Lip ties are extremely common. In fact, every newborn has a piece of tissue connecting the upper lip to the gum, called the upper lip frenulum. A 2017 study of 100 newborns found that all of them had some degree of this attachment, with 83% having a moderate connection and 11% having a more prominent one. The real question isn’t whether your baby has a lip tie, but whether it’s causing a problem.
Every Baby Has a Lip Frenulum
The tissue connecting the upper lip to the upper gum is a normal part of human anatomy, not a defect. It exists on a spectrum, from a thin, barely noticeable band to a thick attachment that extends into the roof of the mouth. Because everyone has this structure, the term “lip tie” can be misleading. It implies something abnormal when, in most cases, the tissue is simply doing what it’s supposed to do.
The confusion often comes from classification systems that grade the frenulum by how far down it attaches. The most commonly referenced scale has four grades. Grade I is the least restrictive, with the tissue attaching high on the gum. Grade II describes an attachment closer to where the front teeth will emerge. Grade III means the tissue reaches into the small triangle of gum between the future front teeth. Grade IV, the most prominent, involves tissue that extends into or wraps onto the palate. These grades describe anatomy, but a higher grade doesn’t automatically mean a problem exists.
Rising Diagnoses Don’t Mean Rising Problems
Lip tie diagnoses and frenulum release procedures have increased significantly over the past decade. Data from the United States, Australia, Canada, and Brazil all show the same trend. One Brazilian study tracking procedures from 2017 to 2022 found a statistically significant upward trend in frenulum surgeries, with the majority performed on babies under one year old.
This increase likely reflects greater awareness among parents and providers rather than an actual change in how babies are born. Social media, parenting forums, and some lactation consultants have brought lip ties into the mainstream conversation around breastfeeding difficulties. But major medical organizations have pushed back on the idea that this surge in diagnoses is warranted. A clinical report from the American Academy of Pediatrics noted that maxillary lip ties “may be being overdiagnosed in some areas.”
The Debate Over Breastfeeding
Most parents searching for information about lip ties are dealing with breastfeeding pain or difficulty. The theory is that a tight or thick frenulum prevents the baby’s upper lip from flanging outward properly during feeding, which limits how much breast tissue the baby can take in. When a baby latches shallowly, it can cause nipple pain for the parent and shorter, less effective feedings for the baby.
However, the evidence connecting lip ties to breastfeeding problems is surprisingly thin. The American Academy of Pediatrics stated in 2024 that labial frenula are “normal oral structures unrelated to breastfeeding mechanics and do not require surgical intervention to improve breastfeeding.” The Academy of Breastfeeding Medicine reached a similar conclusion, reporting no evidence to support surgical treatment of the upper lip frenulum for feeding issues. The American Academy of Otolaryngology also reached consensus that surgery to release these ties should not be performed for breastfeeding purposes.
This doesn’t mean breastfeeding pain isn’t real. It means the frenulum is rarely the cause. Feeding difficulties in newborns have many possible explanations, and jumping to a structural diagnosis can delay more effective help.
What Actually Helps With Feeding Difficulties
The Academy of Breastfeeding Medicine recommends starting with skilled lactation support rather than surgery. Adjusting the baby’s latch position, trying different breastfeeding holds, and temporarily using nipple shields can resolve many feeding challenges. Supplementing with expressed breast milk while working on latch technique gives the baby adequate nutrition in the meantime. As babies grow, their mouth anatomy changes and their ability to latch effectively often improves on its own.
For parents who have already had a frenulum release procedure, it’s worth knowing that post-procedure stretching exercises, sometimes recommended by the provider who performed the surgery, are not supported by evidence. No safety guidelines exist for the manual stretching or topical substances sometimes prescribed for the wound site afterward.
Potential Effects on Teeth
The one area where a prominent lip frenulum can have a measurable effect is dental development. A thick, low-attaching frenulum has been linked to midline diastema, the gap between the two upper front teeth. The tissue can exert mechanical pressure or limit lip movement in a way that affects how the upper front teeth position themselves.
The size of the gap correlates with the type of attachment. Minor gaps of 2 millimeters or less are associated with moderate frenulum variations, while larger gaps tend to involve the most prominent attachment types, where tissue extends into or through the gum between the teeth. Other potential effects of a very prominent frenulum include gum recession, difficulty maintaining oral hygiene around the front teeth, and limited upper lip mobility.
These dental concerns typically become relevant when permanent teeth come in, not during infancy. Many pediatric dentists take a watch-and-wait approach, evaluating whether the frenulum is still causing issues once the adult front teeth have fully erupted. A gap that exists with baby teeth often closes naturally as the jaw grows and permanent teeth arrive.
How to Think About Your Baby’s Lip Tie
If someone has told you your baby has a lip tie, the most important thing to understand is that having one is universal. The tissue is there in every infant. What varies is thickness and how far down it attaches. A prominent frenulum is not a diagnosis on its own. It becomes relevant only if it’s clearly causing a functional problem, and major medical organizations agree that the link to breastfeeding difficulties remains unproven.
If you’re struggling with breastfeeding, working with a board-certified lactation consultant is the most evidence-supported first step. If you’re concerned about a gap in your child’s teeth, a pediatric dentist can assess whether the frenulum is a contributing factor and whether intervention makes sense after the permanent teeth come in.