Tongue Ties: What Every Parent Should Know Before Deciding On Treatment

Written By: Logan Grover, Health Content Writer

Reviewed By: Dr. Alison Grover, Board-Certified Diplomate Pediatric Dentist

Last Reviewed: May 11, 2026

The AAP published a clinical report in August 2024 that changed the conversation around tongue ties. Their position: ankyloglossia is a normal anatomical variation, frenotomy should only follow failed lactation support for breastfeeding problems, and there's limited evidence that releasing a tongue tie prevents future speech or sleep issues. That report matters because tongue tie diagnoses rose roughly 10-fold between 1997 and 2012, then doubled again by 2016.

Tongue ties (ankyloglossia) occur when the lingual frenulum, the small band of tissue connecting the underside of the tongue to the floor of the mouth, is too short, thick, or tight. This restricts the tongue's range of motion and can affect feeding, speech, and oral development. Between 4% and 11% of newborns have some degree of tongue tie, though not all require treatment.

This article covers the signs that matter, when treatment makes sense (and when it doesn't), what the procedures involve, and realistic cost expectations. I'm not covering lip ties here. The assessment is different enough to deserve its own discussion.

How Do You Know If Your Child Has a Tongue Tie?

Symptoms vary by age, and that's the part most articles rush past.

• In newborns and infants (0-6 months), the most common red flags are difficulty latching during breastfeeding, a clicking sound while nursing, prolonged feeding sessions (45+ minutes regularly), poor weight gain, and maternal pain during feeds. Some babies with tongue ties can bottle-feed without obvious trouble, which is why the condition sometimes gets missed in formula-fed infants.

• In toddlers and preschoolers (1-4 years), signs shift toward speech delays, difficulty with certain sounds (L, R, T, D, S), messy eating, trouble licking lips or an ice cream cone, and gagging on textured foods. If your child is showing signs of being tongue-tied, these functional impacts are what matter most.

• In school-age kids (5+), you might notice speech clarity problems that persist despite therapy, difficulty playing wind instruments, jaw tension, and mouth breathing during sleep.

A quick visual check: ask your child to stick out their tongue. If the tip forms a heart shape or can't reach past the lower lip, that's a sign the frenulum is restricting movement. But appearance alone doesn't determine whether treatment is needed. Function does.

Does Every Tongue Tie Need Treatment?

No. And this is where the conversation gets honest.

The AAP's 2024 clinical report, authored by Dr. Jennifer Thomas and co-authors including Dr. Maya Bunik from Children's Hospital Colorado, was direct about this. Many tongue ties are mild anatomical variations that don't cause functional problems. Releasing a tie in a baby who's gaining weight normally and feeding without pain isn't supported by current evidence.

The "release early to prevent everything" advice repeated across parenting forums is overstated. Diagnosis rates have climbed dramatically, driven by increased breastfeeding awareness and, frankly, by the fact that frenectomies are quick revenue-generating procedures.

That said, when a tongue tie is causing real problems (documented feeding failure, significant speech delays, oral development concerns), treatment works and the evidence supports it. The key is matching the intervention to a confirmed functional issue, not a visual finding alone.

A pediatric dentist who specializes in tongue ties can assess whether your child's restriction is actually causing their symptoms or whether something else is going on.

What's the Best Age to Treat a Tongue Tie?

There's no single answer, but there are clear windows where treatment is simpler and recovery is faster.

• Newborns (2-6 weeks) are the easiest group to treat. The frenulum is thin at this age, the procedure takes seconds, and most babies nurse immediately afterward. The suck reflex is still strong, so retraining happens almost automatically. Recovery takes days, not weeks. If your infant has documented breastfeeding problems that haven't responded to lactation support and pediatric evaluation, this is the ideal window.

• Infants 3-6 months can still be treated effectively in-office with minimal anesthesia. The procedure is slightly more involved because the tissue is thicker, and babies at this age have already developed compensatory feeding patterns (horizontal tongue movement, jaw clamping) that take more effort to unlearn.

• Toddlers and preschoolers (1-4 years) often need local anesthetic and may require post-procedure myofunctional exercises or speech therapy to break habits they've built around the restriction. Treatment is still effective, just not as simple.

• School-age kids (5+) and teens benefit from treatment when the tie is causing speech, sleep, or dental issues. The procedure is more complex, sometimes requiring sedation dentistry for kids, and recovery takes longer. Post-op speech therapy is almost always part of the plan.

The contrarian point worth making: waiting isn't always wrong. If your 3-month-old is feeding well, gaining weight, and not in distress, a mild tongue tie that "looks" restrictive may not need intervention. The AAP specifically cautions against preventive tongue tie releases that aren't tied to documented symptoms.

How Does a Tongue Tie Release Work?

Two main procedures exist, and the choice between them matters less than most marketing suggests.

