Infant and Adult Functional Frenectomy


Have you ever heard the phrase “tongue-tied”?

While the term is used commonly to describe a situation in which someone stumbles over words or is left speechless, being tongue-tied is actually a physical condition that can impair speech and other normal oral functions and even contribute to chronic health problems.

What Is Tongue-Tie?

Tongue-tie is a medical condition called ankyloglossia that develops when the frenum, the band of tissue under the tongue, is too short or tight. When this occurs, the tongue is restricted in movement. Restriction in tongue movement can contribute to problems with breastfeeding, speaking, eating, breathing and digesting food, and can lead to tooth decay and gum disease.

Other areas that can be affected by frenums that are too tight or short include the area behind the upper lip in front of the top front teeth (lip-tie) and the cheek (cheek-tie).

Sometimes the tongue is attached too tightly or is attached with tissue that is a little too long or positioned a little too interiorly. That’s called a tongue-tie.

Effects of Tongue-Tie

Tongue-ties are often overlooked in infants and children, which can mean their side effects are also frequently overlooked or misdiagnosed as other conditions.

The signs and symptoms of tongue-tie can appear in infants, children and adults; these symptoms include:

  • Limited tongue mobility, which means difficulty or inability to lift the tongue to touch the upper teeth
  • Difficulty moving the tongue from side to side
  • A hard time sticking the tongue out past the lower front teeth
  • Tongue that appears heart-shaped or notched when stuck out
  • Difficulty latching when breastfeeding; babies seem constantly hungry; a clicking sound when nursing
  • Breastfeeding for long periods of time
  • Trouble gaining weight or diagnosis of failure to thrive in babies
  • Speech delay, speech impairments or lisps
  • Difficulty swallowing
  • Food aversions; picky eating; problems with certain textures
  • Choking or gagging on certain foods or liquids
  • Pocketing food in the cheeks; food falling out of the mouth

Other issues caused by tongue-ties include things that may not be immediately relatable to the tongue-tie but can cause serious or chronic health problems, including:

  • Chronically enlarged tonsils and adenoids
  • Sleep apnea and snoring
  • Night terrors and frequently waking throughout the night
  • Bedwetting or issues with toilet training
  • Dental and oral health issues; cavities and/or bad breath
  • Chronic ear infections
  • Sinus or allergy issues
  • Posture problems
  • Very high palate
  • Bite malocclusions
  • Recessed chin
  • Jaw issues, including tempormandibular joint disorder (TMJD)
  • Tooth grinding
  • Digestive problems, including IBS and reflux
  • Migraines and headaches
  • Behavioral problems, including difficulty concentrating, ADHD-like symptoms, outbursts and mood swings
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Sarah’s parents knew it was important to start orthodontic treatment early. After receiving orthodontic care combined with myofunctional therapy, Sarah is now a thriving teenager who is happy with her smile.

Everyone’s super nice, they’re all welcoming. I love Conchi. I really feel happy here, so I wouldn’t go anywhere else. I trust them completely.

Tongue-tie Treatment


The treatment for tongue-tie is the lingual frenectomy procedure. A lingual frenectomy removes the band of tissue connecting the underside of the tongue to the bottom of the mouth.

Frenectomies can be performed on patients at various ages and for a range of reasons, including problems with breastfeeding (and occasionally bottle-feeding), speech and eating.

The procedure can be done surgically with a scalpel, but at Miami Designer Smiles, Dr. Garcia and Dr. Sanchez-Garcia perform the lingual frenectomy for adults and children using a soft-tissue laser.

Using a laser to perform the procedure means less trauma to the affected tissue, which means minimal to no blood and faster healing times. In most cases, stitches are not required.

Prior to the procedure, the area will be anesthetized to reduce discomfort. The procedure is performed right here in our office and takes between five and 10 minutes.

Healing after a frenectomy takes two to three weeks, and most patients have no complications or discomfort after their procedure.


Frenectomies also often play a role in orthodontic treatment, as frenums that are too long or too short can cause tooth or jaw displacement.

When the lingual frenum is too short, it can cause the lower jaw to be pushed out. Over time, this can cause an underbite or pain in your jaw joints. If this is the case, a lingual frenectomy may be used to facilitate orthodontic treatment and increase the chances that treatment will be successful.

If you have a gap in your front teeth, it may be due to a lip-tie, so you may need a maxillary frenectomy after orthodontic treatment to prevent teeth from moving. Learn more about our orthodontic treatments and Face Forward dentistry here.

Many individuals who have a frenectomy procedure also undergo myofunctional therapy to help retrain the tongue, improve tongue mobility and train the muscles of the face to function properly.

Are you or your child experiencing speech, eating or orthodontic problems? You may be a good candidate for a laser frenectomy to remove tight connective tissue under the tongue or at the upper lip. This procedure can resolve issues caused by impaired tongue mobility. The advanced technology used at Miami Designer Smiles has made the laser frenectomy procedure for tongue-ties and lip-ties a safe and convenient option for patients of all ages.

Call Miami Designer Smiles today for more information or to schedule a consultation.