Tongue-tie – also known as ankyloglossia—occurs when a band of tissue connects the tip of the tongue to the floor of the mouth. This band of tissue is called the lingual frenulum. Tongue-tie, which is present at birth, not only interferes with the way a child speaks, but it also limits the way he or she eats or swallows. It can interfere with breastfeeding, according to information from the Mayo Clinic

While tongue-tie doesn’t always cause problems, when it does, it can be easily fixed by a simple tongue-tie surgery. This procedure can often be performed in our office for newborns. For older children, it is performed in the operating room under a brief, general anesthetic.

What Are the Symptoms of Tongue-Tie?

Indicators of tongue-tie are:

  • Inability to lift the tongue to the upper teeth.
  • Trouble moving the tongue from one side of the mouth to the other.
  • Difficulty sticking out the tongue beyond the lower front teeth.
  • A tongue that appears heart-shaped or notched.
  • Speech problems.

It’s also believed that tongue-tie may run in families, and it’s more common in boys than girls, according to information from the Mayo Clinic

How Is Tongue-Tie Corrected?

The correct course of treatment is highly individualized. In some cases, it may be necessary to correct it as soon as possible after the infant is born---particularly if tongue-tie can interfere with breastfeeding. Depending upon the extent of the tongue-tie, a “wait-and-see” approach may also be appropriate.

If surgery is necessary, there are two types of procedures: a frenotomy or frenuloplasty.

What Is a Frenotomy?

During this procedure, the lingual frenulum (band of tissue) is snipped so it no longer anchors the tongue to the bottom of the mouth. The pain is minimal because there aren’t many nerve endings in the tissue.

What Is a Frenuloplasty?

If the tissue is too thick for a frenotomy, a frenuloplasty is needed. For the procedure, general anesthesia is often used. When the tissue is snipped, sutures are required. These will absorb during the healing process.

Should My Child Have Tongue-Tie Surgery?

We specialize in providing customized care for each patient, and we treat numerous pediatric patients. Each case is evaluated individually. However, according to the Cleveland Clinic, here are a few indicators of when tongue-tie surgery is appropriate:

  • When your baby has difficulty breastfeeding or using a bottle.

  • When your child has difficulty eating.

  • When it is affecting your child’s speech. (This is particularly obvious with the “t,” “th,” and “z” sounds.)

Sometimes speech therapy is needed after surgery.

Raleigh Capitol Ear, Nose and Throat Specializes in Pediatric ENT Services 

Our practice is the only Wake County office to offer all aspects of pediatric ear, nose and throat treatment. Many of our patients are younger than 16, and all of our physicians have had five to six years of specialty training beyond medical school dedicated to helping pediatric patients.

Are you concerned that tongue-tie is affecting your son or daughter? Schedule an appointment today so we can give your family the world-class treatment they deserve.


Raleigh Capitol Ear, Nose, and Throat is the area's premiere physician-owned ENT practice with six convenient locations throughout Wake County. Our board-certified physicians have extensive experience in treating both common and complex cases to help adults and children alike. For more information or to schedule an appointment, contact us.


Cleveland Clinic. “Tongue-Tie: Management and Treatment.” Online.

Mayo Clinic   “Tongue-Tie: Symptoms and Causes.” Online.