Tongue-Ties and Lip-Ties: how to effectively deal with them in 21st-Century America

If you are reading this blog, chances are that you have, or somebody you love has, a ‘frenum’, commonly called Tongue-Tie (if it’s under the tongue) or Lip-Tie (if it’s in between the two upper front teeth). What an adventure it was for us, when we found out our little daughter had one! We hope our experience can help you find a better way to treat it than the one we had to face. What is main stream right now in America’s medical system, in fact, is unfortunately not the most effective way. If you are a doctor, a dentist or an oral surgeon who wants to know what this article is about and is willing to read it with an open mind, I salute you for that, and I kindly encourage you to read through the end.  An overly-short frenulum may require a medical procedure to achieve normal mobility. There are several ways to refer to this procedure, according to how it is performed. Scissors incision is called a ‘frenotomy’ or ‘frenulotomy’. Excising the tissue and then using sutures is called ‘frenuloplasty’. Finally, if the procedure is done with the use of Laser, it is called a ‘frenectomy’ because the laser obliterates the tissue. Let me tell you more about our experience with frenotomy and frenectomy.


When our second daughter was born, in August 2009, I was in terrible pain while nursing her, so I went to see my lactation consultant, Lori, who had helped me to nurse my first daughter correctly.  When I told her that nursing Myla was actually more painful than it had been with Keira, she opened Myla’s mouth and immediately found the reason for that excruciating pain: a very thick frenulum linguae, under her tongue, commonly called ‘Tongue Tie’. (For the importance of a Certified Lactation Consultant during the first few hours of your baby’s life, please visit my blog Lori showed us a book with some pictures of babies with that problem and pictures of the specific soreness on the Mom’s nipples (different than the ones caused by a wrong positioning of the baby at the breast). In the same book, there were pictures of older children or even adults, whose frenulum was so thick it didn’t allow the tongue to move as freely as it should.

Lori also shared with us a very informative Powerpoint presentation by Dr Brian Palmer, where we could observe different kinds of frenula, their level of seriousness and how thick they can become with age, when not clipped at birth ( We immediately opted for a clipping (frenotomy) to be done as soon as possible, considering my pain during breastfeeding and Myla’s obvious impediment in even sticking her tongue out of her mouth. Imagine how uncomfortable it is to have your tongue stuck to the bottom of your mouth! Some babies have serious problems breastfeeding (see the story of the baby from Hawaii, below), others might develop a speech impediment that could affect not only the normal development of their personality and self-esteem, but also their education and their whole life (see Connor’s Story, below).

Well, what seemed as obvious to us seemed not-so-obvious to everybody else! This is where our ‘adventure’ started.

When we took Myla to the pediatrician’s office (our pediatrician was having a baby herself, so we had to see another doctor at the same practice), she claimed that ‘tongue-tied babies are very common, and their sublingual frenulum goes away with time’. True? Well, the book we had looked at and Dr Palmer’s study showed that, in some cases, they do not go away at all, at least for the kind of frenulum our daughter Myla had. When we voiced our position and asked for a referral to a specialist who would clip Myla’s frenulum, the pediatrician said she didn’t have any referral to give us, as no doctor in that practice endorses clipping frenula in babies. I mentioned my pain in breastfeeding and she suggested that I ‘suffered through that until Myla’s frenulum was gone, or choose to give her formula.’ When we left that office, we were in a mixture of disappointment, anger and frustration. Once home, we called Lori again, who sighed (she had already imagined that such an answer could come from a pediatrician, regarding the treatment of a frenulum) and gave us the number of a midwife who could do the procedure on our baby. The clipping, she reassured us, was totally safe. And so it was. We called the midwife, Pam (, set up an appointment that same day, drove to her office and had it done in less than 3 seconds. Myla cried when she had it clipped, and it bled a little, but, as soon as I put her at my breast, she nursed in a way that already seemed different to me. She was totally peaceful after that. My breast healed in a week and she has nursed beautifully for 14 months.


About one year later, at the end of August 2010, Kevin and I were playing with our daughters in our living room and, for the first time, we noticed that Myla had a ‘strange’ smile: her lips would cover her upper front teeth completely, and none of us in the family has that problem.

Instinctively, I pulled her upper lips up and, there it was: a thick piece of tissue in between her teeth, which linked her gums to her lip much lower than what all of us had. Kevin and I looked at each other and instinctively knew that this frenulum too was there when she was born. However, this one was much thicker than the one we had clipped. ‘Oh, boy! Will the midwife be able to clip this one too?’, we wondered.

That same night, I spent hours on the internet, trying to learn more about frenum/frenulum and how to get rid of them. I found some feedback from people that had it removed at their dentist’s office from an oral surgeon and all of them said, “The sooner you do it, the better!” The parent of a 6-month-old boy said it was ‘a walk in the park’, while a 70-yr-old woman said it was so painful to have the frenectomy done in order for her dentist to put dentures in her mouth (the frenum was ‘in the middle’ and needed to be removed), she wishes she had not done it at all and had rather stayed with no dentures and no teeth! None of them, however, specified what kind of procedure they had done (if with stitches or not) – they just called it ‘frenectomy’. The day after, I called Lori, our lactation consultant, and she said that this frenulum could not be just clipped, as it was already thick, and suggested that we went to see an ENT (Ear-Nose-Throat specialist) she had just visited herself for family reasons and had had a good experience with. In order to see a specialist, however, you have to first obtain a referral from your doctor, so I went to see our pediatrician (the one who was giving birth a year before). I explained the situation to her, saying that we were sure this frenulum was already there when Myla was born and now it had got thicker. I also said that Lori, who she knew very well, as she had referred me to her two years before, was suggesting that we went to see a specific ENT, and we were willing to go show him Myla as soon as possible.

To my surprise, our pediatrician said there was no reason to be so upset over something ‘so small’ if compared to Myla’s heart murmur and that we should focus on seeing a cardiologist first. She added that frenula usually go away with time, that this one was not creating Myla any feeding problem, therefore, in a couple of months, I could just show it to a pediatric dentist and see what he might think. Once home, I told my husband what she had said and asked him, ‘Do you think that we are making a fuss over anything and that, this being only ‘esthetical’, we should let it be?’ He was very upset about our pediatrician’s response, and said, ‘Absolutely not! This frenulum is NOT going to go away, as we well know and have seen in the book and in Dr Palmer’s study. What are we waiting for? That she turns 14, has a huge gap between her teeth, not to mention a much thicker frenulum that doesn’t even allow her to smile normally, and that she needs to remove it then, and get braces at a huge financial expense on our part? Nonsense! If we take it off now, she might need braces anyway, but if we leave it there, she will need them for sure. To me, the answer is obvious: let’s get it done Now!’ Having decided that, I called our pediatrician’s office again, told the secretary we had decided this was important to us and wanted it checked by a specialist as soon as possible, and asked to have the referral to the ENT I had been advised about. The secretary said she would talk to the doctor and let me know.

In the meantime, that evening, I kept on researching information online and found some different kind of frenectomies for labial frenula. has excellent videos, so I found there were at least three ways to the procedure: Z-plasty surgery, the traditional way with scalpel and scissors and stitches and, lastly, laser surgery. A few months before, our pediatrician had given me her personal e-mail address, as she was changing practice and that was the way to communicate with the patients who wanted to follow her. Therefore, inspired by the information I had found, I shared it with her through e-mail and I also sent her Dr Palmer’s Powerpoint presentation. The morning after, I received a phone call from the pediatrician’s secretary, who told me, in a very dry tone, that I was not supposed to use the doctor’s private e-mail address and that I had to bring Myla back in, if I wanted any referral from them at all. I was so frustrated and discouraged after that! I had sent her that e-mail with the best of intentions and the answer I got was not at all what I had expected. Rather, the opposite! My husband was furious and said, ‘You stay home. I’ll go’. The doctor ended up not giving my husband a referral to the ENT Lori had suggested, but a list of other ENTs. Therefore, we called the ENT’s office we had been advised on the first place, we fixed an appointment and then called the pediatrician’s office and asked them (with every ounce of patience we had left, as I am sure they felt the same way with us) to fax their referral to this specific ENT. If I had a specific request, why couldn’t that be satisfied? Why is everything so complicated, in 21st-century America’s medical system?? When we went to see him, he said that 90% of tongue-tied babies have an upper labial frenulum too (as we had thought) and that he clips both at birth or during the first months of life, no anesthesia needed. However, Myla being older than 4 months of age (13 months old), he would need to put her under general anesthesia, use scalpel and scissors, put a couple of stitches and be done in a few minutes. When I asked him how bad he thought her frenulum was, he said, “Significant. And, no, it will not go away with time.” He sent us home with the papers ready to be filled out with Myla’s information for the procedure. The cardiologist told us her heart murmur was very normal and he could barely hear it, so he approved the general anesthesia for the frenectomy. However, something held us back: the videos I had watched on showed that laser surgery was so much easier! Why go through general anesthesia on a little child, when you can have it done in local anesthesia? At this point, our questions were, ‘Is it possible to have laser surgery on a 13-month old? And, if so, who could do it?’ That same night, I thought that asking the leading expert in frenula was the way to go. The leading expert for us was Dr Brian Palmer, who had developed such a detailed study on the problem. Maybe he would address us on the right way. So, here I was now, writing an e-mail to this very important doctor, while a little voice in me was saying, ‘Here we go again! Now HIS secretary will call you, to tell you NOT to use his personal e-mail ever again!’

