A particularly challenging condition for breastfeeding infants, combination lip/tongue tie is a type of tethered oral tissue (TOTs) where both the tongue and the lip are restricted. These ties can be a combination of an anterior tongue tie and a lip tie, or of a posterior tongue tie and a lip tie.

If you believe your infant or child may have a combination lip/tongue tie, it’s important that you seek treatment with a dentist experienced in treating tethered oral tissues.. These types of tie can be difficult to diagnose and treat without the right expertise.


At Lasertots, we focus on all forms of tethered oral tissue, including isolated tongue and lip ties as well as combination lip/tongue tie. Using dental laser equipment, our experienced dentist  is able to quickly diagnose and treat combination lip/tongue ties.

Get in touch with us to learn more about combination lip/tongue tie and to book a consultation with our dentist today.

How to Spot Combination Lip/Tongue Tie

As the name suggests, combination lip/tongue tie presents the same or similar symptoms as singular lip or tongue tie. Visually, this tethered oral tissue can present two ways, depending on the type of tongue tie associated with it.

Lip Tie Presentation

Regardless of the type of tongue tie, combination lip/tongue tie will involve a lip tie where the lip is tethered to the upper gum. Depending on the degree of the tie, this type of tie can be seen easily by folding up your baby’s upper lip.

Anterior Tongue Tie Presentation

One presentation of combination lip/tongue tie is a lip tie combined with an anterior tongue tie. An anterior tongue tie is a tie that affects the tip or front of the tongue. With this tethered oral tissue, the tip of the tongue is anchored to the floor of the mouth, resulting in a heart shaped or notched tongue appearance.

Posterior Tongue Tie

The second possible presentation of a combination lip/tongue tie is one with a lip tie and a posterior tongue tie. Posterior tongue ties are trickier than anterior tongue ties to diagnose since they are not visible. These tricky ties are hidden underneath the mucus lining of the mouth and are often overlooked until more significant problems with feeding occur.

Symptoms of Combination Lip/Tongue Tie

Whether your child is struggling with a combination lip/tongue tie that involves an anterior or posterior tie, they will experience similar symptoms.

Symptoms of combination lip/tongue tie in babies and children include:

  • Difficulty latching for breastfeeding
  • Clicking sound while nursing
  • Gumming or chewing the nipple while nursing
  • Excessive drooling
  • Gassiness
  • Reflux or colic
  • Choking on milk or pops off breast frequently to gasp for air
  • Poor weight gain
  • Extended nursing episodes
  • Sleep deprivation due to the need for frequent feedings

Babies with combination lip/tongue tie tethers often face increased struggles when it comes to breastfeeding. These issues can lead to severe pain and discomfort for breastfeeding parents.

Some symptoms parents breastfeeding babies with combination lip/tongue tie are:

  • Severe pain with latching-on
  • Incomplete breast drainage
  • Constant or chronic pain during nursing
  • Infected nipples
  • Plugged ducts or nipple trauma such as cracking, bleeding, bruising, creasing or flattened nipples
  • Low milk supply
  • Sleep deprivation due to frequent night feedings
  • Reflux, vomiting, spitting up

Does Combination Lip/Tongue Tie Need to Be Treated?

To avoid serious long-term issues or complications, it is important your infant or child is treated for combination lip/tongue tie early on. Left untreated, this challenging tether can cause a number of problems through childhood and even into adulthood.

Children with untreated combination lip/tongue tie can experience:

  • Difficulty chewing and swallowing solid foods
  • Increased risk of choking or vomiting when eating
  • Dribbling or spilling liquids from mouth when drinking
  • Delay in speech development
  • Improper speech development
  • Dental problems including severe tooth decay and improper tooth growth

In adulthood, untreated combination lip/tongue tie can continue to interfere with your child’s day to day life.

Many adults with untreated combination lip/tongue tie experience:

  • An inability to properly open their mouth when eating or talking
  • Development of speech impairments that can impact self-esteem and confidence levels
  • Garbled or unclear speech when they try to speak fast, soft or loud
  • Chronic jaw pain
  • Dental problems including extreme tooth decay, cavities and inflamed gums
  • Protrusion or misalignment of the lower jaw
  • Frequent migraines

What are the Treatment Options for Combination Lip/Tongue Tie?

At our clinic, our main priority is ensuring your child receives quick, safe and comfortable treatment. This is why we focus in dental laser treatment. Using a dental laser, our experienced dentist is able to safely release your child’s tethered tissue.

What is Dental Laser Treatment?

Soft tissue dental laser treatment is an advanced technique used to release tethered oral tissues. This safe, effective and comfortable method uses light energy to “vaporize” the ties and release the lip and tongue, allowing your child to feed, grow and develop healthy.

Why is Dental Laser Treatment the Best Option for my Child?

A Quick and Minimally Invasive Procedure

Children who undergo dental laser treatment for tethered oral tissues often do not need sedation or restraint. Depending on your child’s age, freezing may or may not be used.

Minimal Bleeding and Lowered Risk of Infection

As dental lasers work through the ties, the light heat vaporizes and sterilizes the tissue as it passes through the tissue. This allows dental lasers to control bleeding and minimize the risk of infection.

Quick Recovery with Almost No Post-Op Recovery

The vaporization and sterilization done by dental lasers helps to stimulate bio-regeneration and healing. When the laser releases your child’s ties, little to no scar tissue is formed, which allows for a speedy recovery. Many children may be a little uncomfortable the first 1-3 days buy Tylenol/Advil is sufficient for pain control.

Has your infant or child been diagnosed with a combination lip/tongue tie? To remove the possibility of long-term issues and complications, it’s important that they receive treatment to release the tissue.
Contact our clinic today
to speak to our experienced dentist and learn more about the benefits of dental laser treatment.