Tongue-Tie and Surgery


Dr. Greene, my 2 1/2-year-old son is tongue-tied (the skin under his tongue comes to the very tip of his tongue). I have seen several doctors regarding this issue, but none feel that it is necessary to surgically correct this problem. I would like to know at what point it does become surgically necessary. My son gets very upset when we don’t understand what he’s saying — which is about 75% of the time — and the skin under his tongue becomes white and sometimes blistered from the strain he puts on it trying to talk. I’m afraid that he is going to have speech problems and possibly more problems when he reaches school. He is already mispronouncing his words and sometimes corrects us because he feels that we are not saying them properly.His father had his cut and so did his stepbrother. Do you have any advice? Thanks in advance.
Christine Mitchell – Woodbridge, Virginia

Dr. Greene's Answer

When most people hear the term “tongue-tied”, they picture someone nervous, stammering, and at a loss for words. Tongue-tie isn’t just a cartoon caricature or picturesque description of an embarrassing moment; it is a relatively common physical condition.

During fetal development, cords of tissue called frenula form in the front-center of the mouth, beginning as early as 4 weeks of gestation. The word “frenulum” comes from the Latin word for bridle. A bridle can be used to guide a horse. In roughly the same way, the frenula guide the development of the structures of the mouth. Early in development, the frenula are important, strong cords, which then recede over time. After birth, they are still useful in guiding the positions of the baby teeth as they come in.

The tiny cord between the center of the upper lip and the center of the upper gum is called the labial frenulum (or lip frenulum). If you slip your tongue up where your upper lip meets your upper gum, you can probably still feel a remnant of your labial frenulum.

Another cord between the base of the tongue and the floor of the mouth or the lower gum is called the lingual frenulum. If you lift your tongue up and look in a mirror, you probably can see the strand of tissue connecting the bottom of your tongue to the floor of your mouth — what is left of your lingual frenulum.

In some kids, the lingual frenulum is short and taut after birth, partially restricting movement of the tongue. This condition is called ankyloglossitis (don’t doctors have great names for things?) — more commonly known as tongue-tie.

In most of these children, the frenulum continues to recede during the entire first year. Their parents get to watch a part of development that usually happens in the hidden inner sanctum of the uterus.

Although tongue-tie is common, only in rare children is medical treatment necessary. If a tight frenulum is interfering with a baby’s feeding, then early treatment is indicated. To accomplish this, the tongue is “loosened” by means of very simple and effective surgery. If a baby is feeding well, however, it is usually better to wait at least a year before revisiting the question of surgery, since tongue-tie so often resolves on its own.

Treatment is again considered if the tongue-tie is affecting speech — especially making it more difficult to pronounce the “th” sound. Tongue-tie is most likely to persist and pose a problem if the insertion points of the frenulum are on the very tip of the tongue and also on the top ridge of the bottom gum. A strong family history is also suggestive of a need for surgery at some point.

It is normal for toddlers to speak in a charming, partially understandable way. We expect kids to have mostly intelligible speech by age three (i.e. others besides their parents understand more than half of their words easily). Your 2 1/2-year-old’s speech may be normal for his age, or may be hindered by his tongue-tie. I would recommend an evaluation by an experienced speech pathologist. This will give you useful information and may help force the hands of doctors and insurance companies. If the speech therapist feels that the tongue-tie is indeed hindering his language development, then I would certainly ask a pediatric otolaryngologist (ear, nose, and throat surgeon) to consider a simple surgical release for an otherwise healthy child.

If the therapist is unconcerned about his speech development, the simple release surgery could still be performed for cosmetic reasons. Often, Christine, “cosmetic” reasons are not superficial reasons. They can affect such core issues as self-esteem, physical comfort, and development of social interactions. Rarely will you encounter an easier way to free your son from bonds that are holding him back!

March 11, 2011
Published on: November 03, 1997
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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Recent Comments

Plz help me am from Kenya am 22 yrs how can i correct my tongue tie… life has not being easy for me to leave with it..
It has affected my speech.

Hello.. I am 22 years old and I have a tongue tie since birth … I was corrected in 2010 first and second step but my speech did not change… Where can i get treatment?

I have a 2 and a half year old adopted son, who is being tested at some point for Autism, but he is not talking. I can see that his tongue does not extend out of his mouth, and it’s very frustrating for him. He takes us by the hand when he wants something. I’m very disappointed that I’m told by the dentist that it costs $675.00 to correct. Any help would be appreciated.