Well, less than 24 hours later, Dr Brian Palmer in person sends me the following e-mail:

Sept 17, 2010

Hi Alessia, I am retired now.  Someone you might want to contact is Dr. Larry Kotlow.  He has done, and is currently doing, research on tight frenums.  He may be able to consult with you or he may know someone in your area who may be able to help.  His contact information is: Lawrence A. Kotlow, D.D.S., P.C.[…] Hope you find help for your daughter. For Better Health! Brian Palmer, DDS

What a great man! I am sure the medical history of the future will give him thanks for all his research on the topic of frenula! Certainly my family and I will!

The day after, Saturday September 18th, I receive this other e-mail:

Alessia: Brian Palmer forwarded your e-mail onto me for comment. I would go ahead and have a laser frenectomy with no more than local anesthesia performed by an oral surgeon who knows how to do this as soon as possible to prevent further problems. If you live anywhere near Albany, New York Dr. Kotlow performs this procedure very often and is an expert on the subject, perhaps the world’s expert. You can contact him at kiddsteeth.comAlison K. Hazelbaker, PhD, IBCLC

That same day, though, I had brought Myla to a periodontist’s, to ask if he performed laser frenectomies. He said he did, but only on children who were 10 years old or older. He would not take the responsibility of perfoming it on little ones, as they move too much and it can be dangerous. He also suggested that we waited until her new teeth came out, and see if the frenulum would get thinner at that point. If it didn’t, he would consider doing it on her then, when she would be 5 or 6 years old, but not before then. Therefore, even though Dr Hazelbaker’s e-mail gave me encouragement, I wrote:

Dr Hazelbaker, thank you very much for the referral. Unfortunately, we live in Phoenix, AZ and it wouldn’t be easy for us to reach Albany, NY. Our girl is 1 year old and both an oral surgeon and an ENT told us that a local anesthesia wouldn’t be enough, as my girl is too little and would move too much for them to perform a laser frenectomy. Therefore, we were thinking of waiting until she’s 5 or 6 and then get that done. Hopefully, then, she’ll be ‘wise’ enough to stay still during the shot and the procedure. If you have any suggestions, please feel free to send them our way. Thank you so much for your time.

This was her reply: I would strongly encourage you to get a consult with Dr. Kotlow. He does laser surgery on this age child all the time. I am sure he would speak to you on the phone. I also strongly encourage you NOT to wait until she is 5-6. By then she may have developed all manner of compensations like speech delay and dental problems. Now is the time when you have the power to prevent problems from developing. Alison K. Hazelbaker, PhD, IBCLC

Reassured by her words, I picked up the phone and called Dr Kotlow. He talked to me directly, which I so highly appreciated, and explained that very few doctors and oral surgeons, if any, want to accept the fact that frenula need to be removed early and that laser frenectomies on babies or kids of any age, as well as on adults, are totally safe, fast and give great results with a very short recovery time, if compared to any other procedure. He added that people fly to his office in Albany, NY from all over the place and can fly back home the very next day. The procedure itself lasts only 5 minutes or so. I thanked him so much for reassuring us, and then I gently asked him if he knew of anybody who performed laser frenectomies in Arizona. He answered, ‘Nobody in Arizona that I know of. In California, I know Dr James Jesse. You can contact him and, if he can’t help you, you can call me again. Good luck’. Another great man! After talking to him, we felt so confident that we were moving in the right direction, doing what was best for our little daughter. But, man, wouldn’t all this be much easier for your family if your pediatrician and your dentist knew too??

When I called Dr. James Jesse, his daughter and assistant was, too, very kind. She explained that:

– only very little local anesthesia was needed on the frenulum, then laser, the whole thing lasting about 5 minutes;
– Tylenol only if the child complains too much after the procedure. When they follow up after 24 hours, parents 99% of the times say the kid is doing great and needed no Tylenol or other drugs at all;
– two weeks from the day of the procedure, you can barely see a scar on that point!

I ask the magic question again, “Anybody in Arizona?” she says she doesn’t think so, but then asks Dr Jesse and he gives me the phone number of a classmate of his in Scottsdale that might do it. (What a great man and professional he is as well, like Dr Palmer and Dr Kotlow! So hard to find, in today’s age!). I called the doctor in Scottsdale, but his assistant says, “No, he doesn’t use laser. And, wow, on a 1 year old? Oh no, we don’t treat patients that young!” Our new pediatrician defined Myla’s frenulum ‘pretty significant’ and sent a written request to our insurance, to see if they could cover the procedure. In his letter, he mentioned that ‘indications for the surgery include: prevention of potential gum recession, speech articulation defects and front-tooth diastema’ and that laser surgery is to be preferred because, ‘in comparison to traditional surgery, does not require general anesthesia, saving medical risk to this young child, as well as medical costs; perioperative complications and pain are also potentially less’. While waiting for a reply from our insurance, I called the 22 oral surgeons on their list in the state of Arizona. 19 of them told me they don’t perform laser frenectomies (some of them doubted the fact that frenectomies can be performed with laser, especially on children this young), 1 performed Z-plastic surgery with general anesthesia and 2 very confidently told me that there is no way that laser can be as effective as what they perfom, which is scalpel-and-scissor incision in general anesthesia. Another pediatric dentist right by our house bluntly told me that he would never put his own kids into such a ‘distress’ as a frenectomy, especially at this young age, and that “the only intelligent thing to do is wait until her new teeth come out.” When I mentioned laser, he literary said it is ‘dangerous’ on kids so little and that the frenulum ‘comes back’ if treated with laser. “Well”, I said, “pretend she’s 10 today and I’m back and the frenulum is still there. Will you remove it, or would you send me to somebody else?” At my words, he lost his patience, left the room, came back with a phone and called somebody, evidently the oral surgeon he works with, in those cases. To everything the surgeon would say, the dentist would add, “I told her! Yes, I told her!” and, after hanging up, he said, “As I told you very clearly already, there is no need to remove a frenulum at this early age! Wait until her new teeth come out and then we’ll see. I am pretty confident the frenulum will be gone by then. Removing it at this age, and with all the risks involved, just wouldn’t make sense!”

At this point, we just realized that a great part of doctors and oral surgeons do not have the right information at hand on the matter of frenula and frenectomies. This is the ‘why’ of this booklet: to raise awareness that, YES, there is a better way! And that the sooner it gets done, the better.

The result from our insurance came back, saying that “the procedure’s expenses cannot be covered by the insurance, as the frenulum does not interfere with feeding, therefore it is only ‘esthetical’ and has to be paid in full by the patient”. However, the procedure was not too expensive, under $400, so that same day we called Dr Jesse in California, scheduled the procedure for the following week and got it done.

On, Monday, January 3rd 2011, at 8 am, Dr James Jesse performed a laser frenectomy on Myla. Total length of the procedure, from injection of local anesthetic to end: 6 minutes. The laser procedure itself: 1 minute and 25 seconds!

As soon as my husband let go of Myla (he was holding her down during the frenectomy), she stopped crying and enjoyed the popsicle that Dr Jesse’s assistant had nicely given her. We couldn’t believe how fast and simple the whole procedure was!

That same evening, we were back home. Myla had been happy as always during the 6-hour drive back to Phoenix, watching dvds with her big sister in the back seat, having another popsicle on the way and an ice-cream after dinner. As promised, the day after, Dr Jesse’s assistant called us to check that everything was ok. Myla had slept very well that night and had not complained at all about her booboo (she just pointed at it once, saying, ‘Booboo, Mommy’, and, after my kiss, never mentioned it again). No Tylenol was needed. We pulled her lips up and held them for 10 seconds about 6 or 7 times a day for one week, as suggested by Dr Jesse. On day 10, we could barely see the scar. Today, after exactly 1 month after the procedure, you can’t even tell a frenum, a frenulum or a frenectomy happened there! We all enjoy her beautiful smile with her teeth out, not covered by her lips, and her big diastema (gap between her front teeth) is already closing, helping the other two front teeth get in a better position than the lateral one they were growing in before. And, I must add, the whole procedure is very inexpensive, so the fact that our insurance did not cover it was not a big deal. Whichever the price, laser frenectomies, especially when done early in life, are so worth every penny spent to have them done! How much is your child’s smile and, most importantly, his/her health and well-being worth to you?


Some information I found on the web:


J Periodontol. 2006 Nov;77(11):1815-9.
Evaluation of patient perceptions after frenectomy operations: a comparison of carbon dioxide laser and scalpel techniques
Haytac MC, Ozcelik O., Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey.

BACKGROUND: A frenum that encroaches on the margin of the gingiva may interfere with plaque removal and cause tension. Frenectomy is the complete removal of the frenum that can be made by scalpels or with soft tissue lasers. The aim of this article was to compare the degree of postoperative pain, such as discomfort and functional complications (eating and speech), experienced by patients after two frenectomy operation techniques.
METHODS: Forty patients requiring frenectomy were randomly assigned to have treatment either with a conventional technique or with a carbon dioxide (CO2) laser. The postoperative pain and functional complication ratings of each patient were recorded using a visual analog scale on days 1 and 7.
RESULTS: The results indicated patients treated with the CO2 laser had less postoperative pain and fewer functional complications (speaking and chewing) (P <0.0001 each) and required fewer analgesics (P <0.001) compared to patients treated with the conventional technique.
CONCLUSIONS: This clinical study indicates that CO2 laser treatment used for frenectomy operations provides better patient perception in terms of postoperative pain and function than that obtained by the scalpel technique. Considering the above advantages, when used correctly, the CO2 laser offers a safe, effective, acceptable, and impressive alternative for frenectomy operations.

PMID: 17076605 [PubMed – indexed for MEDLINE]


Photomed Laser Surg. 2008 Apr;26(2):147-52.
Evaluation of patient perceptions of frenectomy: a comparison of Nd:YAG laser and conventional techniques.
Kara C., Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.

