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Tongue- and Lip-Ties, also known as Tethered Oral Tissue Syndrome (TOTS) are conditions that occur when the strip of skin (lingual/labial frenulum) that connects a baby’s tongue to the floor of the mouth, or lip to the dental ridge, is shorter than usual. Variation in the attachment points of the frenulae may limit the tongue or lip range of motion. 

TOTS is a common condition that, if addressed quickly, will not hinder a child’s development. However, if left untreated, tongue-tie can result in nursing issues, feeding issues, speech difficulties, complications of dental development, or poor oral hygiene.

Signs of TOTS include:

  • Restriction of the tongue or lip movement, making it harder to breastfeed
  • Difficulty lifting the tongue up or moving it from side to side
  • Difficulty sticking the tongue out
  • The tongue looks notched or heart-shaped when stuck out
  • DIfficulty chewing / swallowing food

Treatment of TOTS

The treatment of tongue-tie for infants is a simple surgical procedure called a frenotomy. Dr. Voss examines the lingual and labial frenulae and then uses the Solea laser to release the frenulum.

Stitches are usually not necessary. Since there are few nerve endings or blood vessels in the lingual frenulum, only a local anesthetic is used.

Frenotomy for tongue-tie in older children and adults is similar to that for infants, although it is usually done under general anesthesia and may involve stitches. Speech therapy may also be necessary.

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