Hi Val,

I’m so sorry to hear you and your son are going through this.

I don’t have recommendations for you, but our friends at might. Depending on where you live they may know of a clinic or other lower cost option for you. It would be such a gift for him to be able to talk.

I hope that helps.
Best, @MsGreene
Note: I am the co-founder of, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

im a mother of a7years old boy he has a tie tounge..he behave like he lost his mind he cant even copy at school.please help

please i am messaging you from west africa nigeria i have a lady i love so much and she is tounge tied and she is around 22 years can they operate on her please i need help because i want to get her a solution to this please

Who does the procedure because I need mine done and i’m almost 15 and its hard for people to understand what i’m saying for example ” I’m going to read this book” and it sounds like “I’m going to weed the book”.

My 5 year old grandson’s speech therapist found that he was tongue tied. It’s not a severe case, not down to the tip of the tongue or anything like that, but definitely interferes with his speech. He gets very upset when we don’t understand what he is trying to say. I am with my grandson more than even his parents so I understand him better than anyone but they will not understand him when he goes to school and I’m very worried. Who would do the procedure? I’ve heard that if they cut too much they can make the condition worse.

My two month old granddaughter just had this procedure completed. Her ability to nurse is greatly improved! Mom and dad are incredibly relieved, was a simple procedure

Who did the procedure? What type of doctor? Oral surgeon?

I am going on 67 years old. would it help me?

I was tongue tied till 9 yrs old. I remember getting so frustrated with repeatingredients myself I actually became mute for about a year. I only talked to my older sister. In my head I knew what I was saying and I thought I sounded fine. Im now almost 30 yrs old and I have communication problems. Especially in an argument. This is the 1st time I actually looked up the issue. To me it was just another obstacle life throws at you sometimes and I learned “a lot” from it.

I don’t think k it has anything yo do with tongue tie because mine is almost at the tip and I talk quite well started talking at 10 months

You ar the luckiest guy in the whole world! Who knows the reason of your luck?
I had my tongue cut 2 times (1981 in Switzerland and in 1987 in Etobicoke, Ont).
The results are undeniable, like the day compared to the night). In my particular case it regrows after 8 to 12 years and the symptoms re-appear. The first person to mock you is the wife and the kids follow. The procedure takes less than 5 minutes and noone should be exposed to such condition…. so very sorry to tell you this…………

I was worndering if I was to get my tongue tie cut, where exactly would I go to do so, could I go to a dentist or somewhere els because I have been needing to get it cut It has been bothering me for a while now.?

I’m 45 and got my tongue tie cut by Dr Ian Jackson when I was 3 or 4 years old, but I’m still tongue tied and my speech is really bad I can’t even lift my tongue up or side to side, please help

I’M 26.. I had my tongue tie surgery yesterday.. it took 15-20 minutes using laser.. bit painful after the surgery.. dr used spray as well as injecting anaesthetic in my tongue.. after 24 hrs now, I feel numbness in tip of my tongue and some pain under my tongue..

I have the same problem would you suggest going through the surgery on how you talk does it help

100% agree. I just had my surgery earlier today.

Good afternoon doctor
Am a Zambian girl aged 21 n I was born tongue tied my parents did not notice until they saw that I had speech problems and they said I just needed to take my time when talking and to be honesty I have tried my best but I can’t manage to stay tongue tied my entire life. And when I used to be in highschool my
Friends used to laugh at me n it made me feel unloved, unhappy about it. The worst part is that I use to feel afraid wen it’s my turn to read in class or anywhere else until now am still tongue tied and am looking forward to get an operation so that I don’t live my life in fear of talking and reading in public please help me doctor please help me

never u feel inferior am 20 and also have the same challenge people mock laugh when I talk,am in higher institutions ,I don’t care if am been heard or not I just believe that was how I was made ,if u are the social type it will help u a lot ……

my 19 month old toddler physical development is good but what I’m worried about is his speech its not so well he learns new words every week but after several days he will just drop saying it and the other problem is his tongue never lifts up I took him to a doctor and he said that he is fine but I just wonder why his tongue never lift up and he has two weired lines underneath his tongue that just worries me.should be worried?

I live in wilmington nc and i have a daughter her name is mia she is 1 years old. I was wondering could you clip her tongue she having a hard time speeching.

I went to 2 specialists and they said I have to learn how to deal with being tongue tied. What should I do?