OBJECTIVE: The aim of the randomized controlled clinical trial described here was to determine the anxiety levels of patients prior to frenectomy using the Nd:YAG laser and conventional technique, and to compare the effects of these two methods on the degree of postoperative pain, discomfort, and functional complications (eating and speech).
METHODS: Forty patients with mucogingival problems due to labial frenums (both maxillary and mandibular) were included in the study. Ratings of preoperative fear and postoperative pain and functional complications for each patient were recorded using a visual analog scale at 3 h, 1 d, and 1 wk post-surgery.
RESULTS: The results indicated that patients treated with the Nd:YAG laser had less postoperative pain and fewer functional complications (p < 0.05).
CONCLUSION: The results suggest that in the population studied, Nd:YAG laser treatment of soft tissue disorders provides better patient perceptions of success than those seen with conventional surgery.

PMID: 18341414 [PubMed – indexed for MEDLINE]


‘A diastema also can be caused by an oversized labial frenum. The labial frenum is the piece of tissue that normally extends from the inside of your upper lip to the gum just above your two upper front teeth. In some situations, the labial frenum continues to grow and passes between the two front teeth. If this happens, it blocks the natural closing of the space between these teeth.’

….Now, knowing how much self-consciusness a big diastema can cause in teenagers growing up and even in adults who often prefer not to smile in pictures or to cover their mouth while smiling or laughing in front of other people, not to mention the much more serious health problems a frenulum can cause, why don’t pediatricians, dentists and oral surgeons naturally search for a better way? They are very busy with a million issues, and I salute each one of them for everything they do for us every day, but I also hope and pray that this article and this blog can help spread the information on laser frenectomy and the advantages of doing it early in life.
In our opinion, there is no better way to treat a thick frenulum than Laser Frenectomy, right here, right now, in 21st-century America. The fact that Dr Kotlow and Dr Jesse perform this procedure is a blessing, and the ‘good news’ need to be spread! Dr Brian Palmer, Dr Lawrence Kotlow and Dr James Jesse have studied the topic deeply – now it is up to us who have the results in our hands to help them with raising awareness on a problem that seems so little, but can affect many young men and women’s self-esteem, health and even finances, when we consider braces, speech therapist and such.

My best wishes of good luck to you, if you are starting your adventure right now! And a call to ‘join the cause’, if you have had a personal experience with frenula and frenectomies and are willing to share your information with others. Remember, a battle for a cause that can improve people’s lives, bringing them physical and psychological well-being, is always a battle worth fighting!

If you wish to share your story, so it can be posted on this blog, please send an e-mail to Alessia Mogavero: We are looking forward to receiving your testimony and read what you have to say on frenum, frenulum and frenectomy!


Kevin and Alessia Mogavero


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Tongue-Tie: Diagnosis, Symptoms, Surgery, and More

Ask the Dentist, a dental website that helps optimizing dental health and well-being, published an excellent and very informative article on the topic of Tongue-Tie in October 2021. You can read the full article, complete with pictures, by following this link:
Or you can read the content here:

Tongue Tie (Ankyloglossia): Diagnosis, Symptoms, Surgery, and More
Written by Sarah Hornsby, RDH on September 17, 2017 (Updated: October 26, 2021)

Is a tongue tie, an issue with the frenulum of the tongue, the source of your child’s breastfeeding or speech issues?

For a long time, people just didn’t seem to know much about tongue ties. In the early years of my practice, few of my patients had ever heard of it! When I pointed out that they or their children might be tongue tied, I was often the very first practitioner who’d mentioned it to them.

When I told them that a tongue tie might actually be the root cause of their oral myofunctional issues, or even their sleep apnea, I’m sure that some of them thought I was crazy.

But in the last few years, tongue ties have gained center stage as more families put an emphasis on the importance of breastfeeding.

Diagnoses have been skyrocketing. Dentists and orthodontists also began reaching out more frequently to discuss the application of myofunctional therapy exercises to tongue tie treatment. Today, that little bit of interest has become a surge of awareness. 

Tongue ties and their impact on health and craniofacial development are finally becoming mainstream. This is great news, because it means that fewer people will suffer from undiagnosed and untreated symptoms of a tongue tie.

Catching and treating a tongue tie early is vitally important, so in this article, I’ll cover everything parents need to know about tongue ties.

What is a tongue tie?

Tongue tie is the improper development of the anchoring of the tongue to the mouth, which results in limited tongue movement. The frenulum, which is what attaches the tongue to the floor of the mouth, is too short, too thin, or too tight to allow for proper tongue use.

Being tongue tied isn’t just a figure of speech—it’s a very real medical condition. Tongue tie affects oral and facial development and has a range of other serious health consequences that may not appear for decades.

We all have a lingual frenulum (or frenum) under our tongue. If you lift your tongue and look in the mirror, you’ll see it. The frenum is the tissue that connects the tongue to the floor of the mouth. 

Normal lingual frenulum function means that the tongue, with the mouth closed, rests on the top of the mouth and touches the back of the front teeth.

In some people, the frenum is tighter or thicker than it should be, which can physically restrict the movement of the tongue.

A tongue tie can also be referred to as ankyloglossia, short frenum, anchored tongue, or tethered oral tissue (TOT).

How to Diagnose a Tongue Tie in Babies, Children, or Adults

There are a few ways to classify or identify tongue ties, but it’s an art, not a science—and experts don’t agree on diagnostic criteria. Not all tongue ties can be seen with the naked eye, and some “normal” looking tongues suffer from limited range of motion and must be treated. 

That’s why it’s important, ultimately, to have a tongue tie diagnosed by a pediatrician, ENT physician, dentist, myofunctional therapist, or board-certified lactation consultant. 

The assessment tool developed by Kotlow can be useful in classifying severity of a tongue tie, although this isn’t the only diagnostic tool available. It defines the distance of the tie to the tip of the tongue:

  • Class 1: Mild, 12-16 millimeters
  • Class 2: Moderate, 8-11 millimeters
  • Class 3: Severe, 3-7 millimeters
  • Class 4: Complete, less than 3 millimeters

Another way to classify tongue ties include looking for anterior or posterior ties. Anterior ties would be all four classes named above, which are visible and measurable, while a posterior tie lies beneath the mucous membranes in the bottom of the mouth. You can only diagnose a posterior tongue tie by touch. 

The system developed by Hazelbaker in the 1990s uses slightly different measurements and includes additional information to identify ties:

  • Type 1, 100% Tongue-Tie: Anterior tongue tie less than 2 millimeters from the tip, attached to the alveolar ridge, frenulum can be thin, thick, restricted, or elastic
  • Type 2, 75% Tongue-Tie: Anterior tongue tie, 2-5 millimeters from tip, attached to the alveolar ridge, or base of ridge/mouth floor, frenulum may be tin, thick, restricted, or elastic
  • Type 3, 50% Tongue-Tie: Mid tongue tie, 6-10 millimeters from tip, attached to alveolar ridge/mouth floor, frenulum may be thin or thick but is more restricted, as more of the tongue is “free”
  • Type 4, 25% Tongue-Tie: Posterior tongue tie, 11-15 millimeters from tip, attached to mouth floor/base of alveolar ridge or on the alveolar ridge, frenulum may be thin or thick but is less restricted
  • Type 5, Submucosal Tongue-Tie: Posterior tongue tie, more than 15 millimeters from tip, attached to mouth floor or base of alveolar ridge, frenulum is typically thin and shiny when tongue is lifted

The method developed in the UK by Griffiths et al used classification by three visual appearances of the frenulum:

  • Diaphanous (transparent)
  • Medium (not transparent)
  • Thick (chunky)

    Other identifiers used to check for tongue ties in newborn babies include:
  • Heart-shaped tongue
  • “Eiffel tower” frenum
  • Lip ties (scroll down for more on this)
  • Unusually thick frenum
  • Nipple pain or other breastfeeding difficulties, especially when accompanied by a “clicking” as baby attempts to latch
  • Prolonged drooling
  • Difficulty raising the tongue, moving it sideways, or sticking out the tongue

In older children or adults, tongue tie can cause symptoms like:

  • Speech difficulties
  • Problems with eating, such as issues licking an ice cream cone
  • Inability to stick out the tongue beyond the upper lip
  • Issues kissing with tongue

8 Symptoms of Tongue Tie

As a myofunctional therapist, the position of the tongue is my key focus. Symptoms that arise from tongue tie are far-reaching and can affect not only breastfeeding but the rest of a person’s life.

The tongue should rest in the top of the mouth, filling up the entire palate from front to back. When the tongue is resting in the correct position, it shapes the maxilla (upper jaw) and guides the growth of the face. The tongue also provides an internal support system for the upper jaw.

But if a person is tongue tied, their tongue may not be able to reach the top of the mouth because it’s physically restricted. This causes the palate to develop smaller and narrower, and the teeth to grow in crooked. Also, the mandible (lower jaw) is often smaller and set back, and the airway is restricted.

Because of this, children who grow into adults without having their tongue tie treated often experience a range of oral myofunctional symptoms, including:

  • Speech issues
  • Mouth breathing
  • Jaw pain, clenching, and grinding
  • Headaches
  • Head, neck, and shoulder tension
  • Forward head posture
  • Snoring, sleep disordered breathing, Upper Airway Resistance Syndrome (UARS), and sleep apnea
  • Increased risk of cavities and gum disease
  • Slower orthodontic treatment
  • Orthodontic relapse

Let’s take a look at the eight most significant issues that arise from a tongue tie.

1. Breastfeeding Problems

Breastfeeding is one of the first ways a tongue tie can be noticed. 

When mothers have trouble breastfeeding, a tongue tie can often be to blame. The baby’s tongue is unable to make a “vacuum” on the breast because it can’t reach the lower gum, resulting in issues with latching. 

