Tongue-Tie in Babies and Adults

By Lovik Mirzaeian, DDS. Updated October 2026.

Tongue-tie is a condition where the small band of tissue under the tongue, called the lingual frenulum, is short, thick, or attached too far forward, so the tongue cannot move freely. In babies it can interfere with breastfeeding. In older children and adults it can affect speech, eating, oral hygiene, and jaw comfort. Not every tight frenulum needs treatment, and the decision to release one should rest on what the tongue can and cannot do, not on how it looks.

Opinions on this have swung hard in both directions. For decades tongue-tie was ignored, and more recently it has been diagnosed and treated in large numbers, sometimes on thin evidence. It is real, it matters for some patients, and it is overdiagnosed in others.

What a Tongue-Tie Looks Like

Everyone has a frenulum, the thin fold running from the floor of the mouth to the underside of the tongue. In a tongue-tie, the fold is short or attached close to the tip, and when the person tries to lift the tongue toward the palate or stick it out, the tip pulls into a heart shape or barely clears the lower teeth.

Some ties are obvious and reach nearly to the tip. Others sit farther back, under the surface, and are found by feel and by testing what the tongue can do rather than by looking. Those posterior ties are the ones most argued about, and experts still disagree about how to define them.

Signs in Babies

The main concern in newborns is feeding. A baby who cannot lift and extend the tongue may struggle to latch, slip off the breast repeatedly, click while feeding, tire quickly, and gain weight slowly. The mother may have persistent nipple pain, cracking, or repeated blocked ducts despite good positioning help. Bottle-fed babies can have trouble too, though less often.

Most feeding problems are not caused by tongue-tie. Latch, positioning, supply, and the baby’s coordination matter more in most cases. Before anyone talks about a release, the family should see a lactation consultant, and ideally one who has no stake in whether a procedure happens. If feeding improves with help, the tie is not the problem.

Signs in Older Children

As children grow, a tight tongue shows up differently. Certain speech sounds, particularly those that need the tongue tip to reach the palate or the front teeth, can be hard to make clearly. The child may struggle to lick an ice cream cone or clear food from the cheeks. Some children have a low resting tongue posture, which is tied up with mouth breathing and a narrow palate, as described in our post on mouth breathing in children.

A gap between the lower front teeth where the frenulum pulls on the gum, and gum recession behind the lower front teeth, are dental signs I look for. Speech concerns should be assessed by a speech-language pathologist first, because many sound errors at age four or five are simply developmental and resolve without any procedure.

Signs in Adults

Adults with an unreleased tongue-tie have usually adapted, and many never know they have one. The ones who come in describe a cluster of small things: difficulty clearing food from their teeth with the tongue, a tongue that gets tired when talking for long periods, trouble with certain sounds, or discomfort when kissing or licking the lips. Some report jaw tension or neck tightness, though the connection there is less certain and I am careful not to promise that a release will fix it.

Oral hygiene is a practical issue. A tongue that cannot sweep the mouth leaves more food and plaque behind, and I see more decay and gum inflammation on the tongue side of the lower teeth in these patients.

When a Release Is Worth Doing

A frenectomy, or tongue-tie release, is a short procedure that frees the tight band, either with a scalpel, scissors, or a laser. In a young baby it takes seconds, usually with no anesthetic or just a numbing gel, and feeding can resume immediately. In older children and adults it is done with local anesthetic, takes a few minutes, and heals over a week or two with some soreness. Simple stretching exercises afterward help stop the tissue from reattaching.

I recommend a release when there is a clear functional problem, the tie is a plausible cause, and conservative help has not solved it. For a baby, that means a feeding problem that has not responded to lactation support. For a child, it means documented speech or eating difficulty that a therapist believes is related to tongue movement. For an adult, it means symptoms that genuinely affect daily life. I do not recommend a release because a frenulum looks tight or to prevent problems that have not appeared.

Risks are low but not zero: bleeding, infection, scarring that reattaches, and, rarely, damage to the salivary ducts or the nerve under the tongue. The American Dental Association recommends a first dental visit by the first birthday, and that visit is a good time to have the frenulum looked at along with everything else.

What Nobody Knows for Certain

There is decent evidence that a release helps breastfeeding in babies with an obvious tie and a clear feeding problem. Evidence for the benefits in speech, sleep, posture, and jaw pain is thinner, and some of the claims made online go well beyond what studies support. A release done for the right reasons is a small procedure with a good chance of helping. A release done for vague reasons may help, may do nothing, and occasionally causes a problem that was not there before.

When to See a Dentist

If your baby is struggling to feed, start with your pediatrician and a lactation consultant, then ask us to look at the tongue if the problem persists. For a child with speech or eating concerns, a speech-language pathologist’s assessment comes first, and we work alongside them. Adults who suspect a tie can simply mention it at a routine exam. As a family dental practice we see every age, and our post on when a child should first see a dentist explains what that early visit covers.

Frequently Asked Questions

What are the signs of tongue-tie in a baby?

Difficulty latching, slipping off the breast, clicking sounds while feeding, tiring quickly, slow weight gain, and persistent nipple pain for the mother despite positioning help. Most feeding problems are not caused by tongue-tie, so a lactation consultant should assess the baby before a release is considered.

Can tongue-tie affect adults?

Yes. Adults with an unreleased tie may have trouble clearing food from their teeth, a tongue that tires with talking, difficulty with some speech sounds, and more plaque and gum inflammation on the tongue side of the lower teeth. Many adults with a tie have adapted and never need treatment.

Does tongue-tie release hurt?

In a young baby the release takes seconds, often with no anesthetic or a numbing gel, and feeding can resume right away. In older children and adults it is done with local anesthetic and heals over a week or two with mild soreness. Simple stretches afterward help prevent reattachment.

Does every tongue-tie need to be treated?

No. A release is worthwhile when there is a clear functional problem, such as a feeding difficulty that has not improved with lactation help or a speech issue a therapist links to tongue movement. A frenulum that looks tight but causes no problems is best left alone.

Questions About a Tight Tongue? Dr. Mirzaeian Can Help

We will look at what the tongue can actually do, tell you honestly whether a release is likely to help, and point you to the right therapist if that is the better first step. Please contact us to set up a consultation.

Lovik Mirzaeian, DDS has achieved extensive training in multidisciplinary dental treatments. His credentials include Dental Implants, Cosmetic Dentistry, Full Mouth Reconstruction, Endodontics, Oral Surgery, Orthodontics, and Sleep Sedation. Our office puts your comfort and smile first, and we are dedicated to giving you top-notch dental care. Get ready to show off your perfect smile!

Looking for a trusted family dentist in Clovis? Dr. Mirzaeian welcomes new patients of all ages.