I’m 38 years old now & it’s hereditary in my family. My Mom, my siblings and all my children had it. It’s irritating because you can’t stick your tongue out but didn’t effect my speech. About 9 years ago I was at my dentist & he was doing my x-rays. It’s always uncomfortable when they put that thing under my tongue to take photos because of that skin. My dentists randomly said, you know you can get rid of that? I came back the next day, he numbed my mouth and used a lazor to cut the skin. I’m not sure if my dentist was just really cool or what but I didn’t have to see my primary care physician. My dentist approached it like I was getting my ears pierced or something. No biggie…My teenage son wants his done but we have a new dentist now. I’m going to ask them at our next cleaning. If not, I may have to call my old dentist to do it.

Hi sir,
My 14 and I have a tongue-tie I wonder if it’s to late to have surgery ?

I’m 26 years old and just had mine done two days ago. It was really easy and only hurt the first few hours after it was done.

Sir, my first , five months child has a tongue tie, I should it to a young doctor and said my son can release his tongue. although he can cry to to here. What should I do.

Hi I’m 13 and tounge-tied, my doctors said that I can’t do the surgery. What should I do?

My fiancé is 33 with the same problem. It causes problems with French kissing as well, do you have any similar problems?

I am 19 years old and I am tongue tied and I have speech problem but I also have autism and I don’t know what to do

Did this surgery help you to talk? My grand daughter is having it done Monday. She is 10 and does not talk at all.

Hi im 30 years old I have a tonque tie I have speech problem as well. Is it possible to sergery it now?

For people with tongue tie, getting treatment can help communication and be a big plus in their lives. The first step is to talk to a primary care physician. He or she will discuss treatment options.

My son is 5 months old and noticed the “tongue tie” issue same as his brother. He gags easily and vomits when he coughs. He does have trouble swallowing. The nicu nurse noticed this. At what age do they snipped the frenulum

I’m writing this message in hopes of helping another child who is tongue tie. My son was about 22 mo old when a mom from swimming lessons asked me if he was tongue tied. I didn’t actually think that there was a real life condition for being tongue tied. I thought it was a joke that people say…after swimming I got on line and started to research this topic. I noticed the heart shape at the bottom of his tongue, and that he could not lick an ice cream cone. His words all sounded the same…
My son had a very easy gag reflex, and was constantly vomiting or gagging. Or if he cried too hard he old easily vomit up the bottle he just drank. Once he turned 1- 1 1/2 I noticed lots of choking. He would start to eat something and then most of the time choke or just choose not to eat. I realized this was not normal too.
I called Children’s Hospital to get an appointment with an Ear, nose, and throat expert. I asked her to look at my sons tongue. At this time we he was 24 mo. She told me his tongue looked ok, and to come back when he’s 3 yrs. and that he has an easy gag reflex and to give him water at night instead of milk. I left that appoint unsatisfied. I called a friend that is a dentist, and asked if he knew of any pediatric dentists I could call. The first Ped dentist said he was fine, and to check back in a year. The 2 Ped dentist had a laser in which she could cut the tongue, and we would have to do exercises post surgery to help to the tongue from reattaching. The 3 Ped dentist referred us to an oral surgeon. He suggested surgery to clip the tongue and put in stitches. He also wanted to put our son under anesthesia. I did not want to do that because he had just turned 2, but was considering it. Finally, we spoke to an oral surgeon that my husband had used in the past. He had performed these surgeries often, and was going to sedate him vs. be put under. This sounded better to me.
We did the surgery it was about 25 min. Honestly, the hardest part was seeing him sedated. He came out of surgery, and I held him. We put him in the car and came home. He slept for awhile.
This was the best thing we ever did. He is a new kid. He eats like a champion now, and his ability to talk and communicate has improved 100%. He just seems over all happier. I would highly recommend clipping the tongue if your child is tongue tied. It’s no way for them to live, and it really just isn’t fair for them.

How long did it take for his speech to get better?

My doc. wont clip mine didnt for 14 yrs

Hello dr.
In childhood, I fell from a bed and a nail entered in my tongue, so my tongue was cut (middle hole). I got 7 stretches at that time. But still I face a problem of stammering. As I grow this cut comes forward, I mean at the tip of the tongue. Please suggest some suitable solution. Because stammering embarrasses me at every point of my life.

