UNDERSTANDING THE CONDITION
What Is a Tongue- or Lip-Tie?
If you point the tip of your tongue toward the inside of your upper lip, you can feel a thin bit of tissue connecting your lip to your gums. This tissue is called a labial frenulum. Now curl the tip of your tongue up. You can see and feel another thin tissue attaching the bottom of your tongue to the floor of your mouth. That's a lingual frenulum.
When the lingual (tongue) frenulum is so short or tight that it affects normal oral functioning, it's commonly called a tongue-tie; when the labial (lip) frenulum is affected, it's called a lip-tie.
The clinical name for this condition for the tongue is ankyloglossia, and poor latch or other breastfeeding issues are often the first clue that there's a problem.
Common Signs & Symptoms
- Poor latch or other breastfeeding issues
- Symptoms of colic or reflux in the child
- Creased, cracked, bruised, blistered, or bleeding nipples in the mother
- Speech difficulties in older children
- Difficulty eating or drinking quietly
- Oral hygiene challenges
NEXT STEPS
What Do I Do If I Suspect My Child Has a Tongue- or Lip-Tie?
Consult with Your Provider
Talk to your pediatrician, lactation consultant, or speech language pathologist to rule out other problems.
Schedule an Evaluation
Schedule an appointment for a full evaluation with Dr. Evy. Although it is helpful, you do not need a referral.
Same-Day Treatment
In most cases, your baby can have the tongue-tie or lip-tie release on the same day as the evaluation.
Watch Dr. Evy perform the procedure on a baby from Mexico City
THE PROCEDURE
How Is a Frenectomy Done?
The procedure itself is simple. If the child is younger than 14 months, they will be gently swaddled. Children 2 years and older are candidates for IV sedation, and nitrous oxide gas is an option for children 4 years and older. For ages in between, the best approach is determined on a case-by-case basis, depending on the child's needs and ability to cooperate.
Once the child is ready, Dr. Evy will administer a topical (ointment) anesthetic to numb the area she will be working on. She then uses a LightScalpel CO2 or other soft tissue laser to remove the frenulum. There is no actual contact of the laser with the tissue and no cutting involved.
This laser is the preferred one for frenectomies -- super fast and super precise, delivering the most predictable results in less time than it takes to get a coffee to-go.
Dr. Evy has performed more than 6,600 laser frenectomies since 2014 for newborns, children, and adolescents — including treating her own children for tongue- and lip-ties. She is a Diplomate of the American Board of Pediatric Dentistry and trained in tethered-oral-tissue release with Dr. Lawrence Kotlow in 2014, with continuing education on tongue-tie treatment every year since.
Her laser dentistry certifications span her whole career with the technology: the Texas Dental Association course (2014), the Academy of Laser Dentistry (2015), and LightScalpel (2020). She is a member of the American Laser Study Club.
Why Laser Frenectomy?
- Super fast and super precise
- Little to no bleeding
- Reduced discomfort for the child
- Reduced post-operative pain
- Same-day treatment available
- Quick recovery time
Alleviating a mom's fear, pain, and anxiety by facilitating the successful nursing of their newborn baby has been one of the most fulfilling rewards of my clinical work as a pediatric dentist. As a mom myself, I once was also a distressed mom worried about my babies' ability to feed well. The excess gas and spit-up caused by air taken in due to restrictive tongue-ties interrupted their sleep, made feeding unpleasant at times, and caused me anxiety.
I am sincerely grateful to the parents of the thousands of babies and children I have treated over the years. Thank you for trusting me and allowing me to become an advanced, experienced provider treating a wide range of cases for over 11 years.
Dr. Evy
Dr. Evy Guerrero, DDS · Diplomate, American Board of Pediatric Dentistry
OUR APPROACH
Not Every Baby Needs Surgery
A frenectomy may feel daunting for parents to even consider for their newborn baby. I want you to know that my recommendations are based on a variety of factors, not only the anatomic restriction itself. In spite of what the general public may think, we do not perform surgery on every single baby that comes through our doors. We have even had to say no, or not at this time, when there have been greater factors affecting a baby's latch, or other medical diagnoses of higher priority for the baby's well-being.
We work collaboratively with other medical providers and rehabilitative therapists to improve the result after a frenectomy, and there are also times I recommend babies have non-surgical rehabilitative services before surgery. I am judicious in my assessment and recommendations, and parents retain control over whether or not they want surgery for their babies. My role is to provide you with the information you need to make an informed decision, and to be your trusted provider to deliver the care your baby needs, if you allow me that privilege.
— Dr. Evy Guerrero, DDS
Is Frenectomy Only for Children?
In a word, no. Frenectomy can be done to correct tongue- and lip-ties in affected teenagers and adults, as well. We also treat teenagers, and for adults we can refer you to specialists such as myofunctional therapists who can help retrain facial muscles and unlearn old habits developed over the years.
LEARN MORE
Informational Videos
Here are some informational videos on the Frenectomy/Frenulectomy procedure.
Tongue Tie Laser Surgery
Laser Tongue-Tie Release
Tongue-tie procedure providing relief for some babies
The Effects of Lip and Tongue Tie on Breastfeeding
Laser lip and tongue ties surgery on infants
The Science
- Effects of office-based frenotomy on breastfeeding — International Journal of Pediatric Otorhinolaryngology (2013)
- Influence of shortened tongue frenulum on tongue mobility, speech and occlusion — Journal of Clinical Medicine (2023)
- How tongue-tie can affect breastfeeding — American Academy of Pediatrics newsletter
More research is linked on our frenectomy FAQ.
For more information on tongue and lip-tie release, including links to the science supporting its efficacy, check out our frenectomy FAQ.
Interested in seeing whether your child -- or you, yourself -- might benefit from this procedure?
Contact Us to Schedule an EvaluationDisclaimer
The information on this page is provided for general education and is not a substitute for professional dental or medical advice. Every child is different — for guidance about your child's specific needs, please talk with Dr. Evy or your pediatric care provider. Call us at 512-917-4550 with any questions.