LIP | TONGUE TIE

Lip and Tongue Tie Care for Children in San Marcos, CA

A lip tie or tongue tie happens when the tissue connecting the lip or tongue is tight enough to limit movement, which can affect feeding, sleep, and speech. At San Marcos Kids Dentistry, we evaluate these tethered oral tissues and, when treatment helps, perform a gentle CO2 laser frenectomy. Call (760) 744-8600.

If your child is having trouble feeding, sleeping, or speaking clearly, a lip tie or tongue tie may be part of the picture. At San Marcos Kids Dentistry, we evaluate tethered oral tissues, also called oral restrictions, to determine whether a child’s lip or tongue mobility is limited enough to affect daily function. Because tongue and lip ties are closely tied to how a child breathes and grows, this care is part of our broader airway-focused approach, and our goal is always function and comfort, not just appearance.

What Are Tethered Oral Tissues?

Every child has connective tissue attachments in the mouth called frenums, or frenulums. Sometimes these attachments are short, tight, or thick, which can limit the movement and function of the lip or tongue. When a restriction actually affects function, it is considered a symptomatic oral restriction, also known as a tethered oral tissue. These bands are remnants of early tissue that normally recedes before birth.

What Is a Tongue Tie?

A tongue tie, known medically as ankyloglossia, occurs when the tissue connecting the tongue to the floor of the mouth is tight enough to restrict normal tongue movement. When the tongue cannot move freely, it can affect feeding, oral function, and development, including the low tongue posture that influences jaw and facial growth.

What Is a Lip Tie?

A lip tie is a tight attachment of the lip that keeps the upper lip from flanging outward the way it should. This can contribute to feeding challenges and other functional concerns, especially in infants who are nursing or bottle-feeding.

Signs a Child May Have a Lip or Tongue Tie

When deciding whether treatment is appropriate, symptoms and function matter more than appearance. We look at how a restriction affects daily life. Signs vary by age.

In infants:

  • Shallow latch at the breast or bottle, or sliding and popping on and off
  • Falling asleep while eating, or seeming always hungry
  • Clicking or smacking sounds, milk leaking, or gagging while feeding
  • Poor or slow weight gain
  • Snoring, noisy breathing, or restless, frequently interrupted sleep
  • Reflux symptoms or excessive gassiness

For a nursing parent:

  • Creased, flattened, blanched, or lipstick-shaped nipples
  • Cracked, blistered, or bleeding nipples and painful latch
  • Plugged ducts, engorgement, or mastitis, or reliance on a nipple shield

In older children:

  • Speech that is hard to understand, delayed, or effortful with certain sounds
  • Feeding struggles such as slow eating, packing food in the cheeks, or texture aversions
  • Restless sleep, teeth grinding, sleeping with the mouth open, snoring, or gasping for air

If several of these sound familiar, an evaluation can help clarify whether a tie is involved.

What Is a Frenectomy?

A frenectomy is the release or revision of a tongue tie or lip tie. At San Marcos Kids Dentistry, our pediatric dentists perform frenectomies using a state-of-the-art carbon dioxide (CO2) laser. It is a gentle, quick outpatient procedure, and when appropriate it can be completed during the same visit as the initial assessment. The treatment carries minimal risk and can meaningfully improve a child’s comfort and function.

Benefits of a CO2 Laser Frenectomy

Compared with traditional scissors, the CO2 laser offers real advantages for children:

  • Little to no bleeding
  • Quicker, more comfortable healing
  • Greater precision for a complete release
  • No sutures needed in most cases
  • No sedation or general anesthesia required, though laughing gas is available for anxious children

A release may support improvements in breastfeeding, bottle-feeding, solid feeding, sleep, and speech, and it can help set up healthier dental and orthodontic development down the road.

A Team Approach for the Best Outcome

A frenectomy on its own does not always resolve every symptom. For the best results, pre- and post-procedure therapy with the right providers is often important. We collaborate with allied professionals such as lactation consultants, feeding therapists, speech therapists, bodyworkers, and myofunctional therapists, and we will recommend which support may help based on your child’s specific needs.

What to Expect on Treatment Day

On the day of treatment, you can expect a consultation with the pediatric dentist and time for your questions, before-and-after intraoral photos, numbing jelly for comfort, and eye protection. Infants are gently swaddled, and breastfeeding or bottle-feeding babies are encouraged to feed right after. Treatment itself is quick, and we will give you a hands-on demonstration of the simple stretches to do at home for the next two to three weeks.

