frenum alone.
What the Evaluation Looks At
Our dentists check tongue and lip mobility and ask about feeding history and speech. They also look at oral hygiene, jaw growth and overall oral function before making any recommendation.
The AAPD frenulum policy notes that tie grading scales mostly describe appearance. How well the tongue can lift and move matters more.
The Evidence Is Still Mixed
Research on releasing ties has not settled the question. A Cochrane review of frenotomy found that it eased nipple pain for mothers in the short term, but it did not show a consistent benefit for breastfeeding.
The trials were small and had design limits. Because the field is still changing, our team does not recommend releasing every lip or tongue tie.
When a Release Makes Sense
If a tie seems to be causing real functional trouble, we explain what we found and talk through options with you. When a release looks appropriate, we refer families to experienced specialists who perform laser frenectomies for infants and children.
Your child may also benefit from a lactation consultant, a pediatrician, a pediatric ENT, a speech-language pathologist, a myofunctional therapist or an orthodontist. Breathing and sleep questions can overlap, which is part of our airway-focused pediatric dentistry.
