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What are Tongue Ties and Lip Ties and How can Speech Therapists Help?

Tongue Ties and Lip Ties

What are Tongue Ties, Lip Ties & TOTs ?


A tongue tie, also known as ankyloglossia, is a condition in which a child’s tongue is restricted from normal motion. Tongue ties occur when a strong band of tissue tethers the tongue to the floor of the mouth. Lip ties occur when an unusually strong or tight frenulum tethers the lip(s) to the gums. Tongue ties and Lip ties are often described as tethered oral tissues or TOTs. Tethered Oral Tissues, or TOT’s, can affect the way a child eats, sleeps, speaks, and swallows. If you want to read more about the basics of tongue ties and lip ties, please click here.

My Child is a Picky Eater, Could Tongue Ties or Lip Ties be the Cause?

Although your toddler may seem like they are not eating certain foods due to disobedience, this is not always the case! There are plenty of reasons as to why children may be picky eaters. A topic we get asked about a lot is the relationship between tongue ties and lip ties, and picky eating.

Why Can Tongue Ties and Lip Ties Lead to Picky Eating?


Because of the lack of range in the motion of the tongue, they may not be willing to try new foods as it can cause discomfort. The tongue must be able to move side to side AND up and down efficiently for it to manage foods safely. The inability to elevate the tongue, use the tip of the tongue, or rock the tongue causes a series of irritations. For example, as the child tries to chew, they are unable to clean the outer edges of their teeth, mouth, and lips. Lip ties can also affect feeding and contribute to picky eating behavior, especially among infants who aren’t able to create an adequate seal around a bottle or breast when nursing due to a lip tie.

Some of the signs that are often seen in patients with tongue ties and lip ties are:


  • Difficulty nursing & bottle feeding
  • Difficulty with speech articulation
  • Heart shaped tongue
  • Clicking/Smacking when bottle/breastfeeding
  • Teeth grinding
  • Strong gag reflex
  • Sleep trouble

How can Speech Pathologists & Feeding Specialists help?


We at Talk about Therapy specialize in children presenting with tongue ties, lip ties, and tethered oral tissue. If you are concerned that your child may have TOT, below are the steps we would use in assessing and therapy:


  • We conduct a formal assessment to determine the reasons behind your child’s oral discomfort.
  • In some cases, we will refer your child to a specialist to have a frenulectomy, frenotomy, or frenectomy. These are a group of closely related procedures which are used to correct the TOT(s) that are causing the restriction of movement in your child’s mouth (also known as a clip).
  • Prior to the procedure, we may begin to conduct some oral motor exercises to strengthen the muscles in the mouth.
  • After the procedure is complete, there are many steps to take for rehabilitation.
  1. We will help your child to relearn the function of the new motions in their mouth. This will be done through a series of techniques & exercises.
  2. We will target any speech and language delays that may be present.
  3. We will use therapeutic feeding techniques to expand your child’s food and texture palate.

Children presenting with TOTs can experience numerous difficulties with feeding and speech, which can be a cause of great fear and anxiety for parents and families. While interventions such as a frenulectomy, frenotomy or frenectomy performed by a trained specialist are the first step in correcting TOTs, as explained by Dr. Baxter- an eminent TOT specialist, Speech Therapists provide essential pre and post intervention care:

“Release of a restricted frenum provides a patient the opportunity for adequate lingual range of motion, but evaluation by a speech-language pathologist or oral function specialist is required to determine whether function is adequate for speech, feeding, and oral health. Many patients who present with tethered oral tissue develop compensatory strategies and poor oral habits that require treatment to ensure the improvement of oral function. Assessment and therapy by a speech-language pathologist or oral function specialist is necessary to ensure the patient receives the full benefit from the release procedure” (Baxter & Hughes 2018).


We believe finding a Speech Therapist or Feeding Specialist who is trained and specializes in Tongue Tie therapy is crucial if you have any of the above concerns. So even if you are not located in the Atlanta area, you can start by searching online for “Speech Therapy near me” or “Feeding therapy near me,” and we hope you’ll be able to use the information here to guide you in searching for and interviewing therapists.

What are Tongue Ties and Lip Ties and How can Speech Therapists Help?

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