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Tethered Oral Tissues: Tongue and Lip Ties in Babies and Children

Medically reviewed and updated on January 16, 2026. 

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Dr. Elizabeth Briceno, pediatric dentist and owner at Dentini Pediatric Dentistry in Houston TX
Dr. Hillary Strassner, pediatric dentist and owner at Dentini Pediatric Dentistry in Houston TX
Dr. Tiffay Miles, pediatric dentist at Dentini Pediatric Dentistry
Dr. Jennifer Siller, pediatric orthodontist practicing at Dentini Pediatric Dentistry in Houston TX

By Dr. Elizabeth Briceno, Dr. Hillary Strassner, Dr. Tiffany Miles, Dr. Jennifer Siller, and the Dentini Pediatric staff

All children are born with a thin membrane under their tongue, but for approximately 5-12% of children, it is so tight that they cannot move their tongues freely. ​

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Since Dentini opened in 2018, we've been helping Houston families evaluate babies for oral health and development. Learn about tongue and lip ties, and how we advise parents through prospective treatment options to ensure long-term oral health.

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Understanding Tethered Oral Tissues (TOTs

Tongue Ties

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A tongue tie occurs when the thin membrane under the tongue (the lingual frenum) restricts the movement of the tongue.

 

All children are born with some of this tissue, but for approximately 5-12% of children, it is so tight that they cannot move their tongues freely. The medical term for tongue tie is "ankyloglossia" and studies show the defect is hereditary.

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Lip Ties

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Many children with a tongue tie also have an abnormally tight membrane attaching their upper gums (the labial frenulum). This is called a lip tie.

 

These oral ties are collectively referred to as tethered oral tissues, or TOTs.

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Health Impacts and Challenges Caused by Tethered Oral Tissues

In infants, tongue ties can:

 

  • Affect their ability to breastfeed

  • Lead to poor latch, nipple pain and trauma

  • Decrease milk intake and cause a decline in milk supply over time

 

Babies with a lip tie often:

 

  • Face difficulty flanging their lips properly to feed

  • Cannot create a proper seal at the breast

  • Take in excess air during breastfeeding, which often makes these babies gassy and fussy.

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In toddlers or older children, tongue ties may affect speech, feeding or sleep. Speech problems include:

 

  • Speech difficulty or delay

  • Struggles with articulation, especially with producing the L, R, T, D, N, TH, SH, and Z sounds

  • Feeding challenges may manifest as choking, gagging, or having difficulty swallowing certain textures

  • Only eating small amounts of food, slow eating, packing food in the cheeks like a chipmunk, and pickiness with textures

  • Difficulty with soft, mushy foods and meats, though children can struggle with other foods as well.

 

Lastly, TOTs may cause sleep disturbances due to grinding or sleep disordered breathing.

What to Do If You Suspect Your Child Has a Tongue or Lip Tie

Parents concerned that their child may have a tethered oral issue should be evaluated by a medical professional. This can include a qualified pediatric dentist or orthodontist.

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Dentini Pediatric Dentistry has both board certified pediatric dentists and an on-staff orthodontist trained in pediatric care. If you need a tongue tie or lip tie evaluation in Houston, we can schedule an exam at our Houston Heights or West University office.

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