In recent years, tongue ties, lip ties, and cheek ties have become hot topics in parenting circles, especially among breastfeeding mothers. Some pediatricians and dentists argue these ties are overdiagnosed and overtreated, while many pediatricians, lactation consultants, bodyworkers, and mothers insist they’re real, impactful, and worth addressing.
In this article, we’ll explore what oral ties are, when a release may be needed, what to expect during the procedure, and gentle tools to support healing.
What Are Oral Ties?
Tongue tie (ankyloglossia), lip tie, and buccal (cheek) tie refer to the restriction of oral tissues due to overly tight or short frenula – small bands of connective tissue that tether the tongue, lips, or cheeks. These restrictions can impair the mobility of the mouth and affect essential functions like breastfeeding, swallowing, and speech (1).
- Tongue tie occurs when the lingual frenulum is too tight or thick, restricting tongue movement.
- Lip tie refers to a tight upper or lower labial frenulum that may inhibit the lip’s ability to flange properly during breastfeeding.
- Cheek tie, or buccal tie, involves restrictive tissue in the cheek area that may limit oral range of motion and impact feeding.
Signs and Symptoms of Oral Ties in Infants
In infants, oral ties can present in subtle or profound ways. Parents may notice signs like:
- Difficulty latching or staying latched
- Gassiness, reflux-like symptoms, or clicking sounds while nursing
- Poor weight gain
- Maternal nipple pain, damage, or recurrent mastitis
- Sleep disturbances or frequent feeding
As children grow, undiagnosed ties may contribute to speech delays, picky eating, dental issues, mouth breathing, or even behavioral concerns (2).
If you’re experiencing nipple pain, read this article to learn about what might be going on: How To Prevent & Treat Sore Nipples While Breastfeeding
The Skepticism: Are We Overdiagnosing Oral ties?
Some medical professionals express concern that oral ties—especially posterior tongue ties—are being overdiagnosed or pathologized unnecessarily (3). This skepticism may be fueled by:
- a lack of standardized diagnostic criteria
- the subjective nature of symptom reporting
- the rising number of surgical interventions without consistent long-term outcome data
However, skepticism does not invalidate real experiences. The truth is nuanced: some babies with ties function well without intervention, while others struggle immensely.
Breastfeeding mothers are often the first to notice something isn’t right, and it is my belief that as healthcare professionals, we need to trust mothers. Their pain. Their baby’s feeding struggles. These are not imaginary. In my practice, I like to keep my focus on functional impact: how well the child is feeding, growing, and thriving, and how the mother feels during breastfeeding.
If Oral Ties are Present, Is a Release Always Necessary?
Not necessarily. While some ties are so functionally restrictive that release becomes essential for feeding, breathing, or speech, others can be managed with skilled lactation support, bodywork, or time. The decision to perform a release should be based on how the tie is impacting the child’s function, not just the appearance of the tissue. For mild ties, oral exercises, craniosacral therapy, or simply continued monitoring may be all that’s needed. A collaborative, individualized approach ensures that families don’t rush into procedures when conservative support may suffice.
In my experience, when families collaborate with skilled providers, including functional dentists, bodyworkers, and IBCLCs, outcomes tend to improve.
A Note on the Role of Bodywork for Oral Ties:
Bodywork is a term that includes physical therapy, craniosacral therapy, pediatric chiropractic care, myofascial release, and other gentle manual therapies aimed at improving physical function and/or nervous system regulation. Before and after any oral tie release, bodywork is often recommended to (4):
- Improve fascial mobility and oral motor function
- Reduce compensatory muscle patterns
- Support the baby’s nervous system
While research in this area is still limited, bodywork post oral tie release seems to point toward in improvement in outcome, and I can add that in my experience and in conversations with other practitioners and families, bodywork has often helped babies functionally compensate for mild oral ties—sometimes avoiding the need for surgical intervention altogether.
What to Expect During and After a Release
If a frenectomy is deemed necessary, it’s typically performed using a laser or scissors—usually in a pediatric dental office or ENT clinic. The procedure is quick (often under 10 minutes), and for infants, it’s typically done without general anesthesia. Babies are swaddled and returned to the parent immediately afterward. Some cry briefly; others nurse calmly right away.
Procedures like this can be a source of great anxiety for parents. This article might help: How To Prepare Your Child For Surgery: Tips For Pre- & Post- Operation
Aftercare is important, and generally involves pain management, continued nursing or bottle feeding, and gentle oral stretches several times a day for a few weeks to prevent reattachment of the tissue (5). This part can be challenging, but it’s generally regarded as being very important for long-term success (5).