This leads many parents to resort to bottle feeding or to deal with several days or weeks of painful, frustrating breastfeeding. In extreme cases, a baby can have failure to thrive after mom’s milk supply has dropped or baby has been unable to latch.

However, if babies are bottle fed from the beginning, or meet weight-gain and growth markers, the tongue tie can be missed or overlooked.

Just because a mother managed to breastfeed her baby doesn’t mean that tongue tie isn’t an issue. 

Many times, a nurse or lactation consultant will notice a tongue tie but not recommend a release because the breastfed baby is able to gain weight. Unfortunately, issues like mastitis or low milk supply can still occur.

2017 Cochrane review found that the release of a tongue tie via frenectomy improved the mother’s pain, but didn’t have a significant effect on breastfeeding success overall. However, a clinical trial published later the same year found that clipping a tongue tie does improve breastfeeding outcomes over the first month after the procedure.

Why does this matter? For one, breastfeeding is important for the development of the mouth, jaw, and entire oral structure. It’s also helpful in bonding between mom and baby.

Not every woman is able to breastfeed, and that’s okay. However, if you can and choose to do so, it will generally help in many ways including the development of your baby’s mouth.

Ideally, correcting a tongue tie before the 72-hour mark seems to have the most positive impact on breastfeeding.

From a myofunctional perspective, the tongue tie still needs to be released so that proper oral development can take place.

2. Speech Difficulties

A tongue tie can certainly affect a child’s speech, but this may not always happen. 

Sometimes, doctors and dentists are reluctant to release a tongue tie if it hasn’t been pointed out as problematic by a speech-language pathologist. However, as I explained above, it comes down to much more than speech—growth and development of the jaws and teeth will be impacted by a tongue tie.

The most common sounds that kids struggle with if they are tongue tied are “r” and “l”. If your child has these specific speech issues, the first thing I’d recommend would be to screen for a tongue tie.

Even after an older child has undergone frenectomy, s/he will likely require speech therapy to correct any habitual speech difficulties.

3. Improper Jaw/Facial Growth

Like Dr. Burhenne, I encourage parents to do what they can to support the best possible growth of the face, jaw, and mouth. This can be done by introducing vitamin K2 in the diet as early as preconception, as well as breastfeeding and minimizing the use of pacifiers and sippy cups.

Why? Because the more you can support your child’s orofacial growth, the lower their chances will be for orthodontic treatment later in life.

Before the year 1940 or so, it wasn’t unusual to see midwives snip a tongue tie immediately upon noticing it. This was generally to support the baby’s ability to breastfeed.

Interestingly, it was during the following decades that the need for orthodontic treatment skyrocketed. This can be attributed to a number of factors, not least of which is the lack of nutrients in the standard American diet. However, it’s possible that tongue tie is partly to blame.

Untreated tongue tie leads to issues with orofacial growth, according to multiple studies. To help your child avoid the need for costly treatment such as braces, it’s a good idea to get rid of tongue ties early.

4. Sleep Disorders

While it might sound unrelated, tongue tie can lead, sometimes decades into life, to issues with sleep.

When children have an abnormally short frenulum, they are much more likely to mouth breathe during sleep. During the first two years of life, the poor tongue position may lead to development of an abnormally small palate and/or airway. These developmental problems very frequently cause disordered sleep breathing, like sleep apnea.

Because sleep apnea in children often presents like ADHD, I suggest you do the following if you know your child has symptoms of ADHD and/or sleep issues:

  1. Talk to your healthcare professional about having a sleep study conducted to look for sleep apnea or other sleep-disordered breathing and determine a treatment plan if necessary
  2. Have your pediatrician or dentist examine for tongue tie and snip it if present
  3. Schedule an appointment with a myofunctional therapist to recover full range of motion after frenectomy (otherwise, your child may still mouth breathe during sleep from muscle memory)

Sleep apnea in adulthood is associated with a large number of related chronic health conditions, so it shouldn’t be left untreated.

5. TMJ Pain

Since individuals with tongue tie don’t have optimal mouth position, more pressure may be constantly applied to the TMJ muscle. This could lead to a TMJ disorder, which can be quite painful. 

Cases of TMJ can also manifest as migraines in addition to jaw pain.

When clipping the frenulum, myofunctional therapy is important to stretching and developing better motion for the TMJ and attached muscles.

6. Slowed Orthodontic Treatment and Orthodontic Relapse

Since the position of the teeth are so impacted by the existence of a tongue tie, many sufferers need orthodontic treatment. But since the tongue can’t move properly, orthodontic treatment may take a longer time.

In addition, tongue tie makes orthodontic relapse, or the movement of teeth away from their reset position after braces/orthodontics, more likely.

7. Problems with Oral Hygiene

Ever tried brushing your teeth without being able to move your tongue? Try it—you’ll discover it’s far from easy.

When the tongue’s motion is limited, it creates difficulty in brushing food debris away from teeth and disorganizing the biofilm. Bacteria may also be caught in the space created by the anchored tongue.

All of these conditions can lead to inflammation and tooth decay. Not only can this translate to painful cavities or gum disease, but a tongue tie that has not been released makes for more uncomfortable dental appointments.

8. Suboptimal Digestion

The mouth is the gateway to the rest of the body and serves as the first step in the digestive process. When you’re unable to properly chew food, digestion is limited.

Over time, this can lead to poor digestion and related issues, like nutrient deficiencies, food sensitivities, and leaky gut

Tongue Tie Causes and Risk Factors

What causes a tongue tie? The answer is still unclear.

Recent research is showing that tongue ties are linked to a mutation in the MTHFR gene. The science behind this is quite complicated but basically, what’s happening is that a specific gene isn’t quite working as it should. 

In this case, the mutation involves a process known as “methylation”, which affects the body’s ability to deal with folate—an important element in prenatal nutrition. Tongue ties are just one of many conditions linked to this mutation. (Click here to get tested for an MTHFR gene mutation.)

Because tongue tie is linked to a genetic cause, it was once thought to be hereditary. I see this a lot in my practice; parents will reach out to me for help with a tongue tied child, only to find out that they’re tongue tied as well.

Interestingly, though, heritability of tongue tie hasn’t been well-established. In fact, some sources find no statistically significant family heritability for it at all.

Boys are more likely than girls to be born with tongue ties.

Treatment for Tongue Tie: Surgery & Myofunctional Therapy

Surgical Procedures for Tongue Tie

In most cases, tongue ties are treated with a minor surgical procedure to release the tie. This procedure is called a frenectomy but is also known as a frenotomy or frenulectomy.

The frenectomy is a simple, very low-risk procedure that only takes a few minutes. It’s usually done in-office by a dentist or ENT using a laser, scalpel, or sterile scissors without general anesthesia. 

I recommend finding a specialist who’s very experienced at performing the procedure. If it’s not done correctly, or released enough, there’s a high chance the frenectomy will need to be done again.

For severe cases in older children or adults, a frenuloplasty might be required. This is a more complex version of the tongue tie surgery that does require general anesthetic.

After the frenectomy, caring for the wound is also critical. The mouth and tongue are great at healing, so it’s possible that the tongue will reattach, meaning it will literally heal back down the way it was. 

So, I meet with my patients immediately following the release to guide them through caring for the wound and to teach them new gentle exercises. This allows the tissues to heal without reattaching and affecting the end result.

It’s often covered by insurance, but the cost of a frenectomy (tongue tie surgery) is somewhere between $795-2729.

Myofunctional Therapy for Tongue Tie and Why It Matters

There’s more to treating a tongue tie than just releasing it, and this is where myofunctional therapy comes in.

It’s very important to do myofunctional therapy exercises for at least 4-6 weeks before the frenectomy. This helps prepare for the procedure by strengthening the muscles of the tongue.

Once the tongue tie has been released, it’s time to train the tongue to move properly. Just because the tongue is now capable of a normal range of motion doesn’t mean it will be able to move the way it should.

Think of it like this—if your arm had been in a sling for a year, and you removed the sling one morning, your arm muscles would be weak and uncoordinated. You’d need to do some rehabilitation using

physical therapy to strengthen the muscles.

In this case, the tongue has literally been tied down. It’s never moved or rested the way it should, but with myofunctional therapy, we can train it to rest in the correct position, and to move correctly in the mouth. 

Without these exercises, it’s entirely possible that the tongue will never regain its full range of motion.

Consequences of Untreated Tongue Ties

Given the list of possible symptoms connected to a tongue tie, and how easy the surgery is, if a tongue tie has been diagnosed in a child, in my opinion it’s always worth releasing it.

It’s difficult to predict exactly how a tongue tie could affect the growth of the face and jaw, or what the other potential health effects could be. However, a tongue tie always has some impact on craniofacial development and overall health.

It’s definitely possible that the negative effects of a tongue tie will only become obvious in adulthood. Basically, adults who are tongue tied have compromised orofacial development and airways. This puts them in high-risk categories for myofunctional problems.

Often, the adults I work with have jaw pain and headaches or sleep apnea that are linked to unreleased tongue ties. Most times, these patients have no idea they were tongue tied to begin with.

Lip Ties

A lip tie is similar to a tongue tie, and the two are often seen together.

With lip ties, the small seams that we all have on the midline between our lips and gums are too short or thick, causing restricted lip movement. This can have a major impact on breastfeeding and speech, as well as dental development.

Lip-ties are treated exactly the same way as a tongue tie; the tie is surgically released, and myofunctional therapy exercises are prescribed.

This condition is less common than tongue tie, but almost every time you see a lip tie, you will also see a tongue tie.

Tongue Tie in Adults: Should adults have theirs released?

As I mentioned above, if a tongue tie has been diagnosed, it’s definitely worth having it released.