Schedule a Lip or Tongue Tie Evaluation

If feeding, sleep, or speech concerns have you wondering about a tie, an evaluation brings answers. Call San Marcos Kids Dentistry at (760) 744-8600 or request an appointment online. Find our hours and directions on our San Marcos office page.

Infant Symptoms:
  • Shallow latch at breast or bottle
  • Falls asleep while eating
  • Slides or pops on and off the nipple
  • Gagging, choking, or coughing when eating
  • Poor or slow weight gain
  • Gumming or chewing the nipple when nursing
  • Pacifier falls out easily or won’t stay in
  • Snoring, noisy breathing, mouth breathing
  • Lip curls under when nursing or taking the bottle
  • Clicking or smacking noises when eating
  • Sucking blisters or callouses on lips
  • Reflux symptoms
  • Gassiness
  • Milk leaks out of the mouth when nursing
  • Restless sleep, short sleeping and waking often
  • Baby frustrated at the breast or bottle
  • Baby seems always hungry and not full
  • Creased, flattened or blanched nipples
  • Lipstick shaped nipples
  • Blistered, cut, or bleeding nipples
  • Painful latch
  • Poor or incomplete breast drainage
  • Plugged ducts/engorgement/mastitis
  • Using a nipple shield
  • Speech (ex: frustration with communication, difficult to understand, difficulty speaking quickly, speech delay, stuttering, speech harder to understand in long sentences, mumbling, difficulty with certain sounds)
  • Feeding (ex: frustration when eating, difficulty transitioning to solid foods, slow eater, packing food in cheeks, picky with textures, choking or gagging on food, spitting out food, won’t try new foods)
  • Sleep (ex: sleeps in strange positions, sleeps restlessly, wakes easily of often, wets the bed, wakes up tired and not refreshed, grinds teeth while sleeping, sleeps with mouth open, snores, gasps for air (sleep apnea)

What Healthcare Professionals May Be Involved in Diagnosis and Treatment?

A frenectomy alone may not fully resolve symptoms. For best outcomes, pre-op and post-op therapy with appropriate providers is essential.

San Marcos Kids Dentistry collaborates with allied healthcare professionals such as:

  • Lactation consultants
  • Feeding therapists
  • Speech therapists
  • Bodyworkers
  • Myofunctional therapists

We will recommend which services may be helpful based on your child’s specific needs.

What Is a Frenectomy?

A frenectomy is the release or revision of a tongue tie or lip tie. At San Marcos Kids Dentistry, our pediatric dentists perform frenectomies using a state-of-the-art carbon dioxide (CO2) laser.

What Are the Benefits of a CO2 Laser Frenectomy vs. Scissors?

Benefits of CO2 laser treatment include:

  • Little to no bleeding
  • Quicker and less painful healing
  • More precision for a full release
  • No sedation or general anesthesia needed
    • Note: anxious children may benefit from laughing gas

  • No sutures needed

    • Note: sutures may be placed under the tongue for cooperative older children and teens

What Should Parents Expect on the Day of Treatment?

On the day of treatment, you can expect:

  • Consultation with the pediatric dentist and time for questions
  • Pre- and post-op intraoral photographs
  • Infants are swaddled during treatment
  • Application of numbing jelly
  • Patient eye protection
  • Quick treatment time
  • Breastfeeding and bottle-feeding infants are encouraged to feed immediately after treatment
  • Hands-on demonstration of post-op stretches/exercises to do at home for 2 - 3 weeks

What Happens After the Visit?

After the procedure:

  • Tylenol or Advil dosages will be advised based on your child’s weight

  • Follow-up with lactation, feeding, speech, bodyworker, and/or myofunctional therapist as recommended
  • 1-week follow-up at San Marcos Kids Dentistry to evaluate healing and the effectiveness of exercises and stretches

Frequently Asked Questions

At what age can a frenectomy be done?
Frenectomies can be performed on infants, including newborns with feeding difficulties, as well as older children and teens. We base the recommendation on symptoms and function, not age alone.

Does a laser frenectomy hurt?
The area is numbed first, the CO2 laser procedure is very quick, and most children are comfortable. Laughing gas is available for kids who feel anxious.

Will my child need therapy after the procedure?
Often, yes. Pre- and post-procedure stretches and, in some cases, support from a lactation, feeding, speech, or myofunctional specialist help the release work fully. We guide you through it.