A lip tie is fixed through a quick procedure called a frenectomy, where a doctor or dentist releases the tight band of tissue connecting the upper lip to the gum. The procedure takes about one minute when done with scissors, and infants typically don’t need any anesthesia. But before jumping to treatment, it helps to understand whether your child’s lip tie actually needs fixing, what signs to watch for, and what the process looks like from start to finish.
What a Lip Tie Actually Is
Everyone has a small strip of tissue called a frenulum that connects the inside of the upper lip to the gum above the front teeth. A lip tie occurs when this tissue is unusually thick, tight, or attached too low on the gum, restricting how freely the upper lip can move. The severity is typically graded on a four-level scale. Grade I is the least restrictive. Grade II describes a frenulum that attaches right at or between the gum margins of the two front teeth. Grade III means the tissue starts inserting into the firm ridge of gum between the front teeth. Grade IV, the most restrictive, involves tissue that inserts deeply into that ridge or even wraps onto the roof of the mouth.
Not every lip tie causes problems. Many children have a visible frenulum that looks prominent but doesn’t interfere with feeding, speech, or dental development. The decision to treat depends on whether the tie is actually causing functional issues, not just on how it looks.
Signs a Lip Tie Needs Attention
In newborns and young infants, feeding difficulty is the most common red flag. A baby with a restrictive lip tie may not be able to latch onto the breast deeply enough, causing nipple pain and damage for the nursing parent. Some babies can latch but can’t maintain suction, repeatedly slipping off the breast with an audible clicking sound. Milk may leak from the baby’s mouth during feeds, and the baby may become fussy when milk flow slows because they can’t extract it efficiently.
The effects on the nursing parent can be significant. Shallow, painful latching often leaves the nipple compressed into a wedge shape, resembling a new lipstick, sometimes with a visible stripe at the tip. Poor milk removal can cascade into engorgement, blocked ducts, and mastitis. Over time, milk supply may drop because the breast isn’t being emptied effectively. These compounding problems lead many families to stop breastfeeding earlier than they planned.
In toddlers and older children, the signs shift. A persistent lip tie can create a noticeable gap between the upper front teeth, since the tissue physically holds them apart. Some children develop difficulty pronouncing sounds that require full lip movement, particularly “p,” “b,” and “m.” A restricted upper lip can also affect tongue positioning, which may further complicate speech development.
How a Frenectomy Works
The procedure to release a lip tie is called a frenectomy (sometimes called a frenulectomy or frenotomy). It involves cutting or releasing the restrictive tissue so the lip can move freely. There are two main approaches: surgical scissors or a laser.
With scissors, the procedure is remarkably fast. It takes about one minute on average. For very young infants, anesthesia isn’t typically needed at all. Some providers offer a sugar solution by mouth beforehand to help the baby stay comfortable, but that’s often the extent of pain management. The frenulum in young babies is thin and has minimal nerve supply and blood flow, which is why the procedure is so straightforward.
Laser frenectomy uses a focused beam of light to release the tissue. It tends to cause less bleeding and may reduce swelling afterward. This approach is more common in dental offices and is often used for older babies, toddlers, and children. Local numbing gel or an injection is typically applied before a laser procedure.
Regardless of the method, the actual release takes very little time. Most of the appointment is spent on evaluation, preparation, and aftercare instructions rather than the procedure itself.
What Recovery Looks Like
Babies can usually breastfeed or bottle-feed immediately after a frenectomy, and many parents notice an improvement in latch right away. Some swelling and mild fussiness are normal for the first day or two. A white or yellowish patch typically forms where the tissue was released. This is a normal part of healing, not a sign of infection.
Most providers recommend stretching exercises to keep the wound from reattaching as it heals. This usually involves gently lifting the upper lip several times a day for one to three weeks. The stretches can be uncomfortable for the baby, so doing them during diaper changes or other already-disruptive moments can help. Reattachment is the most common complication, and it’s more likely if the stretches aren’t done consistently.
Full healing generally takes two to three weeks. For breastfeeding families, the improvement in latch and comfort may be immediate or may take a few weeks as both parent and baby adjust to the lip’s new range of motion. Working with a lactation consultant before and after the procedure can make a real difference in outcomes.
When Older Children Need Treatment
For toddlers and school-age children, lip tie release is usually recommended when it’s contributing to a dental gap between the front teeth or to speech difficulties. Dentists sometimes suggest waiting until the permanent front teeth come in, around age seven or eight, to see whether the gap closes on its own. If the frenulum is thick enough to keep the teeth apart even after they’ve fully erupted, a frenectomy at that point can allow the gap to close naturally or with orthodontic help.
For speech-related concerns, treatment timing depends on the child’s age and the severity of the restriction. If a child is struggling with lip sounds despite speech therapy, releasing the tie can give them the physical range of motion they need to form those sounds correctly. A speech-language pathologist can help determine whether the tie is the actual limiting factor or whether other issues are involved.
Choosing the Right Provider
Frenectomies are performed by pediatric dentists, oral surgeons, ENT specialists, and some pediatricians. Experience matters more than the specific credential. Ask how many lip tie releases the provider has performed, what method they use, and what their aftercare protocol looks like. Providers who routinely treat lip ties will also be able to assess whether the tie is truly causing the symptoms you’re seeing, or whether something else is going on.
If your child is having breastfeeding problems, getting a lactation consultant’s assessment before the procedure is valuable. A skilled consultant can confirm whether the lip tie is the primary issue, identify any additional latch problems, and provide support after the release to help you and your baby get the most benefit from it.