Some tongue tied adults may have few or even no symptoms for most of their life. But then out of the blue, they start having problems. The thing is…their symptoms didn’t just appear. They accumulated over decades of living with a compromised orofacial structure.

The body is an amazing organism, and it will do its very best to maintain health, but after enough time passes, things can start to go wrong. 

It’s never too late to have a tongue tie released and to benefit from myofunctional therapy.

Key Takeaways: Tongue Tie

I hope this article has helped clarify what a tongue tie is, and why it’s so important to take this condition seriously.

If I could sum up my experience with tongue ties, I’d say that the adults I meet who are tongue tied always wish they had known about it sooner. They also wish that their parents had known about tongue ties, and that they were able to get treatment earlier in life.

Are the parent of a child with a tongue tie? I urge you to find an experienced practitioner to perform the release, and a myofunctional therapist to work with before and after. Proper treatment really does make a huge difference!

Sarah Hornsby, RDH

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Lip-Tie and Tongue-Tie, Symptoms

From Dr. Jeanne A. Krizman’s website:


Frenectomy Tucson AZ - LIP TIEA tight upper lip frenum attachment may compromise full lip flanging and appear as a tight, tense upper lip during nursing. This can result in a shallow latch during breastfeeding. Additionally, the tight upper lip may trap milk, resulting in constant contact of the milk to the front teeth. This can result in decalcification and dental decay can develop when the milk is not cleaned off of these areas. This same issue can occur with bottle-feeding. If the frenum attaches close to the ridge or into the palate a future diastema (gap between the teeth) can also occur.


Frenectomy Tucson AZ - TONGUE TIEA tight lower tongue frenum attachment may restrict the mobility of the tongue and appear as a cupping or heart shaped tongue when the tongue is elevated. This can result in an inability to get the tongue under the nipple to create a suction to draw out milk. Long term a tongue tie can result in speech problems and/or issues later with transferring food around the mouth for chewing. Approximately 3-5% of the population presents with this condition.


Some babies can have ties and not be symptomatic. To know if the ties are a problem we ask two major questions: “Is the baby getting enough to eat?” and “Is nursing comfortable for the mother?”

Symptoms can be as follows:

Baby’s Symptoms

  • Poor latch
  • Attempting to latch
  • Colic symptoms
  • Reflux symptoms
  • Poor weight gain
  • Continuous feedings
  • Gumming or chewing of the nipple
  • Unable to take a pacifier or bottle

Mom’s Symptoms

  • Creased, cracked, bruised, or Slides off nipple or falls asleep while blistered nipples
  • Bleeding nipples
  • Incomplete breast drainage
  • Infected nipples or breasts
  • Plugged ducts
  • Mastitis
  • Nipple thrush

Laser Frenectomy Procedure

The frenectomy procedure takes only 5-10 minutes.

Prior to the frenectomy procedure, we administer a homeopathic Tongue Tie Remedy that will aid with healing. All babies receive a specially formulated anesthetic gel to minimize discomfort. No sedation or general anesthesia is needed. Your child is safely swaddled and laser protection goggles are placed over the eyes. One of our dental assistants will gently stabilize your baby’s head for the procedure. For laser safety recommendations, parents are not allowed in the treatment room.

The procedure typically takes less than 5 minutes. The laser tip is used to precisely remove the restrictive tissue under the tongue. Lip ties are treated and released at the same visit with no additional charge.

There is little to no bleeding during the procedure, because the laser seals blood vessels. The laser also seals nerve endings, so there is a numbing effect for a several hours following the visit. Since the laser disinfects, risk of infection is minimized.

To read Dr. Krizman’s full article, visit:
My daughter had great results from the Laser Frenectomy Procedure, the reason why I wrote this blog. For any questions, feel free to write to us:

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The DDS (Doctor of Dental Surgery) and DMD (Doctor of Dental Medicine) practitioners who perform Laser Frenectomy today, to my knowledge, are:



  • Dr Scott Siegel, DDS, MD (IATP member, International Affiliation of Tongue-tie Professionals)
    999 Walt Whitman Road, Suite 202, Melville, NY 11747
    phone: 631-465-0300
    416 East 76th Street, Fourth Floor, New York, NY 10021
    Tel: 212-204-7923
  • Dr Lawrence A. Kotlow, DDS, PC (IATP member)
    340 Fuller Road, Albany, NY 12203
    phone: 518-489-2571
  • Dr Gina Tanios-Rafla, DMD (IATP member)
    646 State Route 18, Suite 114, East Brunswick, NJ 08816
    phone: 732-238-1760

– SouthEast:

  • Dr Brian A. McMurtry, DDS, FAGD
    10816 Black Dog Lane, Suite 100, Charlotte, NC  28214
    phone: 704-392-3883
  • Dr N. Gail McLaurin, DMD
    5555 Peachtree Dunwoody Road, Suite G73, Atlanta, GA 30342
    phone: 404-255-9511
  • Dr Gary Myers, DMD
    3200 Old Jennings Road, Middleburg, FL 32068
    phone: 904-505-2010


  • Dr Fred S. Margolis, DDS
    1770 First Street, Suite 360, Highland Park, IL 60035
    phone: 224-927-9321
  • Dr Ted Reese, DDS, MAGD
    7218 US 31 S, Indianapolis, IN 46227
    phone: 317-882-0228
  • Dr Melinda Miner, DDS (IATP member)
    1010 Downing Ave #10, Hays, KS 67601
    phone: 785-625-6001
  • Dr Steve Fetzik, DMD, and Michale Fetzik, BSN, OMT (both IATP members)
    2548 N Maize Court, Suite 100, Wichita, KS 67205
    phone: 316-440-4432, cell. 316-706-7623
  • Dr Greg Notestine, DDS (IATP member)
    2149 N Fairfield Rd, Beavercreek, OH
    phone: 937-431-916

(Tongue-Tie only:)

  • Dr Greene Colvin, MD, ENT and Dr Victoria Lim, MD, ENT
    Desoto ENT Care
    5960 Getwell Road, Suite 212-D, Southaven, MS, 38672
    phone: 662-895-6455

Rocky Mountains:

  • Dr Branton Richter, DDS
    3300 N. Running Creek Way, Building F, Suite 101, Lehi, UT 84043
    phone: 801-766-2266
  • Dr David Winn, DDS
    6475 Wall Street, Suite 201, Colorado Springs, CO 80918
    phone: 719-260-9000


  • Dr Cara J. Riek, DNP, RN, FNP-BC, IBCLC, DABLS
    15720 N. Greenway-Hayden Loop, Suite 8A, Scottsdale, AZ 85260
    phone: 480-208-1490 / 480-508-0861
  • Dr Jeanne A. Krizman, DMD, MPH (IATP member)
    1601 N. Tucson Blvd. Suite #35, Tucson, AZ 85716
    phone: 520-326-0082
  • Dr Laila B. Hishaw, DDS
    5920 N. La Cholla Blvd, Suite 110, Tucson, AZ 85741
    phone: 520-544-4171
  • Dr High Oser, DDS
    1135 Keller Pkwy, Keller, TX 76248
    phone: 817-431-5514
  • Dr Julie A. Martinez, DDS, PC
    9006 Forest Crossing Drive, Suite A, The Woodlands, TX  77381
    phone: 281-367-6558
  • Dr Melissa Santilli, DDS
    11350 US Highway 380, Suite 140, Cross Roads, TX  75028
    phone: 940-228-2250
  • Dr Lawrence J. Korenman, DDS
    1410 N. Plano Road, Suite 200, Richardson, TX 75081
    phone: 972-231-0585

(for babies up to 8 months of age:)

  • Dr Stacey Cole, DDS
    4812 Bryant Irvin Court, Forth Worth, TX 76107
    phone: 817-731-9291


  • Dr James T. Jesse, DDS
    328 East Commercial Road, Suite 104, Loma Linda, CA 92408
    phone: 909-799-9988
  • Dr Jean Chan, DDS
    260 E. Chase Avenue, Suite 101, El Cajon, CA 92020
    phone: 619-579-2363

(for children 0-2 years old and for adults:)

  • Dr. Andrew Mohlman, DDS
    8511 W. Clearwater Ave., Suite A, Kennewick, WA  99336
    phone: 509-736-2318




Dr Hisham Abdalla, DMD, Laser&Cosmetic Dental Surgeon
Nokia Building,
Street Level (by Vector Arena)
32 Mahuhu Crescent
Auckland CBD, New Zealand
Phone: +64 9 377 2012
Fax: +64 9 307 2382
Link to Website:

Also, if you live in New Zealand, feel free to contact the Lumino dental practice closest to you:

If you know of any other professionals who perform Laser Frenectomy anywhere in the world, please send us an email!

Thank you!

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Problems caused by Tongue-Tie as an Adult

My name is Maria Vittoria and I am 28 years old.
When I was 25, I was suffering from continuous pain in my neck and shoulders, due to a constant muscle contraction. All the doctors I visited told me it was only stress and bad posture. Months of physiotherapy, massage, laser, electromagnetic waves, which should have given me relief, were all very expensive in terms of time and money, but useless: I still felt the same pain in my neck and shoulders.

Finally, I contacted an osteopathic doctor, and, during my visit, he found out that the cause of my neck and shoulder pain was not stress or poor posture, but a tongue-tie that had forced me to swallow the wrong way for 26 years!

As a baby, I had never experienced any problems with nursing and, growing up, I had not had any speech delay; neither my family doctor nor my dentist had ever noticed my tongue-tie!

My tongue being so short had not been able to touch my front hard palate (palate just behind my upper front teeth), where the tongue should position itself during the swallowing motion. Therefore, I had instinctively compensated by doing a small forward movement with my head whenever I had to swallow, doing that several times a day for…well, 26 years! That is where my muscle contracture and my consequent neck and shoulder pain came from!

