Lip Ties

Take the tension out of their smile.

An upper lip tie occurs when an unusually short, thick, or tight labial frenulum tethers the upper lip to the upper gum. While some children experience no symptoms, others may struggle with nursing latches, dental alignment or spacing (such as gaps between front teeth), and maintaining oral hygiene along the gumline. Identifying these functional limitations early allows families to select appropriate care options that foster optimal feeding, dental health, and overall oral development.

Clinicians evaluate a lip tie through a physical exam, a review of medical history, and a functional assessment. They examine the labial frenulum’s length, thickness, and attachment point while checking the upper lip’s ability to flare outward. Diagnostic focus varies by age: clinicians look for latching difficulties by observing lip flanging and seal during infant feedings, whereas in older children, they assess dental spacing, lip mobility, and plaque buildup along the upper teeth.

If a lip tie causes ongoing functional issues, surgical intervention may be recommended. Providers typically perform a frenectomy or frenotomy, also known as a lip tie release, to free the restricted tissue band. This allows a resolution of the tissue restriction in infants with minimal discomfort. At select locations, this is performed using LightScalpel® CO2 Laser technology.

Choosing the appropriate approach depends on the child’s age, anatomy, severity of symptoms, and clinical guidance. For many patients, this intervention successfully restores upper lip mobility and function.

Symptoms

Symptoms of a lip tie (labial restriction) stem from a tight band of tissue anchor connecting the upper lip to the gum tissue above the front teeth. While some children experience no symptoms, a restricted lip can interfere with latching, dental spacing, and oral hygiene.

Physical Signs (All Ages)

• Visual appearance: A thick, tight, or rigid membrane connecting the middle of the upper lip directly to the upper gumline, sometimes extending down between the two front teeth.
• Tethered lip movement: Inability to easily flange or roll the upper lip outward toward the nose without resistance or blanching (turning white) of the gum tissue.

Symptoms in Infants

In babies, a lip tie prevents the upper lip from flanging outward to form a tight, comfortable seal around the breast or bottle nipple.

For the Baby:

• Tucked upper lip: The upper lip curls inward during feeding instead of flaring open like “fish lips.”
• Shallow latch: Inability to take in a deep breast or bottle seal, leading to frequent slipping off or breaking latch.
• Clicking or smacking sounds: Caused by loss of suction while drinking.
• Aerophagia (swallowed air): Excessive gas, bloating, reflux, or colic-like fussy behavior after feeding.
• White callus or blister: A persistent blister in the center of the baby’s upper lip caused by excessive friction while trying to hold a seal.

For the Nursing Parent:

• Painful feeding, pinches, or squished nipples (often looking flattened or “lipstick-shaped” post-feed).
• Blocked ducts or clogged milk glands due to incomplete breast drainage.

Symptoms in Children

As primary teeth emerge, the attachment point of a lip tie creates dental and hygiene challenges.

• Gap Between Front Teeth (Diastema): If the labial frenulum attaches low between the upper central incisors, it can hold the two front teeth apart as they erupt.
• Increased Risk of Tooth Decay: Milk, formula, or food debris easily gets trapped in the pocket above the front teeth, while the tight lip makes it difficult to sweep a toothbrush across the gumline.
• Gum Recession or Blanching: Pulling on the upper lip causes the tissue around the front teeth to turn white or pull away from the tooth root.
• Difficulty Eating or Licking: Pain or tightness when trying to take large bites of food or eating off a spoon.

Symptoms in Adults

If an upper lip tie persists into adulthood, symptoms typically center on esthetic, orthodontic, and periodontal issues.

• Persistent Gap or Relapse: Spaces between the upper front teeth that won’t close, or gaps that open back up after orthodontic braces are removed.
• Gummy Smile or Restricted Lip Elevation: Inability to comfortably lift or flare the top lip, or feeling excess pull on the upper gum when smiling broadly.
• Gum Tissue Pull & Periodontal Disease: Chronic inflammation or early gum recession along the top two front teeth due to persistent mechanical pulling.