Infant Frenectomy Frequently Asked Questions

Play Video
We are so grateful to be able to provide care for patients in their first days of life and to support families during such a special time. We consider it a privilege to serve families in this way. We hope the information below helps as you navigate through the process of infant feeding.
What is a tongue tie?
A tongue tie, or ankyloglossia, is a condition when the frenum under the baby’s tongue is restricted in its ability to move.
Why does it occur?
A combination of genetic and environmental factors contribute to the occurrence of tongue ties
Should I see an ENT or dentist?

The tongue is a unique structure that falls in the scope of practice of both Ear Nose and Throat
doctors as well as dentists. Both are licensed to treat tethered oral tissues, but more important
is their post-graduate training. Tethered oral tissue diagnosis and treatment is not taught in
medical or dental school, so providers must seek additional training to be knowledgeable
in this area.


Those performing the procedure are knowledgeable about the anatomy. How babies feed and use their tongue involves specialties like Speech Pathologists, Lactation Consultants, and
Occupational Therapists. Both are important to in achieving best results.


The main considerations when choosing a provider should be: training of the provider, the
tool used, and whether they take into account both anatomy and function in diagnosis
and treatment.

What do you use for the procedure?

We utilize state of the art CO2 light scalpel laser technology.

How long is the procedure?

The procedure lasts a few seconds, and your baby will be with our team for a few brief minutes in total.

Will my insurance cover it?

We do not file medical insurance at this time, but we will provide you with the codes and information necessary to file your own dental or medical insurance.

What is the ideal time to have a release?
This varies by patient, as feeding concerns may not surface until later in infancy. Ideally, we see patients during the newborn phase, less than 3 months old. However, we treat babies up to 1 year.
What areas will you be evaluating? 

We evaluate lips, tongue, and cheeks (buccal) to screen for any possible restricted areas.

My baby is gaining weight fine, why would I need to consider a release?

Weight gain is not the only indication of healthy functional feeding. Mothers and babies may be compensating in order to find a way to eat, but those compensations may have consequences later as we reach milestones of speech and eating solid foods.

My baby is bottle fed, why would I need to consider a release? 

Healthy tongue function and mobility is important for many reasons other than breastfeeding,
including proper swallow, draining of eustachian tubes, eating solid foods, and speech.

If we do this procedure does that mean we will not have issues with speech or feeding?

Unfortunately, there are no guarantees with this work. Tongue ties are complex and how babies respond can vary. It is important to understand this is a frenectomy meant to help support infant feeding and get babies off to a good start. Other interventions are still likely indicated in the future for full jaw and airway development. We encourage those wanting to learn more to go to our “Myogrow” page. A frenectomy is not the same as a frenuloplasty, which may still be indicated later in life.

Are there benefits other than breastfeeding?

Healthy tongue function is important for breathing, sleeping, feeding, and speaking. This has implications for both craniofacial development as well as quality of life. The pressure of the tongue on the roof of the mouth during swallowing is what forms the upper jaw. The roof of the mouth is the floor of the nose, and the position of the jaws dictates how much space we will have in our airway to breathe. We consider this a fundamental and critical aspect of overall health.

When is the ideal time to have a release? 

This varies by patient, as feeding concerns may not surface until later in infancy. Ideally, we see patients during the newborn phase, less than 3 months old. However, we treat babies up to 1 year.

I can tell my baby is tongue tied, why do I need to see a lactation consultant?

Our role in this process is limited to improving range of motion by addressing the anatomical structures that may be restricting movement. Functional providers, like a lactation consultants, help identify the symptoms that indicate a primary reason for release, offer non-surgical methods first, and are available post release to help babies learn to use the increased range of motion achieved by a release. We require a functional need to be present as the primary reason for a release, and to know that non-surgical methods have been attempted first. This eliminates performing unnecessary procedures and ensures that a release is truly indicated.

Who is considered a functional provider?

A lactation consultant, occupational therapist, or speech pathologist. Within those specialties, we exclusively work with providers who have further education on tethered oral tissues.

We’ve seen other providers who say there is not a tie? How do I know what to do?

This can be frustrating and confusing for families when they get conflicting advice regarding tethered oral tissues. When weighing recommendations, we suggest families also consider what training and experience providers have. With hundreds of hours of post-graduate education on this topic, Dr. Shannon and her team have positioned themselves as local experts in this specific area. Our goal is that our work helps educate other professionals about the importance of healthy tongue function so that messaging to families can be more consistent.

What can I expect during the procedure?

The baby will be gently and expertly secured and all safety precautions taken. Two team members are present in addition to the doctor to ensure the baby’s safety.

Do you allow parents in the room?

We recommend families not be present in the room for the release. This is to help promote mothers’ readiness to feed afterwards, as well as making sure our team is comfortable taking the time they need to do the procedure completely and effectively.

Do you numb the baby?

We do not to use any numbing gel. This is because we do not want the baby to swallow the anesthetic, and we want tongue mobility intact so the baby can feed afterwards.

Will my baby be in pain?
Babies are able to soothe afterwards, so we compare the pain level to circumcision and vaccination. We recommend Tylenol afterwards for baby’s comfort.
What can I expect after the procedure? 

You will be stretching the release site several times a day to promote proper healing. These stretches guide the healing in the right direction and are done instead of stitches. Babies are initially fussy but recover quickly after the procedure. We advise families on pain control methods for the first 1-2 days. We recommend families practice stretches before the appointment to prepare.

We are struggling with feeding, will this help?

Feeding issues are complex, and we encourage families to find a functional provider they trust to help navigate the feeding process. A release can help when it is indicated, but it does not help with every issue every time. It is important to manage expectations and understand there are many factors to consider. However, when we carefully select who is a good candidate and prepare patients well, most families see improvement. We are happy to recommend functional providers trained in tethered oral tissues.

I already have a lactation consultant, can I schedule an appointment?
Absolutely. If your provider is not familiar with how to diagnose and manage tethered oral tissues, we are happy to help make recommendations. Our process involves close co-management of patients with providers with specific training.
We don’t have any concerns but want the long-term benefits of a release.
While we encourage families to be familiar with the process and the importance of addressing TOTs, we do not perform frenectomies for purely preventative reasons. Therefore we engage functional colleagues to help determine if there is a need related to function that would indicate the need for a frenectomy.
I just want my baby “clipped”, why do I need to see multiple people?

Our detailed process is meant to help promote best outcomes. By working with a team, we find families get better results and prevent negative outcomes. We understand this approach may not be the right fit for all families, and that the logistics of managing multiple appointments can be difficult. We are here to support families as much as we can.


Sleeping Tongue Posture Hold
There are many approaches to stretching, but this video is a good resource.