Functional Evaluation
Signs and Symptoms of Tongue-Tie and Lip-Tie
Tongue-ties (ankyloglossia) and lip-ties can affect people at different stages of life, and the signs may look different from one person to the next. For some families, concerns begin during breastfeeding or bottle-feeding. For others, challenges with oral function may become more noticeable as a child grows or even during adulthood.
At Katherman Tongue Tie Center, we take the time to listen to your concerns, understand your experiences, and carefully evaluate oral function. If something doesn’t seem quite right, you don’t have to navigate the questions alone.
You know yourself and your child best. Let’s explore what you’re noticing and whether an evaluation may be helpful.
Signs and Symptoms in Infants
A tongue-tie or lip-tie may contribute to feeding difficulties in some infants, but feeding challenges can have more than one cause.
During Breastfeeding
- Difficulty latching or maintaining a deep latch
- Clicking sounds or milk leaking during feeds
- Long or frequent feeds without seeming satisfied
- Concerns about milk transfer or weight gain
- Difficulty coordinating sucking and swallowing
During Bottle-Feeding
- Difficulty maintaining a seal around the bottle nipple
- Clicking, leaking, or frequent loss of suction
- Prolonged feeds or frustration during feeding
Other Possible Signs
- Limited tongue lift, extension, or side-to-side movement
- A heart-shaped tongue tip when extended
- Feeding-related fussiness or frequent breaks
Signs for the Breastfeeding Parent
When a baby has trouble latching or transferring milk, the breastfeeding parent may notice:
- Pain or discomfort while nursing
- Persistent nipple soreness, cracking, or damage
- Nipple compression or an altered shape after feeding
- Concerns about milk transfer or supply
These signs do not confirm a tongue-tie. A lactation consultant and an oral-function evaluation can help identify possible contributing factors.
Signs and Symptoms in Older Children
Some children have no significant symptoms, while others may have difficulty with certain oral movements or activities.
- Difficulty lifting, extending, or moving the tongue from side to side
- Trouble licking the lips or clearing food from the teeth
- Challenges chewing or moving food around the mouth
- Difficulty maintaining comfortable oral hygiene
- Speech concerns that may warrant assessment by a speech-language pathologist
These signs can have several causes. An individualized evaluation can help determine whether restricted oral movement is contributing.
Signs and Symptoms in Adults
An oral restriction may go unnoticed until adulthood. Possible signs include:
- Limited tongue mobility, including difficulty lifting it toward the roof of the mouth
- Trouble licking the lips or clearing food from the teeth
- Difficulty with certain oral movements or oral hygiene
- Gum recession where a restrictive frenum may create tension
- Spacing between upper front teeth associated with a prominent lip frenum
Gum recession, spacing, and speech concerns can have many causes. An evaluation can help determine whether a restriction may be a factor and whether another specialist’s assessment would help.
Myofunctional Therapy
For children and adults with tongue-ties, myofunctional therapy plays an important role in supporting healthy oral function. A restricted tongue may affect the way the tongue moves and functions, and therapy can help address oral muscle coordination, movement patterns, and functional habits. At Katherman Tongue Tie Center, I work collaboratively with experienced orofacial myofunctional therapists to help ensure each patient receives individualized, coordinated care. Depending on the patient’s needs, therapy may be recommended before and/or after a tongue-tie release to support functional improvement and help patients adapt to new patterns of movement. Our shared goal is to look beyond the restriction itself and support lasting improvements in oral function and overall well-being.
What About a Lip-Tie?
A lip-tie refers to a restrictive attachment of the tissue connecting the inside of the upper or lower lip to the gum. The tissue connecting the upper lip to the gum is a normal part of oral anatomy, and its appearance alone does not mean treatment is needed.
In some individuals, a restrictive lip attachment may be considered as part of a broader assessment of oral function or specific concerns, such as feeding difficulties or tension on the gum tissue. The decision to recommend treatment should be based on an individual's symptoms, examination findings, and functional needs—not simply on how the tissue looks.
When Should You Consider an Evaluation?
If you or your child are experiencing ongoing feeding difficulties, are more cavity prone along the gumline of front teeth, have a large gap between the front teeth, or recession, a lip tie may be a contributing factor and an in person assessment would be helpful to understand what function is.
An evaluation does not automatically mean treatment is needed. Our goal is to help you understand what we find, discuss appropriate options, and make a thoughtful decision based on your individual needs.
You Don't Have to Figure it Out Alone
Whether you're navigating feeding challenges with your baby, have questions about your child's oral development, or are exploring concerns of your own, we're here to listen.
At Katherman Tongue Tie Center, you'll find compassionate, individualized care and a team committed to helping you understand your options.
Have questions or wondering whether an evaluation may be right for you or your child? We're here to help.