My son was born tongue tied when he was born. He is 5 now and has been to several speech therapy and his doctor said he’ll grow out of it in time, stop speech therapy. He is somewhat better, but still having a lot of speech problems. Could it be the same problem and it needs to be cut again or what? Very worried.
Thank you, Cindy :)

I’ve a problem in my tongue or mouth from 5 years old. When I’m speaking with others. Everybody laughing when I’m speaking with them. Oh, what a shame! Now I’m 27 years old. What can I do? How do I get rid of this problem? Please ….

I am 15 years old and I have been troubling with the pronunciation of some words, People may say I speak a bit funny, however, I do have curved teeth due to sucking my thumb causing my teeth to look a bit short but is that contributing to me having tied tongue? If so, is there any treatment for it? I just wanna sound as normal as the others.

My son was born tongue-tied. Even though he lost weight drastically because of it, I could not find a single pediatrician who wanted to refer him to an ENT. I switched him to a bottle which was sad and resolved that doctor’s knew best. By the age of 4 he started having major speech issues and our dentist noticed and offered laser surgery.

He has been doing fantastic, but will need therapy as he never built the muscle properly and will need to be retrained on how to properly use his tongue. The surgery was less that 20 minutes long and painless. It really breaks my heart that my son had to unnecessarily suffer for 4 years and we missed out on breast feeding over what could have been a simple snip 4 years ago.

This is truly the most simple and painless procedure a child could possibly face, yet the lack of timely action affects children negativity in so many ways, even as they grow up. I hope that parents will take time to listen to their doctors, but also listen to their gut and do what’s best for baby.

I am 15 years old, I don’t have a speech problem but I was wondering what it would take for a doctor to clip my tounge?

I’m 16 and had my tongue cut when I was born, but it grew back.

My son is four years old and has a tongue tie. He had difficulty in learning to talk. We discovered the tongue tie late.

The dentist tried to cut it last month, but it was not completely cut because the little boy was scared. After that his speech started improving though not fluent.

We have made an appointment with a private pediatrician to cut it completely. Right now he can talk, but the problem is at his age he is still imitating. When you ask him something he asks you too, until you teach him how to respond to the question. That’s when he can respond well.

He catches everything taught at school, colors he can differentiate, can count from 1-40, from A-Z, and knows songs taught at school — even the prayers he can pray before eating.

Is this normal? How long do you think it will take before the situation goes back to normal and what else can we do to improve his speech?

I am a Pediatric Dentist and managing tongue tie using laser for the past few years. First of all most of my patients had reported to the pediatrician that the baby was not able to breast feed for more than 1.5 to 2 minutes. Hence recognizing tongue tie at an early age is important. I normally use lasers for management with quick and safe results. Of course I do avoid oral antibiotics post operatively in children above three years of age.

Hi Vincent — Have you taken your son to see a doctor about this issue? Do you have an update?

Best, @MsGreene
Note: I am the co-founder of, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

my son is 3 and a half years old, he is severely tongue-tied with constant blisters on his lingual frenulum with minable speech. we’ve done early intervention and speech therapy, non of them helped. talking to his pediatrician tomorrow about getting it clipped

I would highly, highly, recommend clipping his tongue. We did my sons at 24 months, and he is a new child. Not only will his speech get better, but his ability to eat and his confidence level will rise. If it is really restricted speech therapy can only do so much for him. I can’t say enough how much happier you will feel knowing that he does not have to live like that, and how much happier he will be that you did that for him. It seems that professionals can give their opinion, but you are the one that can see if he is struggling. Have it clipped. It’s such a fast procedure for a life time of comfort, He will thank you.

My understanding is the surgery is minimally invasive. There’s even a new laser option that is done by some doctors. You might want to ask about that option.

I hope that helps.
Best, @MsGreene
Note: I am the co-founder of, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

I’m 16 and my tongue is tied and I refused to get the surgery as a kid. Now I am having speech problems and get constant blisters on the tongue tied skin is it too late to have it cut also the skin has been. Pulling my tip of my tongue so . Much that the tip has concave d and now my tongue is so wide from being unable to get longer it doesn’t fit in my mouth. If I get it tied will my tongue ever get back to ‘´normal”

Evan, while the sooner the better when it comes to freeing a restricted tongue, it is never too late to have it done and many adults do notice positive changes. Look into having it released and talk to a knowledgeable professional who releases ties. Some use laser, some snip, but the important thing is that they’re educated on ties and experienced. Best wishes!