Tongue Tie Release
Tongue-tie release, also known as a frenectomy, is a procedure that releases a restrictive band of tissue under the tongue, called the lingual frenulum, restoring fuller tongue mobility and function. At Synera Dental, Dr. Jeremy Montrose performs laser frenectomies for patients of every age, from infants struggling to breastfeed to adults whose restricted tongue movement has gone undiagnosed for decades.
A tongue tie occurs when the lingual frenulum is shorter, thicker, or more restrictive than it should be, limiting how far the tongue can move, lift, or extend. While often identified at birth, tongue-ties can also go unnoticed well into childhood or adulthood, quietly contributing to feeding difficulties, speech patterns, sleep issues, or jaw and bite development long after the newborn stage has passed.
How Tongue Tie Shows Up at Different Ages
A restricted tongue affects function differently depending on the stage of life, which is why diagnosis is often missed until symptoms are connected back to their source.
In Infants: Difficulty latching during breastfeeding, poor weight gain, clicking sounds while feeding, or reflux-like symptoms that may actually stem from an inefficient suck pattern.
In children, speech sound difficulties, particularly with sounds that require tongue elevation, are associated with picky eating, limited tongue mobility, mouth breathing, and airway or sleep concerns related to a low resting tongue posture.
In adults, jaw or TMJ discomfort, difficulty with certain speech sounds that may have persisted since childhood, snoring or sleep disruption linked to tongue position, and in some cases, a lifelong sense that something about eating, speaking, or sleeping has simply never felt quite right.
It is important to note that not every tongue tie requires treatment. The decision to proceed is based on the degree of restriction and the functional impact it is actually causing, not the presence of tissue alone.
How Dr. Montrose Diagnoses a Tongue Tie
Diagnosing a tongue tie requires more than a quick visual check under the tongue. Dr. Montrose’s evaluation considers both the anatomy of the frenulum and its functional effects on movement.
We focus on:
Visual and Structural Assessment: Examining the frenulum’s attachment point, thickness, and elasticity to classify the type and degree of restriction.
Functional Tongue Mobility Testing: Assessing how far the tongue can lift, extend, and move side to side, since two tongue ties that look similar visually can affect function very differently.
Feeding, Speech, or Symptom History: For infants, a discussion of feeding patterns and weight gain. For children and adults, a review of speech, sleep, airway, or jaw symptoms may be connected.
Collaborative Evaluation When Indicated: For infants and children, Dr. Montrose often coordinates with lactation consultants, speech therapists, or myofunctional therapists to determine whether a tongue-tie is the primary contributing factor.
The Laser Frenectomy Procedure
Dr. Montrose performs frenectomies using a soft tissue laser rather than traditional scalpel or scissor techniques, an approach that offers several advantages for patients of all ages.
Precision: The laser enables precise release of the restrictive tissue with minimal impact on surrounding structures.
Reduced Bleeding: Laser energy seals tiny blood vessels as it works, typically resulting in significantly less bleeding than traditional methods.
Minimal Discomfort: Most patients, including infants, tolerate the procedure well, with the laser approach generally associated with less post-procedure discomfort than scalpel-based release.
Quick Procedure Time: The release itself typically takes only a few minutes, though preparation and aftercare instruction add to the total appointment time.
For infants, the procedure is often completed with the baby positioned comfortably with a caregiver nearby. For children and adults, mild numbing is typically used to ensure comfort throughout.
What to Expect After the Procedure
A frenectomy is a relatively quick procedure, but the work that supports a good outcome continues well after the appointment ends.
Immediate Aftercare: Mild discomfort or sensitivity in the days following the procedure is common and typically manageable.
Stretches and Exercises: Active stretching of the treated area is essential to prevent the tissue from reattaching as it heals, and Dr. Montrose provides specific guidance based on age and case.
Myofunctional Therapy: For many patients, particularly children and adults, myofunctional therapy following release helps retrain tongue posture and movement patterns that may have developed to compensate for the prior restriction.
Follow-Up Monitoring: A follow-up visit confirms healing is progressing well and that mobility gains are being maintained.
It is worth noting that the procedure alone does not automatically retrain decades, or even months, of compensatory tongue habits. The combination of release and follow-up therapy is what tends to produce lasting functional improvement.
Why Tongue Tie Release Matters Beyond the Procedure
A restricted tongue does not just limit how far the tongue can move. Tongue posture and mobility influence feeding efficiency in infancy, speech clarity in childhood, and airway and jaw function throughout life. Addressing a true restriction can support improvements that extend well past the original presenting concern, whether that is a baby who finally feeds comfortably, a child whose speech therapy progress accelerates, or an adult whose sleep and jaw discomfort improve once tongue mobility is restored.
Dr. Montrose’s training in comprehensive frenulum evaluation and surgery, spanning infant to adult populations, reflects a focus on getting this diagnosis right at every stage, not just performing a quick release and moving on.
Frequently Asked Questions
How do I know if my baby has a tongue tie?
Signs can include difficulty latching, clicking sounds while feeding, poor weight gain, or maternal nipple pain during breastfeeding. A feeding and structural evaluation can confirm whether a tongue tie is contributing.
Is a laser frenectomy painful?
Most patients, including infants, tolerate the procedure well. The laser approach is generally associated with minimal discomfort and reduced bleeding compared to traditional scalpel methods.
Can adults have a tongue tie released, or is it too late?
It is not too late. Adults can benefit from a tongue-tie release, particularly when it contributes to jaw discomfort, sleep issues, or longstanding speech patterns.
Will my child need speech therapy or myofunctional therapy after the procedure?
Often, yes. Release addresses the physical restriction, but retraining tongue posture and movement patterns typically requires follow-up therapy for the best long-term outcome.
Is tongue tie release covered by insurance?
Synera Dental Wellness is an out-of-network provider, allowing for individualized treatment recommendations. We can assist with out-of-network claim submissions where applicable, and coverage can vary depending on whether the procedure is billed through medical or dental insurance.
