What is a Frenectomy Procedure for Tongue-Tie?


Tongue-tie is a condition present at birth that causes a range of problems, and a simple procedure called a “frenectomy” is the best treatment.Tongue-tie is when the tongue is restricted because it’s connected too tightly to the floor of the mouth by connective tissue called the “frenulum.” The condition is often misunderstood, even among physicians and other health professionals who work in Labor and Delivery. This is unfortunate, since the most beneficial time to treat tongue-tie is when a baby is still a newborn.

Immediate Problems Caused by Tongue-Tie

The most serious problem caused by tongue-tie beginning at birth is that breastfeeding is very difficult and causes mom excessive pain. The baby’s tongue doesn’t have the needed freedom and movement to properly breastfeed.

In trying to nurse, babies find that it’s too painful. They end up making compensations in their attempt to get nourishment. Whether they simply take much longer than usual to nurse, purse their lips, or limit how far their mouths are opened because of tongue tie, the ultimate result is unsuccessful breastfeeding. Babies typically fail to thrive. Some with the muscle strength and ability to stay awake for lengthy feedings usually manage to maintain proper weight, but the ordeal is too painful for moms, who are compelled to stop breastfeeding prematurely.

The following are more signs that an infant has tongue-tie. The baby:

  • Has difficulty latching on
  • Needs frequent or extended feeds
  • Biting or grinding when feeding
  • Low weight
  • Slips off the breast while nursing
  • Drooling
  • Dribbles or makes clicking sounds while breastfeeding
  • Vomits after nursing
  • The tip of the tongue can’t reach the roof of the mouth
  • Difficulty licking lips
  • Swallowing problems
  • Pain
  • Impaired tongue mobility

Long-term results of tongue-tie include narrow dental arches, malocclusion (a misaligned bite), cavities, mouth breathing, and sleep disturbance problems.

What is a Frenectomy?

A frenectomy is a procedure to treat tongue tie in which the tissue connecting the tongue to the floor of the mouth is disconnected, allowing the tongue to freely move. Neither a scalpel nor stitches are needed, thanks to advancements in technology. A frenectomy performed with a laser is quick and precise, and no anesthesia is needed. The entire procedure is typically performed in about three minutes.

Frenectomies are performed with a very high success rate. Any discomfort during the healing process is typically treated with ibuprofen or acetaminophen.

Contact the Experts at GEP TOTs Dental Group / Woodbridge Orthopedics

A team of specialists in the Greater Toronto Area are experts at diagnosing and treating infants and children with tongue-tie and the other form of tethered oral tissue (TOT), lip tie.

If your newborn has difficulties feeding and possibly other symptoms of tongue-tie, consult our professionals at GEP TOTs Dental Group / Woodbridge Orthodontics as soon as possible. The healing time for a frenectomyis quicker and post-operative pain is minimized when a baby is still in the newborn stage. Contact us online or call (803) 223-7655 for an appointment with our dental specialists. There are many immediate and long-term issues that will be resolved with a frenectomy, if your child has tongue-tie.


Tongue tie and lip tie can both make breastfeeding difficult and painful for babies. As a result, some infants manage to shift their approach, relieve the pain, and get needed nourishment. Two results are that feeding times are prolonged, as is pain for the mother. Other things are going on at the same time, however, that create long-term negative effects. Overall, what’s happening is proof of two things. First, weight gain should not be considered a universal measure of successful breastfeeding. Secondly, greater awareness is needed regarding the importance of identifying and repairing tongue/lip tie. More details follow.

How Babies Compensate for Tongue/Lip Tie Pain during Breastfeeding

Tongue tie and lip tie are both conditions that interfere with the ability to successfully breastfeed. The following are some methods babies use to adapt to the situation, but the outcomes do not equate to successful breastfeeding.

Prolonged Breastfeeding

A baby with high muscle tone can be tenacious about receiving needed nourishment. Due to their high level of muscle tone, these babies don’t fatigue at the breast as quickly as infants normally do when oral restrictions make breastfeeding difficult and uncomfortable. They succeed in thriving; but when mom is tempted to quit breastfeeding because of unbearable pain associated with a baby’s tongue or lip tie, early weight gain is irrelevant.

Pursing the Lips

A common type of compensation for tongue/lip tie is that the baby latches on by pursing the lips. The tongue is unable to create the seal and suction required for proper breastfeeding.

“Small Mouth”

If a baby fails to fully open his mouth during breastfeeding, it’s because of pain associated with tongue/lip tie. The baby closes the mouth until the painful tension caused by a short frenulum dissipates, resulting in a shallow latch. Experts have had the experience of finding that lactation experts are often unaware of the association between tongue or lip tie and:

  • “Small mouth” breastfeeding
  • Pursing the lips, and
  • Prolonged, painful nursing.

Long-Term Effects: Tongue/Lip Tie and Dental Occlusion

A normal palate and process of development

Research shows that proper breastfeeding directly contributes to improved dental occlusion, which is the position of the teeth when the mouth is closed. Successful breastfeeding also encourages optimum craniofacial development. The palate is naturally expanded through normal breastfeeding, and the following explains the process:

The palate is molded into a broad shelf when a pliable breast is lifted by the tongue, and at the same time, pressure is placed on the gums. The teeth, as a result, ultimately grow inadequately spaced.

As a child grows older, the palate is central to facial growth. With a low, broad palate, breathing out of the nose is easy and the potential for sleep apnea and sleep disordered breathing is reduced.

A high palate and disruptions resulting from tongue/lip tie

If an infant has a high palate and tongue-tie and therefore fails to breastfeed properly, the following are among the potential results:

  • The nasal cavity is contracted because the palate becomes arched instead of properly expanding. A high palate is often immediately noticeable after the child is born because the baby will snort heavily during nursing. For children with tongue/lip tie, the latch is further complicated by nasal obstruction.
  • If the floor the septum is on rises up, the result is a deviated septum, though this is a delayed response, occurring over the course of years.
  • Above two responses predispose an infant to mouth breathing.
  • A high palate is associated with crowded teeth, referred to as maxillary constriction.

More Medical Professionals Need to Know

It helps a great deal when health care professionals are able to identify various behaviors as symptoms of tongue/lip tie. There are many preventable consequences associated with failing to treat these conditions, including: premature termination of breastfeeding, misalignment of the teeth, and disordered breathing that disrupts sleep later on in life.