Understanding Tongue Tie in Infants:

How Agape Pediatric Dentistry Can Help

At Agape Pediatric Dentistry, we understand that feeding your newborn should be a joyful bonding experience. But sometimes, difficulties can arise, and parents may wonder what's causing their baby's feeding challenges. One possible factor could be what's known as a "tongue tie."

tongue tie treatment agape pediatric dentistry

What Exactly is a Tongue Tie?

A tongue tie (known medically as ankyloglossia) is a condition where the thin band of tissue beneath your baby’s tongue—called the frenulum—is unusually tight, short, or thick. When this happens, your baby’s tongue movements may be limited, leading to challenges with breastfeeding or bottle feeding.

Two Types of Tongue Tie

Anterior Tongue Tie: Easy to Spot, Easier to Diagnose

An anterior tongue tie is the more noticeable type of tongue tie:

Location: The frenulum—that small band of tissue connecting the tongue to the floor of the mouth—is attached near the front of your baby's tongue, close to the tip.
Appearance: This type of tie is typically visible during basic observation, causing the tongue to appear heart-shaped or notched when extended.
Diagnosis: Because it's easy to spot visually, an anterior tongue tie can usually be identified quickly during a regular physical examination at our office.

Posterior Tongue Tie: Less Obvious, but Just as Important

A posterior tongue tie can be trickier to identify:

Location: This type occurs when the frenulum is attached further back, closer to the base of the tongue.
Appearance: Unlike anterior ties, a posterior tie is not easily visible. The frenulum is shorter, tighter, and tucked deeper underneath the tongue, making it more subtle.
Diagnosis: Posterior ties often require a trained eye and experienced practitioner for accurate diagnosis. At Agape Pediatric Dentistry, Dr. G and our specialized team know exactly what to look for, even with these less obvious oral ties.

Difference Between a Normal Tongue and a Tongue-Tied Tongue

Signs & Symptoms of Tongue Tie

Tongue, lip, or cheek ties can affect babies, toddlers, and even older children differently. At Agape Pediatric Dentistry, we're here to help you recognize these signs early, making sure your child can feed comfortably, speak clearly, and thrive as they grow. Below, we've outlined common symptoms to help you identify if your child (or you, as a breastfeeding mother) might be experiencing difficulties related to an oral tie.

Symptoms for Breastfeeding Mothers

Painful breastfeeding (nipple soreness, cracks, blisters, or bruising)
Flattened, creased, or blanched nipples immediately after feeding
Breasts don’t feel fully emptied after feeding sessions
Frequent clogged milk ducts or mastitis (breast infections or inflammation)
Low milk supply due to ineffective milk removal
Long, exhausting feeding sessions due to ineffective latch

Symptoms in Infants

Difficulty latching onto breast or bottle
Frequently slipping off or losing latch during feeding
Clicking noises while feeding (signs of improper latch)
Gumming or chewing on the nipple instead of effective sucking
Prolonged feeding times (baby feeds slowly or seems constantly hungry)
Falling asleep quickly or tiring during feeds
Poor weight gain or growth concerns due to inadequate milk intake
Colic or gas (fussiness, drawing knees up, arching back, tummy discomfort)
Reflux-like symptoms (frequent spitting up, discomfort after feeding)
Difficulty accepting a pacifier or bottle
Mouth breathing rather than breathing comfortably through the nose
Notched or heart-shaped tongue appearance when extended

Symptoms in Toddlers

Speech difficulties or unclear pronunciation (especially letters like T, D, L, S, TH, Z)
Limited tongue mobility (trouble sticking out tongue, raising tongue upward, or moving it side-to-side)
Challenges chewing or swallowing solid foods (resulting in picky eating or preference for soft foods)
Gagging or choking on foods easily due to poor tongue movement
Mouth breathing during the day or nighttime
Noticeable gap between lower front teeth

Symptoms in Older Children

History of breastfeeding challenges in infancy
Speech delays or ongoing speech difficulties
Slow eating, prolonged mealtimes, and picky eating behaviors
Frequent colds, congestion, allergies, or respiratory issues
Digestive problems such as reflux, upset stomach, or colic-like symptoms
Teeth grinding (bruxism), especially at night
Difficulty concentrating, restlessness, or daytime sleepiness
Misaligned teeth or orthodontic concerns (crowding, spacing, improper bite)
Snoring or heavy breathing during sleep

How Can I Tell if My Child Has a Tongue Tie?

At Agape Pediatric Dentistry, we know parents want to understand every detail about their child's health. If you're wondering whether your little one might have a tongue tie, here are some simple ways to check at home. Look closely at your child's tongue when they cry, yawn, or lift their tongue upward. You might notice:

A heart-shaped or notched appearance at the tip of the tongue
Difficulty moving the tongue side-to-side
Inability to touch the tongue to the upper gums or roof of the mouth
Difficulty extending the tongue past the lower gums
Trouble licking their lips or lifting the tongue toward the nose
Additionally, you can gently examine the frenulum (the small band of tissue under the tongue). A tight, short frenulum is easier to spot when your baby cries or yawns and may be a sign of tongue tie.

What Causes Tongue Tie?

While the exact cause of tongue tie isn't fully understood, several factors may play a role:

Family History: Tongue tie often runs in families. If a parent had an oral tie, it's possible their child might have one, too.
Developmental Factors: Normally, the frenulum under the tongue loosens before birth, allowing free movement. With tongue tie, this doesn't fully happen, leaving the frenulum short or tight.
Environmental Influences: Though rare, certain environmental factors during pregnancy, like nutritional deficiencies or exposure to toxins, might contribute.
Related Health Conditions: Occasionally, tongue tie appears alongside other conditions, though it frequently occurs in babies who are otherwise perfectly healthy.

Laser Technology for a Gentler Frenectomy

At Agape Pediatric Dentistry, we use the Fotona laser to perform precise and minimally invasive frenectomies. This advanced laser technology offers several benefits, including minimized bleeding, less swelling and discomfort, a reduced risk of infection, shorter procedure times, and faster healing and recovery. The procedure begins with the BabyLase process, which gently releases the fascia (connective tissue) to improve mobility. If additional release is needed to restore proper function, a laser frenectomy may be recommended for optimal results.

What to Expect During Your Baby’s Frenectomy

Your baby will be treated with gentle, loving care throughout the procedure, and we take every precaution to minimize discomfort while ensuring a calm, safe experience. Before the procedure, your baby will be fitted with protective eyewear, and a topical numbing gel will be applied to enhance comfort. During the procedure, the laser gently releases the restricted tissue in a quick process that lasts only a few minutes. Once complete, your baby will be immediately returned to you for comfort. We encourage you to nurse or feed your baby right away, as this helps soothe them and promotes healing.

Our Location

Welcome to Agape Pediatric Dentistry in Peachtree Corners, your local Board-Certified Pediatric Dentist located right above Trader Joe's at The Forum at Peachtree Corners. We service families in Peachtree Corners, Peachtree Station, Norcross, CC of the South, Johns Creek, DoubleGate, Duluth, Dunmoor, Embry Hills, The Fields Club, Winwood, Glenn Abbey, Berkeley Lakes, Neely Farm, Oxford Mill, Park Brook, St Ives CC, St Marlo, Sugar Mill and surrounding areas.