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Dr. Gregory Dietz, DMD

Tongue Tie / Lip Tie - Diagnosis

You may have been told that your newborn son or daughter has a lip and/or tongue tie.  These ties can be very problematic for infants and children.  In infants, these ties can make breastfeeding very difficult and painful.  In children, these ties can lead to problems speaking and swallowing, as well as dental and orthodontic issues.  It is very important to get your child evaluated by someone who is knowledgeable and appropriately trained in the diagnosis and treatment of tongue and lip tie.


Lip Tie                                             

A tight upper lip frenum attachment may compromise full lip flanging and appear as a tight, tense upper lip during nursing. This can result in a shallow latch during breastfeeding.  Additionally, the tight upper lip may trap milk, resulting in constant contact of the milk to the front teeth.  This can result in decalcification and dental decay can develop when the milk is not cleaned off of these areas.  This same issue can occur with bottle-feeding.  If the frenum attaches close to the ridge or into the palate a future diastema (gap between the teeth) can also occur.



Tongue Tie

A tight lower tongue frenum attachment may restrict the mobility of the tongue and appear as a cupping or heart shaped tongue when the tongue is elevated.  This can result in an inability to get the tongue to the roof of the mouth to create a suction to draw out milk.  Long term a tongue tie can result in speech problems, facial growth problems and/or issues later in life with transferring food around the mouth for chewing.




Some babies can have ties and not be symptomatic. To know if the ties are a problem we ask two major questions: “Is the baby getting enough to eat?” and “Is nursing comfortable for the mother?” Symptoms can be as follows:

For Baby

  • Poor latch

  • Slides off nipple or falls asleep while attempting to latch

  • Colic symptoms

  • Reflux symptoms

  • Poor weight gain

  • Continuous feedings

  • Gumming or chewing of the nipple

  • Unable to take a pacifier or bottle

For Mom

  • Creased, cracked, bruised or blistered nipples

  • Bleeding nipples

  • Incomplete breast drainage

  • Infected nipples or breasts

  • Plugged ducts

  • Mastitis (inflammation of the breast)





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