Tongue-Tie and Lip-Tie: Assessment and Release
A tongue-tie is a band of tissue under the tongue that restricts how far it can move. It matters when it causes a functional problem — a baby who cannot latch, a child who cannot clear food from the roof of the mouth. We assess what the tongue can actually do before deciding whether anything needs releasing, because appearance alone is a poor guide.
- Assessment
- 30–45 min
- Release
- 5–10 min
- Anaesthetic
- Topical or local
- Method
- Diode laser
- Fee
- S$872
What happens
A functional assessment: how far the tongue lifts, extends and moves sideways; for a baby, how it cups and seals. For infants we ask about feeding history and, where relevant, work alongside your lactation consultant.
A discussion of what we found and whether release is likely to change anything. Sometimes the answer is that it will not.
If release is indicated: topical anaesthetic for a baby, local anaesthetic for an older child or adult. The band is divided — a matter of seconds.
An immediate feed for infants, and pressure held until any bleeding stops. Bleeding is normally a few drops.
Aftercare: stretches or tongue exercises, and a review. This part does most of the work, and skipping it is the usual reason a release disappoints.
Tongue-tie is both under-recognised and over-diagnosed, which is an awkward thing for a clinic to say. A genuine restriction that stops a baby feeding is worth releasing, and the difference can be immediate. But many babies labelled tongue-tied are struggling with position and latch, and will feed well after help from a lactation consultant without anything being cut. We would rather send you to one first and see you again than divide tissue that was not the problem.
In older children and adults, the reasonable indications are functional: difficulty clearing food, discomfort, restriction that interferes with orthodontic treatment or with cleaning the lower front teeth. Release is not a treatment for speech delay on its own — speech is a coordination skill, and if the tongue can reach the palate it can make the sounds. We work with speech therapists rather than instead of them.
A release alone changes anatomy, not habit. The tongue has to learn to use the range it now has, which is what the exercises are for.
How the release is done
Where a release is indicated, it is carried out with a diode laser — a Sirona SIROLaser with a blue diode — rather than scissors or a scalpel. The laser cuts and seals the tissue at the same time, so bleeding is minimal, sutures are usually unnecessary, and the procedure itself takes five to ten minutes under topical or local anaesthetic.
This does not change who is a candidate. The assessment above still decides whether a release is worth doing at all; the laser only changes how it is carried out once that decision is made.
Who does this at Calm Dental
Fees for this treatment are on our fees page, including GST. A written quotation follows examination.
Questions
How do I know if my baby actually has a tongue-tie?
Function tells you, not appearance. The signs worth taking seriously are an inability to sustain a latch, feeding that takes very long and still leaves the baby hungry, a clicking seal, poor weight gain, and nipple pain or damage that does not resolve with a better position. We assess all of that before suggesting anything.
Does the release hurt?
There are very few nerve endings in the frenum. Babies are treated with topical anaesthetic and usually settle within a minute of feeding. Older children and adults have local anaesthetic and feel pressure rather than pain. Soreness for a few days afterwards is normal.
Will releasing a tongue-tie fix my child’s speech?
Not by itself. If a tongue can reach the roof of the mouth, it has the range needed for speech sounds, and the difficulty is one of coordination — which is speech therapy’s territory. Where restriction genuinely limits the range, release can make therapy more effective. We will say honestly which situation your child is in.
Can adults have a tongue-tie released?
Yes, and the indications are the same: a functional restriction that causes a practical problem. It is done under local anaesthetic in one appointment.
Who does this at Calm Dental?
Dr JD Tan. He assesses function first and will refer you to a lactation consultant or speech therapist rather than treat, where that is the more useful step.