Pediatric Dentistry Lip & Tongue Tie Evaluations
A Thoughtful, Conservative Approach
At Chelsea Pediatric Dentistry, we understand that every child develops differently. While oral ties can affect some children, not every lip tie, tongue tie, or cheek tie requires treatment. That’s why we take a careful, evidence-based, and conservative approach to evaluating oral restrictions.
Our goal is simple: to determine whether a restriction is actually affecting your child’s function not just how it looks.
What Are Oral Ties?
Oral ties, also called tethered oral tissues (TOTS), occur when the tissue connecting the lips, cheeks, or tongue limits normal movement.
During your child’s examination, we evaluate:
- Lingual frenum (tongue tie)
- Maxillary labial frenum (upper lip tie)
- Mandibular labial frenum (lower lip tie)
- Buccal frenums (cheek ties)
Every child has these tissues. The presence of a frenum is completely normal. The question is whether it is restricting movement enough to interfere with normal function.
Looking Beyond Appearance
One of the biggest misconceptions about oral ties is that they are diagnosed based solely on appearance. In reality, appearance is only one small part of the evaluation.
At Chelsea Pediatric Dentistry, we assess both the anatomy and, more importantly, how your child’s mouth functions. We evaluate tongue mobility, lip mobility, feeding history, speech development, oral hygiene, jaw growth, and overall oral function before making any recommendations.
Our philosophy is that we treat children, not frenums.
How Can Oral Ties Affect Children?
When an oral restriction significantly limits movement, it may contribute to challenges such as:
In Infants
- Difficulty achieving or maintaining a deep latch during breastfeeding
- Prolonged or painful nursing
- Poor milk transfer
- Clicking sounds while nursing
- Excessive gas from swallowing air
- Slow weight gain
- Maternal nipple pain during breastfeeding
In Older Children
Depending on the child, restricted oral tissues may contribute to:
- Difficulty licking or moving the tongue normally
- Challenges with chewing certain foods
- Difficulty clearing food from the teeth
- Speech concerns involving tongue mobility
- Mouth breathing or altered tongue posture
- Orthodontic or periodontal concerns in select cases
Many of these symptoms can have multiple causes. A comprehensive evaluation helps determine whether an oral tie is likely contributing to the problem.
A Conservative, Team-Based Philosophy
Because oral ties are an area of active research and evolving clinical understanding, we believe treatment decisions should always be individualized.
We do not recommend releasing every lip or tongue tie.
Instead, we consider:
- Your child’s symptoms
- Functional limitations
- Clinical examination findings
- Growth and development
- Recommendations from other healthcare professionals involved in your child’s care
If we believe an oral restriction is contributing to functional concerns, we’ll discuss our findings with you and answer all of your questions.
Working Together With Specialists
When treatment appears appropriate, we refer families to experienced specialists who perform laser frenectomies and have expertise in caring for infants and children.
Depending on your child’s needs, we may also recommend evaluation by:
- A lactation consultant (IBCLC)
- Your pediatrician
- A pediatric ear, nose, and throat (ENT) specialist
- A speech-language pathologist
- A myofunctional therapist
- An orthodontist
We believe children achieve the best outcomes when providers work together to evaluate the whole child rather than focusing on one procedure alone.
Our Commitment to Families
As pediatric dentists, our responsibility is to provide thoughtful guidance based on your child’s individual needs. Whether we recommend simple observation, continued monitoring, supportive therapies, or referral for further evaluation, our priority is always making recommendations that are in your child’s best interest.
Parents can feel confident knowing that we will never recommend treatment simply because a frenum is present. Instead, we focus on whether it is affecting your child’s ability to feed, eat, speak, maintain good oral health, or develop normally.
Our commitment is to provide honest recommendations, compassionate care, and individualized treatment plans that support your child’s healthy growth and development.
Frequently Asked Questions
Does every tongue tie need to be released?
No. Many children have tongue or lip ties that never cause functional problems. Treatment is recommended only when a restriction is believed to be contributing to specific symptoms or limitations.
Do you perform laser frenectomies in your office?
We carefully evaluate oral ties during your child’s examination. When a release is indicated, we refer to trusted specialists with extensive experience performing laser frenectomies in infants and children.
Can a tongue tie affect breastfeeding?
For some infants, a restrictive tongue tie may make it more difficult to latch effectively or transfer milk. Because breastfeeding challenges can have many causes, we often recommend a collaborative evaluation with your pediatrician and an International Board Certified Lactation Consultant (IBCLC).
Can oral ties affect speech?
Most speech concerns are not caused by tongue ties alone. However, in some children, a significant restriction in tongue mobility may contribute to specific speech or articulation difficulties. If indicated, we may recommend evaluation by a speech-language pathologist.
Why is your approach conservative?
Every child deserves individualized care. We believe treatment decisions should be based on function, symptoms, and the best available evidence, not appearance alone. Our goal is to recommend only the care that will truly benefit your child.