How to Recognize a Tongue or Lip Tie

The possibility that an infant could be affected by a tongue or lip tie usually becomes apparent through difficulties with breastfeeding. However, breastfeeding problems can also be caused by other factors, which may delay the diagnosis of a tongue or lip tie while health care providers rule out other possibilities.

In order to either confirm or rule out a suspected tongue or lip tie, it is helpful to understand what to look for when you physically examine the patient. The presence of physical signs in addition to the classic troubles in nursing may help point the way to effective treatment more quickly.

• Examining the Tongue

  Some tongue ties may be obvious, with a thickened band of tissue extending nearly to the tip on the underside of the tongue. Others may be less apparent, with the connection not extending as far, or with a thinner webbing connecting the tongue to the bottom of the mouth. So while your examination should start with a look under the tongue to gauge the appearance of the lingual frenulum, it should also evaluate the tongue’s overall movement.

  Extension: Can the tip of the tongue extend past the lower gums and out of the mouth?

  Shape: Does the tip of the tongue look rounded when it is extended, or is it heart-shaped (indicating a restriction holding back the center)?

  Lateralization: Can the tongue move side to side in the mouth?

  Elevation: Can the tongue be raised independently, or does it drop as a unit with the lower jaw when the mouth is opened?

  Cupping: When a finger is inserted in the mouth, can the tongue cup the finger completely, or is the cupping incomplete or weak?

  The tongue should be able to move freely from side to side, up and down, and to project past the lips. Any restrictions should be an indication that a referral to a specialist for further examination is warranted.

• Examining the Lip

  As with the tongue, an evaluation for a lip tie should begin with a look at the labial frenulum, but not stop there. The frenulum may be thickened, short, and inelastic, which are more apparent signs of a problematic tie. However, it is the movement of the lip rather than the look of the frenulum that helps determine if a problem exists.

  The primary physical concern is whether the upper lip can flange completely upward. If the lip cannot flange fully up when the muscles are relaxed, or if you observe blanching of the frenulum and lip strain when it is attempted, that is a clear indication of a lip tie that could potentially cause ongoing issues.

• Preventing Future Problems

  While the effects of tongue and lip ties start with breastfeeding problems, they don’t end there. Untreated ties can contribute to speech and dental issues, as well as trouble in eating and breathing properly. At Calabasas Pediatric Dentistry, we can thoroughly evaluate your patient and determine if a tongue or lip tie is present. If treatment is indicated, our laser frenectomy is a safe and effective means of providing relief in one quick outpatient procedure.

  To find out more about identifying tongue or lip ties, or to learn more about our services, contact us here.