A small cut of that tie (frenulotomy) freed my tongue immediately, but now, as an adult, I’ve had to re-learn how to swallow, re-train my tongue and my mind. After the frenulotomy, I had to do stretching exercises with my tongue for 5 minutes three times a day for three months, to avoid the frenum from coming back. That was very hard. I also have to use a particular device in my mouth with a hole in the front hard palate, where my tongue should be during swallowing. Furthermore, I discovered that I had always pronounced some consonants in a funny way: the sound was right, but the way the sound was produced was wrong, so I constantly have to do speech therapy exercises now. And all of this because nobody, when I was a baby or a child, thought of looking under my tongue!

Moms, Dads, check your babies, toddlers and children! Get the right information, eliminate your child’s tight frenum early on: waiting is absolutely NOT worth it!

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No such thing as, ‘Let’s wait and see’!, with Dr Scott A. Siegel, DDS

“Dr Siegel, is there any such thing as ‘waiting’ when considering releasing a tongue-tie and/or a lip-tie on a patient of any age?”

Dr Scott A. Siegel, “In my experience of over 10,000 babies over the past 15 years: knowing what I know, I safely recommend the procedures as preventive. There is such a significant amount of experience by those of us seeing these issues over a lifetime of development and the impacts it has on speech, swallowing, airway growth and development that, in my opinion, we are practicing good medicine by offering a preventive alternative to the ‘wait and see’ approach.  I do not like to watch problems develop, I like to prevent them.”

Scott A. Siegel, D.D.S., M.D., F.A.C.S., F.I.C.S.


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A chat with Dr Santilli, DDS

This morning, April 16th 2014, I had a telephone conversation with Dr Melissa Santilli, DDS, who performs Laser Frenectomy in Cross Roads, Texas.

It was refreshing and comforting to see that more and more professionals like Dr Santilli are appreciating the value of using laser in their dentistry, and how important it is to remove frenums (both tongue tie and upper frenums) early in life.

I want to share some of the things we talked about, by taking some of what Dr Santilli writes on her website (parenthesis added by me):

“One of the most important things that usually happens after the birth of the baby is breast feeding to help create a bond between mother and child, as well as provide immunity for the baby and prevent mastitis in the breast tissue.  A physical issue that can prevent this from happening is the lingual frenulum, which is a band of tissue that attaches the tongue to the floor of the mouth.  This phenomenon is called ankyloglossia, more commonly known as “tongue-tied.” Sometimes this tissue is unnecessarily tight and restricts the tongue from touching the top of the mouth.  The tongue is very important for latching on and suckling motion during breast feeding, otherwise, the baby may start damaging the nipple tissue by chewing and also experience weight loss from inefficiency to obtain nutrients from the mother.

(At Honey Dental), we use topical numbing gel and advanced laser technique to remove the excessive band of tissue to relieve the tongue, this procedure is called laser frenectomy.  We do not use scalpel or scissors.  We specifically invested in having an advanced laser unit because of less chance of reattachment, more comfort for the baby, no post-op bleeding, little post-op chance of infection, fast and efficient treatment, and predictable healing.

Breast feeding is already challenging without the added issue of ankyloglossia, (we are a resource to help you and your baby if you ever face this situation).  Sometimes this problem may not be detected early, so the child may grow up with slight to severe speech issues due to the tongue’s restricted movement.  We would love to evaluate the child or even adult for this procedure that can change his or her life.

I totally agree with Dr Santilli and with all the wonderful and trusted Laser practitioners listed on our blog (‘Who performs laser frenectomy…‘). I pray that you can find one close to you!

Thank you.

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On February 9, 2018, Bonnie writes, “Alessia, I wanted to thank you so much for this information. My five-year-old has struggled with speech and eating issues for a long time. She has been in speech therapy for months with no results and was becoming more and more self-conscious about other people’s difficulty in understanding her. A couple weeks ago, I was feeling desperate for answers to why we’ve made so little progress. We had been told that she had a tongue-tie as a newborn, but they said as long as it did not affect nursing there was no reason to address it. She had always nursed like a champ, so I never thought about it much. Last year, a dentist brought it up to us and also said there was no reason to address it unless she had speech issues. Well, she definitely did have speech issues so I told them I’d like to have it done. Between getting it approved by our insurance company and squeezing her into the schedule, we never had time to get it done there before we moved. Once we moved, I started pursuing it again. I asked my family doctor to refer us to an ENT to ask about it. He referred us to someone I did NOT care for and this man insisted there was no reason to address it since her main issues were the “c” and “g” sound and a tongue tie would not affect that. He said he would only do it if a speech therapist recommended it. That’s when we got her set up with speech therapy, something we were already planning on anyway. Her speech therapist told us the same thing. In fact, she seemed a little horrified that we were considering it. Feeling defeated and like I must be running down the wrong path, I gave up for a while. When I started researching again with a vengeance a couple weeks ago, I stumbled onto your site and started reading. I couldn’t believe all of the stories I was reading and became more and more convinced that this is what we needed to do. Then I started hearing about the likelihood of having a lip tie if you already have a tongue tie. I literally ran into my daughter’s room and lifted up her lip while using a flashlight while she was sleeping! And there was her lip tie! I had no idea and no one had ever mentioned it to me or even checked. It was a significant one that explained her gap between her teeth since it went down to her palate. I immediately contacted our closest Laser Dentist from your site and set up an appointment. They were able to get her in a couple days later. She hated the procedure, but it was only about 5 minutes and her recovery has been remarkably easy. The best part about it is that now, only a week later, she said her first “g” sound!! I am absolutely convinced that releasing her tongue has helped her to do that and she is already so thrilled at her own success. I fully expect her other issues to get better as time goes on as well. But wait, there’s more… Shortly after figuring out this tongue/lip tie thing with my daughter, I started checking my other three children to see if any of them had it. I read some of the symptoms for infants and a few resonated: lots of popping and loss of suction during feeding, very short and frequent feedings, tiring and fall asleep easily during nursing, reflux from taking in too much air. Well I open up my 5-month-old daughter’s mouth and sure enough – a significant lip and tongue tie!! I was shocked that I had missed something so simple. I scheduled her procedure for the very next week with the same dentist and it was much easier than my five-year-old’s, although a little sad to watch. BUT only 3-4 minutes of having to hold her mouth open for the procedure and she was done! She is already nursing better! Her latch is much deeper and she seems to be getting more. The very first night after it was done she slept so much better (she often had nights of waking up every hour and I could never figure out why). She has never taken a bottle and struggled with solids because she would gag so violently every time anything went into her mouth (including during breastfeeding sometimes). She is now taking solids so much more easily and I feel confident she may take a bottle soon now that everything is cleared up. She doesn’t mind the stretches/exercises at all. In fact, she often laughs when we do it. I am so grateful that the Lord led me to your site and gave me the information I needed to move ahead with this procedure for both of my girls!!”


On January 1, 2018, Melissa writes, “I’ve read your blog before and came back to it again as I was about to update the dentist that did my daughter’s laser frenectomy at 17 months old with her current smile. I’ve attached a photo of a baby with a maxillary frenum like my daughter’s when she was born in Feb 2010 (I didn’t get any pictures of her like this) as well as a photo of her now at nearly 8 years old. We had a similar run around from dentists saying it wasn’t a problem, including one supposed specialist at the children’s hospital who claimed that there was nothing wrong with her lip at all: “look, mine is exactly the same!” (no no it’s not). Ultimately, we drove 13 hours each way to the only dentist I could find who would do the laser frenectomy on a child less than 6. About 2 years later, there were at least 3 locally who started doing them but many still don’t want to do laser on babies. Like you, I have no regrets about pushing for the frenectomy. My daughter didn’t need speech therapy and her gap has totally closed – if she needs braces it won’t be because of the frenum! Thank you for sharing your story, and for the list of dentists who will treat this problem.”


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On March 2, 2016, Gail writes, “Hi Alessia, I wanted to provide an updated photo of Violet for anyone who is curious if the gap closed!  She is 3 years old (almost 4) in this picture.  We are still so grateful that I found your website with this information on it and that we went through with the procedure! Thank you again!  Sincerely, Gail.”


On May 18, 2015, Megan writes, “Hi there, my name is Megan, and we are up here in Alaska. Last year, when my 17 month old daughter was teething her first molars and I was looking around her mouth, I discovered she had a lip tie. I had always noticed the gap in her front teeth since she got her front teeth in, but never thought much of it. When I pulled back her upper lip, I noticed that her frenulum extended between her teeth. I was concerned and did some research and found your website and article about your experience with your daughter and I have been meaning to thank you for bringing awareness to this issue. I felt so inexperienced when I learned about lip ties, because I am a doula and I know all about tongue ties and have counseled women about them before. Lip ties, and even tongue ties, are something that most doctors and midwives don’t even check for at birth. They really should, for how common they are! Many people in the birth community don’t know what I am talking about when I tell them about my daughter having a lip tie. Anyway, upon reading your info, I called Dr. James Jesse in California and sent him photos of my daughter’s frenulum to get a consultation. Her frenulum wasn’t quite as restrictive as your daughter’s was – you could see the bottom half of her teeth when she smiled – but it was causing a gap and had created some issues while breastfeeding. We were already planning a trip to my MIL’s house (45 mins from Dr. Jesse’s office in CA) a month later and we were able to schedule my daughter an appointment for her laser frenectomy. Almost a year later, her gap is pretty much gone entirely and her frenulum looks normal with no scar tissue. Dr. Jesse was very skillful. The real reason I am writing is that my newborn son was having some issues nursing, so I immediately thought to check for a lip and tongue tie. Sure enough, he had an upper lip tie, just like his sister! (I should mention that my first-born son never had a lip tie, so I had some good basis for comparison.) Anyway, I mentioned this to my midwife and she referred me to a dentist in Anchorage, AK who performs laser frenectomies. I was very excited, because I had never looked around within our state for a dentist who does this. I just assumed that no one was specialized in this in AK because we don’t have many specialists at all, and it is still a relatively new procedure. We took our son in and he is almost two weeks post-frenectomy. Here is the dentist’s info, so you can add it to your list of dentists in the West/northwest: Dr. Chris Coplin […]. I was very impressed with the staff and the atmosphere there as well. They were very good to answer all of my questions and you could tell they really loved working with children. Thanks again for your website!”


