Tongue Tie Frenectomy: A Parent's Guide for Babies and Kids
Dr. Muhammad Rahim, DMDOctober 7, 20269 min read
A tongue tie frenectomy is a small procedure that releases a tight band of tissue under the tongue so it can move more freely. If your baby is struggling to feed, or an older child has trouble with certain sounds, you've probably heard the term and wondered whether your child needs one.
This guide covers the signs, what the research says about who benefits, and how the procedure and recovery work. One honest note up front: our team checks for tongue tie during children's visits, but we refer babies and young children who need treatment to providers who focus on it every day. You can see all of our dental services for the rest of the family.
Worried your child might be tongue-tied?
Dr. Muhammad Rahim and Dr. Jasper Ainslie can take a look during a visit in Peterborough, NH, and point you to the right specialist if treatment makes sense.
A tongue tie frenectomy releases or removes the lingual frenulum, the band of tissue connecting the underside of the tongue to the floor of the mouth. When that band is unusually short, thick, or tight, it limits how far the tongue can lift, stretch, and move from side to side.
Doctors call the condition ankyloglossia. According to the Mayo Clinic overview of tongue-tie, it's present at birth, it's more common in boys than girls, and it sometimes runs in families. You'll hear a few procedure names, and they aren't quite the same thing:
Procedure
What it involves
Who it's usually for
Frenotomy
A quick snip of the frenulum with sterile scissors or cautery.
Mostly young babies
Oral Health TipsPediatric DentistryPeterborough NH
Dentist · Peterborough Family Dental & Implant Center
Peterborough, NH dentist providing gentle general, cosmetic, restorative, and implant dentistry for the whole family.
Was this article helpful?
Frequently asked questions
Coverage varies by plan and by who performs the procedure, and some plans treat it as medical rather than dental care. Call your insurer before treatment and ask the provider's office for the procedure code so you can check your benefits.
Often not for a simple frenotomy in a young baby. The Mayo Clinic notes it can be done with or without anesthesia, in a hospital nursery or doctor's office. A frenuloplasty, used for thicker tissue or older children, is usually done under general anesthesia.
No. A lip tie involves the frenulum connecting the upper lip to the gums, while tongue tie involves the band under the tongue. Both can be tight, but they're evaluated separately, and in each case the decision depends on how the tissue affects function, not just how it looks.
Not necessarily. Many families keep breastfeeding with help from a lactation consultant, who can suggest positioning and latch changes while you look into the cause. Talk with your pediatrician before making changes, and make sure your baby is gaining weight well.
Sometimes. According to the Mayo Clinic, speech therapy with a speech-language pathologist may help improve speech sounds. A therapist can assess whether tongue movement is truly limiting your child's speech and whether a release would add anything to therapy.
Our office checks for tongue tie at children's visits and refers infant and pediatric cases to trusted specialists.
Frenectomy
Releasing or removing the frenulum, often with a soft-tissue laser.
Babies, older children, and adults
Frenuloplasty
A more extensive release, usually closed with dissolving stitches.
A thick frenulum or when more repair is needed
Parents and providers often use these terms interchangeably. What matters more is how tight the tissue is and whether it's actually causing a problem.
How Common Is Tongue Tie in Babies?
Tongue tie is fairly common. A 2017 Cochrane Review reported that it affects between 4% and 11% of newborns. Diagnoses have also risen sharply in recent decades, which has led many experts to ask whether some babies are being treated who don't need to be.
Inpatient frenotomy procedures in US children, by year
19971,279
20001,633
20032,538
20063,988
20096,900
201212,406
Source: Walsh et al., Otolaryngology Head and Neck Surgery, 2017 (Kids' Inpatient Database)
4% to 11%
of newborns have tongue tie
Source: Cochrane Review, 2017
8x
rise in US inpatient tongue tie diagnoses from 1997 to 2012
Source: Otolaryngology Head and Neck Surgery, 2017
63.6%
of children diagnosed with tongue tie were boys
Source: Otolaryngology Head and Neck Surgery, 2017
A 2017 study by Walsh and colleagues used a national hospital database and found inpatient tongue tie diagnoses climbed from 3,934 children in 1997 to 32,837 in 2012. Frenotomies rose from 1,279 to 12,406 over the same period. The authors noted that this wide variation may reflect local practice patterns rather than more babies being born tongue-tied.
The same study found that diagnosed children were more often boys (63.6% versus 51.2% of all child hospital discharges) and more often privately insured (60.1% versus 43.6%). Patterns like these suggest that where a baby is born, and who examines them, can shape whether a tie gets diagnosed and treated at all.
What this means for parents
A rising number of procedures doesn't tell you whether your child needs one. The decision should rest on how your child's tongue works, not just how the tissue looks.
What Are the Signs of Tongue Tie in Babies and Kids?
Common signs include trouble lifting the tongue to the upper gums, difficulty moving it side to side, and a tongue that looks notched or heart-shaped when stuck out. In babies, feeding struggles are often the first clue. In older children, certain speech sounds may be harder.
Feeding struggles are often the first sign parents notice.
Signs can look different depending on age:
In babies: trouble latching, chewing rather than sucking during breastfeeding, slow weight gain, and nipple soreness for the nursing parent, as described by the Mayo Clinic.
In toddlers and young kids: trouble sticking the tongue out past the lower front teeth or reaching the roof of the mouth.
In school-age kids: difficulty with sounds such as t, d, z, s, th, n, and l, or trouble licking an ice cream cone or their lips.
