Hey everyone, Dr. Boom here with Rising Stars Pediatric Dentistry & Orthodontics in Irving, TX. Today, let’s dive into a topic we get a lot of questions about: tongue ties. What are they? How do they affect your child? And when should we actually do something about them?
Let’s break it down in simple terms.
What Is a Tongue Tie?
A tongue tie is when the tongue is tightly tethered to the floor of the mouth. That tight tissue underneath the tongue is called a frenum (or sometimes “frenulum”). While many people assume tongue ties just mean you can’t stick your tongue out very far, it’s a bit more nuanced than that.
In the dental world, we often refer to these conditions more broadly as tethered oral tissues or tethered oral ties, because this tight tissue can also exist in the upper lip, cheeks, or even lower lip.
Everyone has these frenum tissues, they help anchor and support the soft tissues in your mouth. But when they’re too tight or restrictive, they can interfere with key functions like feeding, speaking, breathing, and even oral development.
The Parent-Infant Dyad: Why We Treat the Whole Family
At Rising Stars, we don’t just treat anatomy. We treat people—and often that means treating more than one person at a time. One concept we like to talk about is the parent-infant dyad. This simply means that when a baby is struggling with a tongue tie, the parent is usually struggling too.
When Baby Suffers
We often see babies who:
- Feed for over an hour without getting full
- Can’t sleep well due to fatigue or gas
- Aren’t gaining weight appropriately
- Are irritable or wake frequently throughout the night
These symptoms can be signs that the tongue is restricting movement so much that feeding is inefficient and exhausting.
When Parents Suffer
We also see parents (especially nursing moms) who:
- Experience toe-curling pain during feeds
- Have cracked or bleeding nipples
- Feel emotional distress due to failed nursing sessions
- Are physically and emotionally exhausted
Sometimes, we treat the baby for the baby. Sometimes we treat the baby for the parent. But most often, we treat both. And that’s a perfectly valid reason to move forward with care.
Why Laser Is Our Preferred Method
Let’s talk about technology. The way tongue ties have been treated has changed a lot. Believe it or not, midwives used to clip tight tongue tissue using their fingernails. We’ve thankfully moved beyond that.
Today, we use two types of lasers at Rising Stars Pediatric Dentistry & Orthodontics:
1. CO₂ (Carbon Dioxide) Laser
- Non-contact laser
- Precise and gentle
- Minimal bleeding
- Fast treatment (often under a minute)
- Smooth, clean healing
2. Diode (Contact) Laser
- Laser touches the tissue directly
- Still offers quick, safe release
- Great for toddlers and older children
Using lasers allows us to perform frenectomies with less discomfort, faster recovery, and less trauma to the surrounding tissue. And compared to scissors or scalpels, the healing is typically easier for both the child and parent.
Our Three-Visit Tongue Tie Treatment Process
Treating a tethered oral tie isn’t just a one-and-done moment. It’s a process that involves thoughtful planning, clear communication, and guided aftercare. Here’s what to expect at Rising Stars:
Visit 1: The Consultation
This is where we listen. Whether you’re bringing in a 5-day-old baby, a toddler, or a teen, we start with an in-depth conversation.
We use age-specific evaluation forms to understand:
- For infants: Are they gaining weight? Is there a shallow latch? Do they choke, click, or fall asleep during feeds?
- For toddlers/children: Is there delayed speech? Trouble with certain sounds? Excess drooling?
- For older children or teens: Is there a gap between front teeth that won’t close? Trouble chewing or speaking clearly?
Dr. Boom or Dr. Coko will spend one-on-one time with you and your child to assess the issue and explain what treatment might look like.
Visit 2: The Procedure
If treatment is recommended, we schedule a separate visit for the procedure. We:
- Review everything again to ensure you’re comfortable
- Use topical/local anesthetic as needed
- Perform the release with laser for quick, gentle care
- Show you exactly how to handle aftercare
It usually takes just a few minutes, but we block extra time so you never feel rushed.
Visit 3: One-Week Follow-Up
This appointment is crucial. Healing is where the real work begins.
We want to:
- Make sure the site is healing correctly
- Address any concerns or discomfort
- See if the tissue needs a quick revision (rare but possible)
- Offer encouragement and guidance on next steps
The Importance of Aftercare
The actual frenectomy is only a small part of the treatment. Aftercare is everything.
For Infants
- Parents are shown how to stretch the area gently several times per day
- Stretching helps keep the tissue from reattaching
- Expect this to continue for 3–4 weeks
We walk you through how to:
- Perform stretches
- Support feeding post-procedure
- Spot signs of reattachment or healing trouble
We also recommend checking in with your lactation consultant or infant feeding therapist if you have one.
For Older Children and Teens
Post-release care often includes working with a myofunctional therapist or speech-language pathologist to help retrain the muscles of the mouth.
Why? Because the tongue and lips develop habits around restriction. Once the tissue is released, those habits don’t magically go away—they have to be retrained for full function.
These professionals help your child:
- Learn to speak with improved clarity
- Chew and swallow efficiently
- Maintain long-term oral health and function
Symptoms We Commonly See by Age Group
Infants (0–12 months)
- Poor latch on breast or bottle
- Long or frequent feeds
- Clicking or gulping sounds
- Falling asleep mid-feed
- Reflux or gassiness
- Inadequate weight gain
- Maternal pain (blisters, bleeding, pain while nursing)
Toddlers (1–3 years)
- Difficulty transitioning to solids
- Gagging or choking when eating
- Delayed speech development
- Excessive drooling
Children (4–10 years)
- Trouble with articulation (R, L, S, T, SH sounds)
- Slurred or rushed speech
- Mouth breathing
- Difficulty chewing
- Orthodontic issues (like spacing or open bite)
Teens
- Persistent spacing between teeth
- Difficulty with certain foods (chewy meats, etc.)
- Embarrassment or frustration with unclear speech
- Tension in jaw or face muscles
When NOT to Treat a Tongue Tie
Not every tight frenum needs treatment. If your child shows no symptoms, we may recommend a conservative approach: observation and regular check-ins.
We don’t treat based on appearance alone. We treat when function is affected.
What Sets Rising Stars Apart
We believe:
- In educating parents, not pressuring them
- That no question is too small
- That emotional care matters just as much as clinical care
Our team is trained in both the technical precision and the gentle communication that makes a huge difference in pediatric care.
We also offer:
- Same-day consults when possible
- Age-appropriate sedation if needed
- A warm, fun, and family-focused environment
Let’s Talk About Your Child
If your baby is struggling to feed or your older child is having speech or chewing difficulties, we’d love to help you get answers. Whether you’re ready for a procedure or just want to learn more, we’re here for you.
Call our office in Irving, TX or book your consultation online today.
At Rising Stars Pediatric Dentistry & Orthodontics, we treat more than mouths. We treat families. And we’d be honored to care for yours.