Tongue-Tie and Lip-Tie: What the Research Says
Social media has a lot to say about tongue-tie. Here’s what the evidence — and the specialists who study it — actually support.
If you’ve spent any time on parenting social media, you’ve probably seen tongue-tie come up — often paired with dramatic before-and-after videos and claims that a quick snip can fix everything from poor sleep to speech delays. So, what’s the real story?
First, what is it?
Everyone has small bands of tissue under the tongue and inside the lips, called frena (singular: frenum, also called a frenulum). In some children, the one under the tongue is short or tight — that’s what’s known as tongue-tie, or ankyloglossia. In most kids, it’s simply a normal variation that causes no problems at all.
Procedures to cut or remove a frenum — called a frenotomy or frenectomy, and sometimes referred to as a “release” — have become dramatically more common since the late 1990s. That increase has caught the attention of the American Academy of Pediatric Dentistry, which has raised concerns that many of these procedures aren’t necessary.
When a frenectomy can genuinely help
- Infants with feeding problems. If a baby has a restrictive tongue-tie and is struggling to breastfeed, a frenotomy may help — but only after a lactation consultant has evaluated the baby and other causes have been ruled out.
- Older children with a true restriction. A frenectomy may be worth considering for a specific, diagnosed speech or function problem, after an evaluation by a speech-language pathologist.
- Lip frena affecting the gums. If a lip frenum is pulling on the gums and contributing to gum recession, a frenectomy may be recommended. For a gap between the front teeth, an orthodontist may recommend one after the permanent teeth have come in and the gap is closed.
Where the evidence runs out
There are several popular reasons parents are given for pursuing a frenectomy that simply aren’t backed by good research:
- Treating or preventing sleep apnea. One small trial reported improvement, but a comprehensive 2026 review found the evidence too weak to recommend the procedure for this purpose.
- Preventing future speech problems.
- Treating “posterior tongue-tie” — a term multiple professional organizations consider poorly defined.
- Operating on “buccal ties,” which are frena inside the cheeks.
- Cutting the upper lip frenum in babies or young children to prevent a gap between the front teeth.
- Performing a frenotomy on a baby who is already feeding well.
What the professional organizations say
This isn’t just our opinion — it’s the consensus across multiple specialties:
Ear, Nose, and Throat Specialists Tongue-tie does not cause sleep apnea. Buccal tie surgery shouldn’t be performed. Cutting the upper lip frenum in young children won’t prevent a gap between the front teeth.
Pediatricians Tongue-tie is a normal anatomical variation. Babies who feed well need no treatment, and using frenotomy to prevent speech problems or sleep apnea isn’t evidence-based.
Orthodontists Frenectomy isn’t recommended for preventing or treating sleep apnea.
Pediatric Dentists The term “posterior tongue-tie” is misleading and anatomically inaccurate.
Speech-Language Pathologists The decision to perform a frenectomy is a medical one, made case by case — an SLP evaluation is recommended before frenectomy for speech concerns.
Good questions to ask before agreeing to a frenectomy
- What specific feeding, speech, or other problem is this meant to fix?
- Has a lactation consultant or speech-language pathologist evaluated my child?
- What happens if we wait?
- What are the risks? (Rare complications include bleeding and breathing problems.)
Our approach at Parkside Orthodontics
We evaluate the tongue and lip frena as part of every exam. If we notice a frenum that’s affecting a specific function, we’ll refer you to the right specialist for further evaluation. We don’t recommend frenectomies to prevent sleep apnea or speech problems, because the evidence simply doesn’t support it. We’re always happy to talk through the research with you at your child’s next visit.
This post is for general education and isn’t a substitute for a professional evaluation. Updated September 2026.
Sources
- Messner AH, et al. Clinical consensus statement: ankyloglossia in children. Otolaryngology–Head and Neck Surgery, 2020.
- Thomas J, et al. Identification and management of ankyloglossia and its effect on breastfeeding in infants. American Academy of Pediatrics, Pediatrics, 2024.
- Palomo JM, et al. Sleep-disordered breathing and orthodontics. American Association of Orthodontists white paper, 2026.
- American Academy of Pediatric Dentistry. Policy on management of the frenulum in pediatric patients, 2025.
- American Speech-Language-Hearing Association. Orofacial myofunctional disorders, ASHA Practice Portal.
- Fioravanti M, et al. Efficacy of lingual laser frenectomy in pediatric OSAS. International Journal of Environmental Research and Public Health, 2021.
- Venugopal N, et al. Is ankyloglossia correlated with pediatric sleep disordered breathing? The Laryngoscope, 2026.
- Booth L, et al. Misinformation and readability of social media content on pediatric ankyloglossia. JAMA Otolaryngology–Head & Neck Surgery, 2025.