• Frenotomy (scissor release) involves cutting the frenulum with sterile scissors. It takes seconds for newborns, causes minimal bleeding, and doesn't require general anesthesia. Cost: typically $250-$500. This is the simplest option for young infants.

• Laser frenectomy uses a dental laser to release the tissue. It cauterizes as it cuts, which means less bleeding and often no sutures. It's more common in pediatric dental offices and costs $500-$800 on average. 

Here's what most articles won't tell you: outcomes depend more on the provider's experience than on the tool they use. A skilled practitioner with scissors will get better results than an inexperienced one with a $50,000 laser. Ask how many frenectomies they perform monthly and what their revision rate looks like.

For older children who need general anesthesia, costs can climb depending on the facility. That's a big reason early assessment matters even when immediate treatment isn't needed.

Factor	Newborns (0-6 weeks)	Infants (3-6 months)	Toddlers (1-4 years)	School-age (5+)
Anesthesia	None or topical	Topical/local	Local	Local or sedation
Procedure time	Seconds	1-2 minutes	5-10 minutes	10-15 minutes
Recovery	1-3 days	3-5 days	5-7 days	7-14 days
Post-op therapy	Rarely needed	Sometimes	Usually	Almost always

What Happens After a Tongue Tie Release?

Recovery varies by age. Newborns typically nurse within minutes of the procedure. Some fussiness for 24-48 hours is normal. For infants and toddlers, your provider will prescribe post-operative stretching exercises to prevent reattachment. These stretches are uncomfortable, but skipping them is the most common reason families need a revision procedure.

For older kids, post-op care includes soft foods for several days, pain management with children's acetaminophen or ibuprofen, and a referral to speech or myofunctional therapy. Working with a care team that coordinates treatment and follow-up makes the biggest difference in long-term outcomes.

What Questions Should You Ask Before Agreeing to a Frenectomy?

Five questions that separate good providers from rushed ones:

1. Have we exhausted non-surgical options (lactation support, feeding therapy) first?

2. What specific functional problem are we treating?

3. How many frenectomies do you perform per month, and what's your revision rate?

4. What post-operative care and therapy will my child need?

5. What happens if we wait and monitor instead?

If a provider can't answer all five clearly, or gets defensive about question one, that's information. The best pediatric dentists in Erie, CO and surrounding areas welcome these questions because they know that informed parents make the right decision for their child, whether that's treatment or watchful waiting.

One Thing to Get Right About Tongue Ties

The best age to treat a tongue tie is the age at which it's causing a confirmed functional problem. Not before. Not because a visual assessment says the frenulum looks short. Not because a social media post scared you into acting. Tongue ties deserve the same evidence-based decision-making as any other medical procedure. Schedule an evaluation at Mini Miners Pediatric Dentistry if you have concerns, and walk in knowing the right questions to ask.

Frequently Asked Questions

Does the AAP recommend tongue tie release for all babies?

No. The AAP's August 2024 clinical report states that frenotomy should only be considered for infants with breastfeeding problems that haven't improved after proper lactation support. They specifically advise against routine or preventive tongue tie releases, noting that ankyloglossia is a normal anatomical variation in many cases.

Will my baby's tongue tie resolve on its own?

Some mild tongue ties become less restrictive as a child grows, and many don't cause functional problems at all. Prevalence is estimated at 4-11% of newborns, but the percentage who actually need intervention is much lower. Monitoring with a pediatric dentist is often the appropriate first step.

Is laser better than scissors for a tongue tie release?

Both methods are effective. Laser frenectomy reduces bleeding and often doesn't need sutures, while scissor frenotomy is faster and less expensive ($250-$500 vs. $500-$800). Research hasn't shown universal superiority for either tool. Provider experience and case volume matter more than the instrument.

How much does a tongue tie release cost in Colorado?

Office-based frenectomy typically runs $250-$800 depending on the method and provider. Laser procedures in the Lafayette and Louisville area average $400-$600. If general anesthesia is required for older children, costs can reach $2,000-$8,000. Insurance often covers the procedure when medical necessity (documented feeding

problems) is established.

What if we wait until our child has speech problems to treat the tie?

Treatment at age 3-5 for speech-related tongue ties is still effective, but it usually requires speech therapy or myofunctional exercises after the release to break compensatory habits. Earlier treatment (under 6 months) avoids this added step and cost. Still, a late release is better than no release when symptoms are present.

What's the most common mistake parents make with tongue ties?

Getting a release without trying lactation support first, or skipping post-operative stretching exercises. The AAP 2024 report emphasizes that non-surgical options should come first for breastfeeding issues. After a release, incomplete stretching is the top reason families need a revision procedure.

How do I know if my child's tongue tie is "posterior" and harder to diagnose?

The term "posterior tongue tie" is poorly defined and lacks expert consensus. The AAP cautions against using it as the sole reason for surgery. A thorough functional assessment by an experienced provider matters more than the label. If your child feeds, speaks, and functions normally, the anatomy is likely not the problem.