At any age: difficulty sweeping food off the teeth with the tongue, which can raise the risk of cavities and gum irritation.
Signs to write down before an appointment
Tick off anything you've noticed.
Does Every Tongue Tie Need a Frenectomy?
No. Many tongue ties never cause problems, and the Mayo Clinic notes the frenulum may loosen over time on its own. Treatment is considered controversial: some providers recommend releasing it right away, while others prefer to wait and see whether feeding or speech is actually affected first.
The research is mixed. The 2017 Cochrane Review of frenotomy by O'Shea and colleagues looked at five trials with 302 infants. Frenotomy reduced nursing mothers' nipple soreness in the short term, but researchers didn't find a consistent improvement in how well babies breastfed. No serious complications were reported.
A 2026 meta-analysis in Pediatric Dentistry by Dhar and colleagues found that babies with a restrictive frenulum tended to have more feeding difficulties reported by their mothers, but the link wasn't statistically significant and the evidence was very low certainty. In short, tongue tie can matter, but it isn't always the cause.
Myth
Every tongue tie should be released as soon as it's found.
Fact
Many tongue ties cause no problems, and some loosen over time. Treatment makes the most sense when the tie clearly affects feeding, speech, or daily comfort.
Other help can come first, too. According to the Mayo Clinic, a lactation consultant can often help with breastfeeding, and a speech-language pathologist can work on speech sounds.
Who Evaluates and Treats Tongue Tie in Children?
Several professionals may be involved: your pediatrician, a lactation consultant for feeding, a speech-language pathologist for speech, and a pediatric dentist or ear, nose, and throat doctor for the procedure itself. A good evaluation looks at how the tongue moves, not just how the tissue looks.
Who should I talk to first?
Is your baby under a few months old and struggling to feed?
Yes: Start with your pediatrician and a lactation consultant, who can assess feeding and refer if needed.
No ↓
Has a speech-language pathologist raised concerns about certain sounds?
Yes: Ask them whether the tongue's movement is part of the issue before deciding on a release.
No ↓
Did a dentist spot a tight frenulum at a checkup?
Yes: Ask how it affects function, then get a referral to a provider who treats children's tongue tie.
No ↓
No feeding, speech, or cleaning problems? Many families simply keep an eye on it at regular checkups.
Here's how we fit in. During children's visits, our team looks at the tongue and lip frenulum as part of a routine exam. If a tie looks like it's affecting your child, we'll tell you so and refer you to trusted providers who treat infant and pediatric tongue tie every day.
That referral isn't a brush-off. These cases deserve someone who does them constantly, and we'll help you find the right fit close to home. Bring your list of signs and any feeding or speech notes along, since they help the next provider see the full picture quickly.
What Happens During a Frenectomy and Recovery?
For babies, a frenotomy is usually quick: the provider snips the frenulum with sterile scissors or cautery, often in the office, and the baby can usually feed right afterward. According to the Mayo Clinic, discomfort is minimal because the frenulum has few nerve endings or blood vessels, and bleeding is usually just a drop or two.
A good provider explains the options, the procedure, and aftercare before anything happens.
Older children may need a frenectomy with a soft-tissue laser or a frenuloplasty, which is more involved and usually closed with dissolving stitches. The general steps look like this:
An evaluation of how the tongue moves and whether a release is likely to help.
Comfort measures suited to the child's age, from none for a quick infant snip to anesthesia for a frenuloplasty.
The release itself, using scissors, cautery, or a laser.
Aftercare instructions, which may include tongue exercises after a frenuloplasty to improve movement and limit scarring.
A follow-up to check healing and function.
Complications are rare but can include bleeding, infection, scarring, or the frenulum reattaching, according to the Mayo Clinic. Ask your child's provider exactly what to watch for and when to call.
Can Adults Have a Laser Frenectomy Too?
Yes. Adults can have a tongue tie frenectomy too, and many choose a soft-tissue laser. At our office we offer laser frenectomy for adults when a tight frenum is causing real problems, such as tugging on the gums, loosening a denture, or restricting the tongue in daily life.
We evaluate every case individually and only recommend a release when the frenum is genuinely part of the problem. You can read more about our laser frenectomy for adults, including how the laser compares to a traditional release.
Patient
How our office helps
Infants and young children
Checked at our visits and referred to trusted pediatric providers
Adults
Evaluated and, when it makes sense, treated in our office with a soft-tissue laser
What Should Parents Do If They Suspect Tongue Tie?
Write down what you're noticing, such as feeding struggles, speech sounds, or how far the tongue moves, and bring it to your pediatrician or your child's dental visit. A professional can check how the tongue functions and tell you whether treatment, therapy, or simple watching is the right next step.
Writing down what you notice makes the appointment more useful.
Try not to rely on photos online or a quick look at home. A tight-looking frenulum may work perfectly well, while a less obvious one can still affect feeding. Function is what counts.
Tongue tie is just one thing to watch as your child grows. Our guide to dental milestones by age covers what to expect from the first tooth through the teen years.
Results may vary. Please consult with your dentist at Peterborough Family Dental for personalized treatment recommendations.
Have questions about your child's tongue or teeth?
Book a visit and we'll take a look, explain what we see, and help you find the right next step. Call (603) 924-3664 or request an appointment online.
Do Cavities in Baby Teeth Need to Be Filled? What to Know
Do cavities in baby teeth need to be filled? Learn why baby teeth matter, what happens if decay is left alone, and options from fillings to kids' crowns.
Dr. Muhammad Rahim, DMDOctober 7, 20269 min read
