When is treatment required?


A new baby whose frenulum is too tight can have trouble sucking and may have poor weight gain. Such feeding problems should be discussed with your child’s pediatrician who may refer you to an ear, nose, and throat specialist for additional treatment.

NOTE: Nursing mothers who experience significant pain while nursing or whose baby has trouble latching on should have their child evaluated for tongue tie. Although it is often overlooked, tongue tie can be an underlying cause of feeding problems that not only affect a child’s weight gain, but lead many mothers to abandon breast feeding altogether.


While the tongue is remarkably able to compensate and many children have no speech impediments due to tongue tie, others may. Around age three, speech problems may be noticeable, especially on the sounds l, r, t, d, n, th, sh, and z. Evaluation may be needed if more than half of a three-year-old child’s speech is not understood outside of the family circle.

Although there is no obvious way to tell in infancy which children will have speech difficulties later, the following characteristics are common:

  • V-shaped notch at the tip of the tongue
  • Inability to stick out the tongue past the upper gums
  • Inability to touch the roof of the mouth
  • Difficulty moving the tongue from side to side

As a simple test, caregivers or parents might ask themselves if the child can lick an ice cream cone or lollipop without much difficulty. If they cannot, then it may be time to consult a physician.

For older children with tongue tie, appearance can be affected by persistent dental problems such as a gap between the bottom two front teeth. Your child’s physician can guide you in the diagnosis and treatment of tongue tie. If surgery is recommended, an ear, nose, and throat specialist can perform a surgical procedure called a frenulectomy.

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