Managing Pain Post Oral Tie Release in Infants
Pain management after a frenectomy is an important part of the healing process. While many babies experience only mild discomfort, others may be fussier for a few days, especially during oral stretches.
It is absolutely okay to use conventional pain medicine if your baby is in pain. Please do not withhold relief if your child needs it, Tylenol (acetaminophen) and Motrin (ibuprofen, for babies over 6 months) can be safe and effective when dosed appropriately. Always follow your healthcare provider’s guidance for dosage and frequency. To learn more about these pain relievers, read this article: Are Over-The-Counter Painkillers Safe?
Homeopathic remedies are often regarded as great options for gentle support for infants recovering from an oral tie release procedure:
- Arnica montana – for bruising, swelling, and general trauma
- Chamomilla – for irritability and teething-like discomfort
- Hypericum – traditionally used in homeopathy for nerve discomfort
- Staphysagria – traditionally used in homeopathy for discomfort following minor surgical procedures or cuts
To learn more about using homeopathic remedies, read these articles: How To Create A Family Homeopathy Kit and How To Use Homeopathic Remedies – A Quick-Start Guide For Families
Herbal blends can help maintain comfort, ease fussiness, and support a healthy inflammatory response. Look for third-party tested, infant-safe herbal remedies that include some or all of the following herbs:
- Fennel (calms the digestive tract and nerves)
- Ginger (supports a healthy response to inflammation)
- Spilanthes (commonly known as the toothache plant, soothing to the mouth and throat)
If you are using herbal remedies, be sure to be aware of guidelines and best practices on whether these can be combined with other painkillers. To learn more, read this article: FAQ: Can My Child Take Motrin® or Tylenol® with Temperature Tamer™ or Nature Profen™?
Here’s another tip: A glistening of coconut oil lightly massaged on the wounds can be very soothing. It has a pleasant taste and is safe to use for babies.
Additional comfort measures like babywearing, baths, breastfeeding, skin-to-skin contact, massage, and co-regulating (keeping yourself calm) can also go a long way in supporting your baby’s recovery and overall sense of calm.
Summary
Tongue, lip, and cheek ties are connective tissue restrictions that can impact feeding, speech, and oral development—especially in infants. While some believe these ties are overdiagnosed, many families and providers have seen firsthand how much they can affect function. Not every tie requires a release, and many babies benefit from skilled lactation support and bodywork alone. When a frenectomy is needed, knowing what to expect – and how to manage pain with options like Tylenol, homeopathic remedies, and herbal remedies – can make the process smoother. Bodywork before and after the procedure is often key.
References:
- O’Shea JE, Foster JP, O’Donnell CP, Breathnach D, Jacobs SE, Todd DA, Davis PG. Frenotomy for tongue-tie in newborn infants. Cochrane Database Syst Rev. 2017 Mar 11;3(3):CD011065. doi: 10.1002/14651858.CD011065.pub2. PMID: 28284020; PMCID: PMC6464654.
- Dydyk A, Milona M, Janiszewska-Olszowska J, Wyganowska M, Grocholewicz K. Influence of Shortened Tongue Frenulum on Tongue Mobility, Speech and Occlusion. J Clin Med. 2023 Nov 29;12(23):7415. doi: 10.3390/jcm12237415. PMID: 38068467; PMCID: PMC10707515.
- Thomas, J. (2024, July 29). AAP: When breastfeeding problems arise in infant with tongue-tie, don’t jump to surgery. American Academy of Pediatrics. https://publications.aap.org/aapnews/news/29421/AAP-When-breastfeeding-problems-arise-in-infant?autologincheck=redirected
- Smart S, Grant H, Tseng RJ. Beyond surgery: Pre- and post-operative care in children with ankyloglossia. Int J Paediatr Dent. 2025 Mar;35(2):318-338. doi: 10.1111/ipd.13235. Epub 2024 Jul 9. PMID: 38982581; PMCID: PMC11788522.
- Dodal AA, Shelke AU, Subhadarsanee C, Gaikwad SP, Patil KS, Bajaj P. Postoperative Tongue Exercises for Ankyloglossia Following Lingual Frenectomy: A Case Report. Cureus. 2024 Sep 20;16(9):e69806. doi: 10.7759/cureus.69806. PMID: 39429286; PMCID: PMC11491111.
