Many parents first hear the terms “tongue tie” and “lip tie” from a lactation consultant shortly after birth. Others do not encounter them until a speech therapist raises the question years later, or until a dentist notices restricted movement during a routine exam. In either case, families are left sorting through a lot of information and trying to figure out what it actually means for their child’s development.
At HulaGrins Pediatric Dentistry in Torrance, we assess and treat both tongue ties and lip ties across a wide range of ages, from infants through teenagers. Dr. Sena Hiradate performs laser frenectomy procedures using the LightScalpel CO2 laser, and our team coordinates with myofunctional therapists and other providers to support outcomes before and after release. Here is what we find families most want to understand when they come in with questions.
What Is a Tongue Tie?
A tongue tie, clinically called ankyloglossia, occurs when the lingual frenulum, the small band of tissue connecting the underside of the tongue to the floor of the mouth, is too short, too thick, or attached too far forward. This restricts how freely the tongue can move. According to StatPearls via the National Institutes of Health, ankyloglossia has been linked to difficulties with breastfeeding, speech, and oral development, though the degree of functional impact varies from one child to the next.
Tongue ties range from anterior ties, which are clearly visible near the tip of the tongue, to posterior ties, which sit closer to the base and are often harder to identify without a thorough clinical assessment. Not every restricted frenulum causes significant problems, and not every case requires treatment. The evaluation is always about what the restriction is doing functionally, not just what it looks like.
What Is a Lip Tie?
A lip tie involves the labial frenulum, the band of tissue connecting the inside of the upper lip to the gum tissue above the front teeth. When this attachment is unusually thick or extends too far down toward the gum line, it can limit how well the upper lip flanges outward.
In infants, a lip tie is most commonly associated with difficulty creating a proper seal during breastfeeding. In older children, a prominent labial frenulum can contribute to a gap between the two upper front teeth, and may make thorough cleaning along the gumline harder to achieve. Lip ties are often seen alongside tongue ties, though each can occur independently.
How These Ties Affect Oral Development
The mouth is a highly coordinated system, and the tongue plays a central role in how it develops. When tongue movement is restricted from early on, the effects can show up in a number of ways over time. Here are the areas we look at during an evaluation.
- Feeding: In infants, poor tongue mobility can interfere with latch, milk transfer, and the coordination required for effective nursing or bottle feeding
- Speech: Restricted tongue movement can affect articulation of certain sounds, particularly those requiring the tongue tip to lift or move to specific positions in the mouth
- Jaw and bite development: The tongue is meant to rest against the roof of the mouth at rest. When it cannot do so comfortably, it may affect the width of the palate and the relationship between the upper and lower jaw over time
- Breathing and mouth posture: A restricted tongue can make it harder to keep the mouth closed and the tongue resting properly, which may lead to habitual mouthbreathing. Over time, this shift in mouth posture can influence how the face and jaw grow
- Oral hygiene: Limited tongue mobility can reduce the tongue’s natural ability to self-cleanse areas of the mouth, and a low lip tie can make it more difficult to clean along the upper gumline
- Eating habits: Some children with restricted tongue movement become selective eaters, favoring certain textures over others as a way of managing how food feels or moves in the mouth
These effects do not appear the same way in every child. Some children with a restricted frenulum compensate well and show minimal functional impact. Others benefit meaningfully from release. Every child who comes through our doors for a tongue tie or lip tie evaluation gets a thorough assessment, not a blanket recommendation.
What the Assessment Involves
During a frenulum evaluation, we look at both the anatomy and the function. That means observing how the tongue moves, not just how the frenulum appears. For older children, we ask about speech, eating habits, breathing habits, and any history of orthodontic concerns. For infants, we gather a feeding history and, when possible, coordinate with the lactation consultant or pediatrician who referred the family.
Dr. Sena Hiradate has completed training in tongue tie assessment and release and works with myofunctional therapists in the South Bay area. We do not recommend treatment unless the functional case supports it, and we take time to explain our findings clearly so families can make informed decisions.
Treatment: Laser Frenectomy
When a release is indicated, we use the LightScalpel CO2 laser for soft tissue frenectomy procedures. Laser-assisted release is precise, involves minimal bleeding, and typically requires no sutures. Recovery for most children is straightforward, and we provide detailed aftercare instructions to support healing.
One aspect of our approach worth highlighting is that we see older children and teenagers for this procedure, not just infants. In the South Bay, most providers offering frenectomy releases focus on infants, and fewer are set up to evaluate and treat older children and teens. Tongue tie release for an older child involves different considerations than an infant procedure, including behavior management and a different post-release recovery process, and our team is equipped to handle that evaluation and treatment well.
What Comes Next After Release
A frenectomy is often one part of a larger picture. For many children, particularly those who have had a restricted frenulum for years, the surrounding muscles have adapted to working around the restriction. Myofunctional therapy, which involves targeted exercises to retrain tongue posture and movement, is frequently recommended alongside or following release to support long-term outcomes. Stretches are often prescribed both before and after the procedure to help prepare the tissue, improve range of motion, and prevent the area from reattaching as it heals. Children and teenagers typically follow a different variation of these stretches than infants, tailored by the myofunctional therapist to the child’s age and ability to participate in the exercises.
We may also recommend a pediatric orthodontic evaluation if the restriction has affected bite development or palate width. The goal is always to address the full functional picture, not just the tissue.
During your child’s routine dental cleaning and exam, our team keeps an eye out for signs that may suggest a frenulum restriction is worth evaluating further. You do not have to come in already certain about a diagnosis; a question is enough to get the conversation started.
Schedule With HulaGrins Pediatric Dentistry
If you have noticed any signs of a tongue tie or lip tie in your child, or if another provider has raised the question, we are glad to help you sort through it. Dr. Sena Hiradate brings focused training in this area and a commitment to thorough, unhurried assessment for every patient. We see families from across the South Bay, including Torrance, Redondo Beach, Hermosa Beach, Carson, and Lomita.
New patients are always welcome, and our team will walk you through what to expect at that first visit. Use our contact form to request an appointment, and we will get back to you promptly to find a time that works.