About Tongue-tie

About Tongue-tie 2021-02-15T11:59:14-08:00

Definition of Tongue-tie

The many terms used to describe a lingual frenulum are due to the intermix of anatomical and functional descriptions. The interchangeable terms of ‘‘tongue-tie,’’ ‘‘ankyloglossia,’’ ‘‘sublingual frenulum,’’ and ‘‘short frenulum’’ are misleading to both lay people and professionals.

Based on current data (Haham A1, Marom R, Mangel L, Botzer E, Dollberg S. Prevalence of breastfeeding difficulties in newborns with a lingual frenulum: a prospective cohort series. Breastfeed Med. 2014;9:438-41.) we recommend the following terminology:

  1. Infants and mothers dyads who have breastfeeding difficulties not solved by a lactation consultation and judged as being due to the infant’s lingual frenulum should be clinically diagnosed as having ‘‘symptomatic tongue-tie’’ or ‘‘symptomatic ankyloglossia.’’
  2. Infants with no breastfeeding difficulties and those with breastfeeding difficulties that are corrected after a lactation consultation should be considered as having an asymptomatic ‘‘sublingual frenulum.’’
  3. The term ‘‘short frenulum’’ should be abandoned, given that clinical measurement of the length of the lingual frenulum is impossible and can be based solely on subjective assessment.

For the description of tongue-tie by the American Academy of Pediatric Dentistry click here

These definitions would differentiate between a normal anatomical finding and an abnormality in tongue function that affects breastfeeding. Given that 99.5% of infants have a sublingual frenulum and in the face of a paucity of clear indications for lingual frenotomy in the medical literature, we suggest that a lingual frenotomy should be reserved to infants with ‘‘symptomatic tongue-tie.’’

Definition of Lip Tie

Definition of lip tie: An attachment of the upper lip to the maxillary gingival (gum) tissue. (AKA superior labial frenulum, median labial frenulum, or maxillary labial frenulum)

Classification allows practitioners dealing with tongue-tie to better communicate. The most common classification is the one proposed by Coryllos et al in 2004 and published under the auspice of the American Academy of Pediatrics.

Professional Perspectives

Pediatric dentists

Larry Kotlow, a pediatric dentist and member of the IATP shares his views on tongue and lip tie (Click). 


Myofunctional therapists

Sandra Holtzman, MS, CCC-SPL.


Coming soon:

Lactation consultants


Speech and Language pathologists

Manual therapists/Body-workers