(BEFORE:) On March 11th, 2013, Gaby writes, “Hello, I live up in Washington state.  My son has an upper lip tie and I just came to realize this about a month ago.  No pediatric dentist here seems to want to touch this with a 10 foot pole!  I know of Dr. Jimmy Chan in BC, but we don’t have our passports yet, LOL!  Thank you for your help!”
(AFTER:) On Sept. 25th 2013, she writes, “Hi Alessia! We called Dr. Chan’s clinic and made an appointment with him.  It was a 5 hour trip up and a border crossing, but totally worth it. First off, Dr. Chan was WONDERFUL!!!  His bedside manner is fantastic and his office staff is to die for!  He checked Alex and confirmed that he had a stage 4 (!) lip tie and a stage 1 PTT, the procedures would cost $600 in total.  They strapped Alex to a papoose board; the procedure literally took about 5 minutes and afterwards he asked me to latch Alex on to see how it felt.  OH MY GOODNESS, THE DIFFERENCE!!!!  It was like night and day.  No pain whatsoever.  All of his gastrointestinal problems cleared up immediately as well, and I mean the very next day.  No more choking and vomiting while eating and no more constipation!  At one point before the procedure, he was so backed up even the radiologist was impressed!  So, now that we are 4 months post procedure, the lip tie area looks great!  The under the tongue area reattached a little, but I hear that happens.  Dr Chan said that the most important thing was function.  I weaned him about a month ago and he packs his mouth full like a little chipmunk when he eats, so the reattachment can’t be that bad. I totally recommend Dr. Chan.  He is absolutely wonderful.  We went up for a 2 week evaluation after the initial procedure and he waived the office fee as we paid out of pocket.  I would totally do it again in a heartbeat.  If we decide to have another baby and it has the same problem (God forbid) I would take them immediately (especially now that I know what to look for).  So, there is our story!  Alex is saying lots of words, at least 10+ right now, and TONS of baby jibber jabber.  He sticks his tongue out and is totally happy and well adjusted.  Best wishes!!Gaby and Alex.”


On July 24, 2013, Gail writes, “Dear Kevin and Alessia, it is with sincerest thanks that I write to you about my daughter’s (Violet) story.  My daughter’s top front teeth starting coming in around 13 months of age.  It was then that we noticed a large gap between her teeth.  So large that it looked like the two teeth on the bottom row could fit in between them!  While putting her to sleep one night, I was researching possible causes (as no one else in my family had a large gap) and came across your website. I am SO grateful that I did.  As I read your story, I had a gut feeling that this was the cause of my daughter’s gap. I confirmed it the next morning by pulling up her lip and seeing two thick “cords” between her teeth.


After reading your testimonial and some other research, I was determined to have the laser frenectomy performed as soon as possible.  I discussed it with my husband and family and began to called pediatric dentists in our area to no avail. My husband contacted Dr. Ted Reese in Indianapolis, Indiana, about a 5 hour drive from our home. Dr. Reese’s staff were very helpful. We drove to Indiana and stayed in a hotel the night before.  The next morning we got to the office, filled out the paperwork and were taken into the back.  My daughter sat on my lap for the entire procedure.  First, Dr. Reese checked her mouth and said it was a very thick frenum. Next, they swaddled her into a blanket so she didn’t move her arms and used a topical numbing agent followed by a small numbing injection into the gums.  Finally, he performed the procedure.  The laser was a machine connected to a tool the size and shape of a large pen (not too intimidating at all).  My daughter cried (mostly because of the restraint) up until the point they put the mouth suction in and then she chewed on the suction for a few minutes and then it was over!  About 10 minutes on my lap total.  We gave her tylenol only a few times after that.  She had very little bleeding the first 10 minutes and then none.  She was drinking from a sippy cup and using her pacifier as soon as we were walking to the car.  We paid out of pocket, but they also submitted to both our dental and health insurance in case either one would cover it and reimburse us.  Here is Violet two days after the procedure:


The laser procedure was exactly 2 weeks ago and now her mouth is completely healed:


We are very happy with the results!  Dr. Reese and his staff were extremely nice and made us feel very comfortable! Thank you again for all of your help and informative website! Gail & Jeremy”.


On April 28, 2013, Janelle writes, “Thank you for writing this.  I live in Portland, Oregon and my son was born with tongue tie and a very thick lip frenulum.  We were lucky enough to have a great lactation consultant who referred us to an ENT that does laser (Dr Bobak Ghaheri, MD, ENT). He got me in the same day because he realized how important to my breastfeeding it was to fix as soon as possible.  He personally dealt with tongue tie with his own baby and, even though he didn’t learn a lot about it in medical training, he saw how much of a change in breastfeeding it made with his wife.  So we had it fixed by 4 months old.  I’m glad I read your blog because i have gotten negative feedback from my pediatrician on doing it.  Your story just validated in my mind that we did the right thing.  And nursing has gotten raised too. Thank you again, Janelle.”


On April 15, 2013, Leah writes, ” Hello – Thank you for creating such a useful blog. It has been a very valuable resource! I wanted to share that I was able to find a very qualified DDS, Dr. Ted Reese, here in Indianapolis, who did an excellent job on my daughter’s (age 2.5) very thick maxillary frenum (classified as a grade IV). The office staff was amazing and the laser frenectomy took less than 3 minutes. Prep was about 20 minutes. He used a little nitrous oxide gas and also gave her juice with a mild sedative mixed in. I felt very comfortable with the whole process and the staff was very experienced and professional. All in all, we were in and out in about an hour. She was back to herself the same day. Hope this helps anyone in the Mid West looking for an option. Kind Regards :) “.


On February 28, 2013,  Gemma writes, “Good Afternoon from NZ, Alessia. My daughter is now 5 months today YAY and thriving on breastmilk 🙂 After reading your blog, we searched the internet and found a place in Auckland that would do it which is around 8 hours drive from here (they told us they were the only place in NZ that did laser for babies of this age and for $1000+ NZD). I thought there must be somewhere else, so calling around 20+ dentists in Wellington (capital of NZ) we found a dentist called Lumino that did it (we went to Burton Brown in Wellington CBD) and they asked us to go to a lactation consultant to see how bad it was. It was the worst she has ever seen. she is now using her photos when doing clients and seminars.


She also checked for tongue tie, which we also knew she had, but we only thought it was minor as it wasn’t right at the end. Well not the case at all either. It was so bad she had no lift in her tongue at all so was having trouble swallowing. she thinks the only reason why she was gaining weight at all was because this was my second child so didn’t have to bring in breast milk and i have a huge supply and it pours out. I also showed her your blog which she said was great. So, we did it with laser. Our daughter went straight on the breast after. All up costs including lactation consultant $500 NZD. We got it done by 10 weeks of age and she started to put on weight straight away.  Not a great start to life but doing well now. Thank you so much for all your help, Again Thanks so much – you made my life so much easier with your blog as it was a very scary time for me and baby. Gemma and Shane.”


On February 26, 2013,  Luxi writes, “I just took my 2 month old daughter to see Dr. Jesse last week, he was AMAZING! She had both a severe upper lip tie and a severe posterior tongue tie. He was the first doctor that believed me. It has made a huge difference in breastfeeding. We are going back tomorrow after realizing that our 2 year old also has a posterior tongue tie, which explains why she has a thrust. I HIGHLY recommend him!”


On February 21, 2013, Sophia writes, “Just wanted to leave a note to thank you for making this information available. I just discovered that my baby needs a frenectomy and ever since I’ve been searching online for information. Your website has been the most helpful and we just went to Dr. Jesse’s office to get the procedure done today. My baby is already doing better and I couldn’t believe how quick the whole thing was. THANK YOU!!!”


On February 15, 2013, Carol writes, “We went to Albany last week and she’s doing great. She had severe ties on upper lip and tongue. Dr Kotlow is wonderful. Thank you for your support, advice, and encouraging words! We already see tremendous differences.”


On December 13, 2012, Anna writes, “Just went to Dr.James Jesse today with my 23 month old!! They were amazing! My daughter had both lip and tongue tie fixed for ONLY $400 total. His staff helped me hold my daughter still. Dr. James Jesse was so nice and explained everything he was doing and was very patient despite my daughter moving around and even biting him several times. There was no bleeding, within 1 minute after it was done my daughter was happily eating a ice pop. It was as if nothing had even happened. I am so happy he provides this service WITHOUT putting the kids to sleep and we need to spread the word!!! This was night and day from when my son had this done with another doctor (who didn’t use laser), he was put to sleep, and he bleed for days, was in a lot of pain and cost almost $2000 total, and the tongue tie even grew back for him so now we need to have it done again. DEFINITELY taking him to Dr. James Jesse. He told me in the 15 years he has done this with laser only about 3 patients have had it grown back and needed to get it redone. And he said that if it were to grow back for any reason he would not charge anything. What’s also great is that you can get an appointment almost immediately because it is so quick he schedules these things in between his other patients. I called on Monday and booked an appointment 3 days days later, could have gotten it the next day if my schedule had permitted. Thanks for this blog that helped me find him!”

