In recent years, there has been a surge of misinformation surrounding tongue-tie releases, also known as frenotomies or frenectomies. This surgical procedure, aimed at correcting the anatomy for a condition known as ankyloglossia (tongue-tie), has become the subject of many misconceptions. While the procedure can offer significant benefits for those who need it, the spread of myths has led to unnecessary anxiety for parents and patients alike, and even to some unnecessary procedures. In this blog post, we’ll explore what tongue-tie really is, clarify common misunderstandings about its treatment, and help you make informed decisions if you or your child is affected by this condition.
What is Tongue-Tie?
Tongue-tie occurs when the lingual frenulum, the band of tissue connecting the bottom of the tongue to the floor of the mouth, is too short, tight, or attached too far forward. This can restrict the movement of the tongue, potentially contributing to challenges with breastfeeding bottle feeding, solid feeding, speech, dentition, craniofacial pain, dentition, and/or oral hygiene. Only those with functional issues accompanying abnormal anatomy are considered to have a tongue-tie. Otherwise, a frenulum is a normal occurring anatomical feature.
In cases where tongue movement is severely restricted, healthcare professionals may recommend a frenotomy—a procedure to release the tongue-tie by cutting or lasering the frenulum. This can improve mobility and help to acquire normal function and reduce symptoms. However, the decision to perform this procedure should be made after careful evaluation and consideration between patient/parent and their healthcare team.
Common Myths and Misconceptions
1. “Tongue-Tie Release is Unnecessary Due to Lack of Research”
One of the most persistent myths is that tongue-tie releases are often unnecessary and that there isn’t enough research to support the procedure. This claim is misleading. While it’s true that tongue-tie diagnosis and treatment have evolved, it’s incorrect to say that there is no solid evidence backing the release procedure.
Several studies have demonstrated that a frenotomy can significantly improve breastfeeding outcomes. Babies with tongue-tie often struggle to latch effectively, leading to pain for the mother and inadequate feeding for the infant. Research shows that after tongue-tie release, many mothers report reduced pain and improved breastfeeding within days of the procedure. In a systematic review published in Pediatrics, over 80% of mothers experienced immediate improvement in breastfeeding after their infant underwent a frenotomy.
Speech development is another area where the procedure is beneficial. Although not all tongue-tied children will develop speech difficulties, some do. Studies indicate that early release of a tongue-tie can prevent speech articulation issues, which are harder to address once they’ve developed. Furthermore, those who have struggled with speech often see significant improvement after a frenotomy, particularly when combined with speech therapy.
2. "Tongue-Tie Always Requires Treatment"
One of the most pervasive myths is that every person diagnosed with a tongue-tie needs a release. In fact, sometimes just doing therapies and other interventions can improve function and reduce symptoms. The decision to pursue a tongue-tie procedure should be based on a thorough assessment by a qualified healthcare provider, taking into account the severity of symptoms, rather than just the appearance of the frenulum.
3. "A Tongue-Tie Release Instantly Solves Breastfeeding Problems"
While a frenotomy can help some infants with breastfeeding difficulties, it is not a magic solution. Tongue-tie is only one of many potential causes of breastfeeding problems. Other factors, such as latch issues, milk supply, and the baby’s overall health, should be considered. A lactation consultant can help determine if tongue-tie is a contributing factor and if a referral should be made. Furthermore, intervention is needed to help the tongue develop proper movements after the procedure.
4. "Tongue-Tie Releases Are Painful and Risky"
A common concern among parents is that tongue-tie release procedures are painful or carry significant risks. In reality, frenotomies are usually quick and minimally invasive. For infants, the procedure often takes just a few minutes and can be performed in a doctor’s or dentist’s office. The baby may experience some discomfort, but recovery is generally swift. While any procedure carries some risk, complications are rare, especially when performed by an experienced provider.
5. "Laser Frenectomies Are Superior to Scissor Releases"
Laser frenectomies have gained popularity in recent years, leading some to believe they are a superior option. However, both laser and scissor releases are effective methods of treating tongue-tie. The choice of technique often depends on the practitioner’s preference, the specific case, and the patient's needs. There is preliminary research, but no conclusive evidence that one method is significantly better than the other in terms of outcomes, though lasers may result in less bleeding during the procedure. The key is to choose a skilled and experienced practitioner, regardless of the method used.
6. "All Speech Problems Are Caused by Tongue-Tie"
Another common misconception is that tongue-tie is always the culprit behind speech delays or articulation issues. While severe cases of tongue-tie may contribute to speech difficulties, most children with speech problems do not have tongue-tie. A thorough evaluation by a speech therapist or pediatrician is essential to identify underlying cause(s) of any speech concerns. In some cases, tongue-tie release may improve speech clarity, but it is not a guaranteed solution for all speech-related challenges.
When Is a Tongue-Tie Release Necessary?
The decision to proceed with a tongue-tie release should be based on functional issues rather than appearance alone. If an infant struggles with breastfeeding despite other interventions, or if an older child or adult has significant speech or oral health problems related to tongue mobility, a frenotomy may be beneficial.
However, if the tongue-tie does not interfere with daily activities like eating, speaking, or maintaining oral hygiene, treatment may not be necessary. Consulting with a team of healthcare professionals—such as a lactation consultant, pediatric dentist, or speech therapist—can help determine the best course of action.
Conclusion: The Importance of Individualized Care
The spread of misinformation about tongue-tie releases can lead to confusion and unnecessary procedures, or worse, delay essential care for those who truly need it. Each case of tongue-tie is unique, and treatment decisions should be based on a careful evaluation of symptoms and functional limitations, not myths or assumptions. If you suspect that you or your child may have a tongue-tie, seek advice from a qualified healthcare provider who can offer evidence-based recommendations.
Ultimately, the goal is to ensure that the patient’s needs are met with appropriate, individualized care—not driven by fear, hype, or misinformation. To learn more about assessing and treating disorders related to tongue-ties, the CE courses TOTS Training® and The Pre-Release Paradigm are outstanding education opportunities that delve more deeply into research as well as protocols needed for optimal outcomes.
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