What is a Frenectomy?

A tongue tie (lingual frenulum) and lip tie (labial frenulum) are small pieces of soft tissue under the tongue and lip that are present due to a failure of this tissue to resorb during development. This resorption process is supposed to happen around week 12 in utero, but when it fails to happen, can cause significant restrictions in the movement of the tongue and lip. These restrictions can present themselves soon after birth as nursing difficulties for mother or difficult weight gain for baby. If not treated as an infant, symptoms of a tongue and/or lip tie as a child/teenager/adult can include difficulty with speech development, feeding struggles, and trouble getting good sleep at night.

The Impact of a Lip or Tongue Tie Release


One out of four children present restrictions in their lip or tongue. Many of these children have learned to compensate for the restriction and have little to no symptoms. In order for a baby or child to benefit from a tongue or lip tie frenectomy , the child must demonstrate symptoms along with an anatomical variation when examined. Symptoms of tongue and lip ties can often be blamed for other factors such as “He’s a lazy nurser,” or “He’s a picky eater,” or “He snores like his daddy.” We want children not just to survive through these symptoms, but to thrive and live without having to adapt to nursing, feeding, speech, or sleeping challenges.

Our practice believes in a team approach to successful lip or tongue tie release for your child, through a labial or lingual frenectomy. Depending on your child’s symptoms, we may recommend that you and your child also see a lactation consultant, speech pathologist, myofunctional therapist, chiropractor or physical therapist.

Does my baby have a tongue or lip tie?

Even if your baby is gaining weight, if you and/or your baby have multiple symptoms listed below, they should be evaluated for a tongue or lip tie:

Mother’s Symptoms

  • Painful nursing
  • Creased/Flattened nipples
  • Blistered/Cut nipples
  • Incomplete breast drainage
  • Plugged ducts/mastitis
  • Inability to nurse without using a nipple shield
  • Decreased milk supply

Baby’s Symptoms

  • Poor latch
  • Poor weight gain
  • Reflux or frequent spitting up
  • Frequent gassiness and fussiness
  • Clicking/smacking noises when eating
  • Dribbling milk out of mouth
  • Inability to hold a pacifier
  • Prolonged nursing or bottle feeding sessions

Does my toddler, child or teenager have a tongue or lip tie?

If your child or teenager has multiple symptoms listed below, they should be evaluated for a tongue or lip tie:

Toddler/Older Child Symptoms

  • Frustration with communication
  • Trouble with speech sounds, hard to understand, mumbling
  • Speech delay
  • Slow eating, difficulty finishing meals
  • Picky eater, especially with certain textures (ex.meat, mash potatoes)
  • Choking, gagging on certain foods, liquids
  • Spitting out foods, packs food in cheeks
  • Restless sleep (kicking, moving often while asleep)
  • Teeth grinding at night
  • Snoring
  • Sleeping with mouth open, mouth breathing during the day
  • Frequent headaches, neck pain
  • Enlarged tonsils, adenoids
  • Recurrent ear infections
  • Hyperactivity, Inattention

Does Your Child Show Signs of a Tongue or Lip Tie?

If so, we recommend scheduling a consultation with Dr. Elizabeth Miller to evaluate your child and review their signs/symptoms. At Richmond Pediatric Dentistry and Orthodontics, we perform lingual and labial frenectomy procedures with a CO2 laser (LightScalpel) which is relatively painless, minimizes risk for postoperative complications (infection), minimizes bleeding, and makes the healing process faster for your child.

For more information about our laser frenectomy procedure, or if your child is experiencing any of the symptoms above and you suspect they may have a tongue tie or lip tie, give our team a call at 804.409.9032 to schedule a consultation with Dr. Elizabeth Miller. After scheduling, please print and fill out one of the following forms and be sure to bring it with your to your consultation. We can’t wait to share the benefits of our frenectomy procedure with you!

Dentistry Services

Oral Health Appointments

Regular return visits to our office are vitally important to keeping healthy teeth. Our check-up appointments include the same services as the initial exam but provide an opportunity to review the tools needed to remain cavity free.

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Preventative Treatments

Check-up appointments are a critical component of your child’s dental care however, your child’s home care habits are more likely to influence his/her ability to stay cavity-free.

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Restorative Dentistry

In all cases with restorative treatment, our goal is to keep our patients as comfortable as possible. We will make sure that the patient’s teeth are numb using topical and local anesthesia.

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Surgical Procedures

We perform both baby tooth extractions and extractions of permanent teeth when needed. This includes the need for extractions prior to or during orthodontic treatment.

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Behavior Management

Children are often very nervous or scared when experiencing something new. Our goal as trained pediatric dentists is to make your child’s visit to the dentist as comfortable as possible.

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Laser Procedures

Dr. Elizabeth Miller performs lip/tongue release procedures with a CO2 laser (LightScalpel) which is relatively painless and minimizes risk for postoperative complications, making the healing process faster so your child can thrive in their everyday life!