Thank *you* so much, dear Moms and Dads, for writing to us! I encourage any reader who has a story to tell to send it our way: Thank you! 🙂

Posted in Lip tie, Tongue tie, frenum, frenectomy, frenotomy, Uncategorized | Leave a comment

Feeding Problem and Speech Delay: Jaxson’s Story

On February 22nd, 2014, Anne Marie writes:

“Dear Alessia,

     I was reading your story and the other parents stories and thought I’d share mine.  My son Jaxson is 20 months old and does not eat solid food (just pureed food) and only says one word “eat”.  Probably because I am constantly asking him to eat…LOL.  I have been concerned that Jax would not eat solid food since he was 12 months old.   Anytime you presented any kind of food to him that wasn’t pureed he would turn his head away or close his lips tight.  If I was able to get solid food in his mouth he would gag violently.    I would offer him puffs, small cut up fruit, cheese, cookies, pretzels, ect…  You name it I tried it.

I voiced my concern with my Pediatrician a few times and he kept saying if Jaxson is not eating by 2 years old then we can be concerned…. REALLY?!?!?  I immediately started looking for a new Pediatrician.  I found a new Pediatrician I liked and she agreed with me that Jaxson needed feeding therapy and referred me to a speech therapist she knew.  She said it was hard to find a feeding therapist and she was the only one she knew in our area.  I called and of course she didn’t take my insurance.  So I decided to have my son evaluated by the county at 16 months.  The therapist felt that he did not qualify for the services because he needed to lack in more than one area, which he did not.

Two months later I heard a commercial on the radio saying “does your child have trouble eating certain foods?” and I thought YES!  I called L.I. Speech therapy MO and made an appointment for another evaluation.  At this point Jax is 18 months.  The therapist did feel that Jaxson needed feeding and speech therapy and thankfully my Insurance would cover 100% of the treatment!  This was great news and I felt such relief that help was FINALLY on its way.  I was told that we needed to wait 4 weeks before we started therapy because my Ins co had to review the evaluation.

Three weeks into the 4 week wait period I noticed something I never noticed before.  Jaxson’s web on his top lip was connected to the middle of his two front teeth.  I could not believe that I never noticed this before and that the Doctor’s never discovered this!  It was really thick and tight!  I was texting with my friend who also has a baby,  we would always talk about Jaxson’s feeding/speaking issues and I told her about what I found.  She said “oh that sounds like a lip tie”.  I immediately googled “lip Tie” and I couldn’t believe my eyes!  It looked exactly like Jaxson’s mouth.  I called my Pediatrician and made an appointment for my husband to take Jax in to see her (I had to work).  My husband said she was like “oh, yeah it’s no big deal.  The dentist will just cut it when they put braces on him”.  Again I am in shock and again I am searching for a new Pediatrician.

I e-mailed Jaxson’s feeding therapist telling her about my discovery asking if she thought that had anything to do with Jaxson’s eating and speaking delays.  She said it is possible and I should definitely look into a Frenectomy procedure.   Thankfully I don’t need a referral through my Insurance so I asked  Jaxson’s feeding therapist if she could recommend an oral surgeon.  She referred me to Lynn Pierri DDS,MS.  I met with Dr. Pierri  and she agreed that Jaxson needed a Frenectomy and she could do the procedure with a laser and the whole thing wouldn’t  take 5 minutes.

We have the Frenectomy scheduled for March 19th  (about a month away) and I am hoping that this procedure is the answer to our prayers.  Reading all of the success stories gives me great comfort and hope.  Especially the one from “MR” in Sleepy Hollow, NY.  Her son’s situation seems the closest to mine.  And the fact that her son started talking up a storm 6 weeks after the procedure gives me hope.  Thank you for sharing your story.


Anne Marie”

I look forward to adding Anne Marie and Jaxson’s story among our Success Stories! We are praying for you, guys! 🙂

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Alyssa’s story, 16 months old, Wisconsin, USA

Hi Alessia

I wanted to send you our story to post to your blog…  Here you go and thanks again for starting this blog!  It was because of you that our daughter has a beautiful smile now!  I’ve also attached “before and after” pictures so feel free to use those. Also, i also just wrote letters to all of the practioners that told us “no we would wait until age 7” telling our story and encouraging them to educate themselves on pediatric laser dentistry as an option!
We live in Wisconsin and discovered our 14 month old daughter had a very abnormal frenum (it was very thick and attached between her teeth creating a huge gap in between her front teeth). After hours upon hours of research and phone calls to dentists/surgeons, I discovered this blog and Dr Kotlow’s work and our true journey began! Thank you Alessia for sharing our stories with others so everyone that has a child with an abnormal frenum can have the knowledge and power to get it corrected now, with laser dentistry!
After many visits with quite a few different practitioners (her pediatrician, who referred us to a dentist, who referred us to a pediatric dentist, who referred us to an oral surgeon that refused to see us because he doesn’t do the procedure until age 7, to another oral surgeon, and another laser dentist practice), we were left feeling very frustrated because everyone was completely against doing this procedure before age 7. All of them agreed her case was very severe and that she will need something done, but refused to do anything now because they would put her under general anesthesia and use a scalpel, and said that she couldn’t handle the “healing time” and her arms would have to be boarded for days so she wouldn’t pull on her lip and rip the stitches. I emailed Dr Kotlow for advice and within minutes received a reply reaffirming my thoughts on laser frenectomies being the way to go, and with a recommendation to Dr Margolis in Chicago IL ( who was trained by Dr Kotlow and he said “he will take great care of your daughter”. We scheduled her procedure for a few weeks later in Chicago. FYI – We paid out of pocket for the procedure but is it VERY reasonable so it wasn’t an issue (our health insurance denied the claim, and we did not have dental insurance on our children).
The day of her procedure we were in and out of the dentist office within less than an hour. Dr Margolis swiped some numbing cream on her gums, and the actual laser procedure was over within 7 minutes (no other anesthesia was used). She cried during the procedure while I was holding her arms, but immediately after she drank milk and had her pacifier. Her recovery was so fast it boggled our minds! We only gave her two doses of Tylenol that day and she did not need anything for pain after that. Within 10 days her mouth had completely healed and the gap between her front teeth had almost fully closed. We are so grateful to those pediatric dentists that perform this procedure with lasers!
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Serious Speech Delay caused by Tongue Tie ~ Connor’s story

Following, is a letter Dr. Palmer received from a very thankful mother because her son had a life-changing experience when he had a frenectomy.  This is a true, but a very scary story, because it illustrates what little healthcare providers know about frenums.

January 24, 2008

Dear Dr. Palmer,

I wanted to thank you and tell you my son’s story.  My son was born in Feb. 2001, and by 22 months was only saying one word: go.  

It was clear to my husband and I that he was very intelligent, but we worried. His doctor recommended that we have him evaluated by Early Intervention. When the speech evaluator visited, I brought up the subject of Connor’s tongue. I had noticed that, when he stuck his tongue out, it never really extended out of his mouth, and I wanted to know if that could be causing the speech problem. She said that it would have no effect.  I was a bit confused by that, but deferred to her “expertise.”  

He was assigned a speech therapist who came twice a week.  After three months with no progress, she said to me “Have you thought about getting his tongue checked by an ENT doctor?”  I was furious that she had waited three months to mention it, and mad that the evaluator had dismissed my concerns.

At this point, he was 26 months old.  I took him to an ENT doctor to be checked.  She told me that, yes, he had a tight frenum, but that there was “no established literature” about the effect on speech, and that it would have no effect.  She suggested that I might want to get it fixed before his teen years “so that he would be able to kiss properly,” and even suggested that I have it done by a dentist in the dentist’s office!  It was clear to me that she wanted no part of giving me a diagnosis of any kind or providing any treatment to my son.

I immediately started talking to everyone that might know something about it, and searching the internet.  My Early Intervention coordinator gave me a phone number of a couple who had been told to wait a year to perform the operation, and regretted it.  I also found and downloaded your frenum document (2003).

Between those two inputs, I was given the courage to stand up to the doctor.  I went into her office and said “I want this surgery done, and I want you to do it as soon as possible.”  She did not argue, and scheduled the surgery for the following month.  It was performed without a hitch.  For six weeks, he didn’t utter a single sound.  He was constantly moving his tongue and mouth around with a fascinated look on his face – exploring his new possibilities.

Meanwhile, my son was up to his neck in therapy of all kinds.  His new speech therapist was telling me that my son was severely autistic and would never function in a normal classroom.  The therapist advised me to take him to a neurologist.  Fearing that I would be accused of negligence if I didn’t, I took him to the neurologist.  The appointment occurred during my son’s six weeks of silence following the operation.  The neurologist immediately discounted the speech therapist’s opinion because “it’s clear to me after two minutes with him that he understands every word I’m saying.” He was very alarmed at my son’s lack of speech.  When I explained everything about the tongue and the recent surgery, the neurologist said “That’s irrelevant.”  He wanted to hospitalize my son overnight for heavy testing.  I refused, and he was not happy about it.

In the meantime, after the six-week silence, my son started using every word in the book. He’s now turning seven, and you can’t keep him quiet for five seconds.  I have received comments from teachers that his vocabulary and diction are excellent.  It took us two more years to completely escape the well-meaning machine of special education, thankfully just before he started kindergarten.  He is currently ahead by two years in reading and math skills, has many friends and is a joy to us.

I cry whenever I tell this story, from great relief.  If I had not seen your presentation, talked to the right people and stood up to all the various doctors and therapists, I am terrified to think what might have happened to my son, and what might be happening to countless other kids.  Please continue to do whatever you can to spread the word about these issues.  If you reach even one other parent like me, it’s worth it.

Thank you, thank you, thank you!  I can never thank you enough.


Sleepy Hollow, NY

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