Lip & Tongue Tie 101: Everything You Need to Know

Lip and tongue ties are a common topic of conversation for new parents. It is a relatively new subject matter as it was a commonly missed diagnosis during infancy. Now both pediatricians and pediatric dentists are educating lactation consultants and parents about lip and tongue ties in hopes to alleviate many of the disruptions that occur during the early stages and prevent future concerns.

Lip & Tongue Ties: What Are They?

The band of tissue behind your upper lip and under you tongue is clinically called a frenum. When these membranes have developed unusually short, thick, or tight, the bands of tissues tend to tether the tongue down to the floor of the mouth restricting movement and mobility of both lip and/or tongue to move comfortably and freely. As a result, the tie oftentimes interferes with breastfeeding, chewing, speech, oral hygiene, and other activities such as licking your favorite ice cream cone, licking the lips, kissing, or even playing an instrument.

Why is it Important to Treat a Lip or Tongue Tie?

Proper oral development and/or infant breastfeeding helps to expand the size of the palate, open the airway, oxygenate the blood, support brain growth, and helps to prevent future disorders like Obstructive Sleep Apnea. Tethered oral tissues have a huge affect on oral development in infants and children, which can lead breathing and airway concerns.

How To Recognize the Symptoms of Lip & Tongue Ties

A tongue-tie is a condition where an abnormally short, thick, or tight band of tissue binds the bottom of the tongue to the floor of the mouth. A lip tie is when the length and width of the band of tissue extends between the upper lip and gums above the upper front teeth.

Both lip and tongue ties are congenital circumstances, which means children are born with them. They limit the movement of the lips and/or restrain the tongue which impacts most oral functions, like speaking, feeding, swallowing and most crucial, breathing.

Some mothers may come to suspect a lip or tongue tie during their infant’s breastfeeding sessions. This is because tongue-tied babies are unable to draw the nipple as deeply into the mouth to receive adequate milk.

Some babies with tongue or lip ties may only be able to nurse just enough to grow in their first few weeks but are not able to maintain enough nourishment to continue growing. These same children may have difficulty managing solid foods when they are older.

Baby Signs & Symptoms

Weak latch, or clicking sounds while nursing
Gumming or chewing or choking while nursing
Swallowing air (aerophagia)
Reflux or colic
Fatigue during eating
Projectile spitting up during or after eating
Struggle to gain weight; maintain weight, or weight loss
Gagging, popping off the breast to gasp for air
Lip blisters and callouses
Gassiness (babies with ties often swallow a lot of air)
Inability to hold a pacifier
Milk consumption, dribbling from sides of mouth (excessive drooling)
Heart-shaped tongue

Signs & Symptoms for a mother of an Infant with Lip or Tongue Tie

Cracked, blistered, bleeding nipples
Plugged ducts
Continual discomfort or pain during nursing
Compromised milk supply
Long nursing sessions (or extremely short because baby gets tired)
Postpartum depression

Child & Adolescent Signs & Symptoms

Impeded tongue movement
Speech interference
Difficulty swallowing
Improper chewing/digestive issues
Gum Recession
Inability to clean teeth with tongue swipe
Sleep and breathing problems
Behavior and attention issues
Nighttime walking
Nighttime tooth grinding
Spacing or gaps between front teeth

Lip And Tongue Tie Evaluation

Is your child having trouble with the movement of their lips or tongue?

At Smiles 4 Keeps we recommend having your child assessed for a lip or tongue tie during the early phases of infancy to determine if there are any foreseen oral tissues and that everything is developing correctly. During this assessment, we will safeguard that the length and thickness of the lip and tongue tissues are appropriate and check for any signs or symptoms that your child may be experiencing.

During these evaluations, our goal is to diagnose a tie as early as possible to prevent any developmental constraints. One of our Smiles 4 Keeps, specially trained providers will observe the length of the tie and its point of attachment to surrounding tissues. We will also consider any other symptoms that the child may be experiencing to help us achieve resolution.

As far as physical signs, it is not uncommon for there to be a visible large space between the upper front teeth or for the tongue to have a heart shape at the tip with a cupped appearance

Lip And Tongue Tie Treatment

If your child is be subjected to a severe enough tie that negatively impacts their oral function or development, our maxillofacial surgery department can perform a simple procedure called a frenectomy to minimize the tie and restore proper function. From there, our team will continue to monitor your child’s oral development to ensure they are brought up with proper oral hygiene instruction

What to Expect: Frenectomy

The frenum tissue is very thin and easily treated with a laser or a traditional surgical approach. The tissue is number, then using our suggested surgical tools, is released by cutting and sealing. There is very minimal trauma to the tissue and sutures are not usually needed. There is little to no discomfort during the procedure and an expedited recovery.

We do not recommend a “wait and see” approach when it comes to lip and tongue ties due to the range of potential developmental difficulties. The treatment for these conditions is quick, simple, and virtually devoid of complications. Therefore, if you suspect one of these conditional conditions, please do not hesitate to schedule an appointment with one of our providers.

Call to schedule your infant or child’s lip and/or tongue tie evaluation with one of our Smiles 4 Keeps providers today!

Need to Schedule a Pediatric Dental Appointment?

If your child is ready for his or her first pediatric dental visit, call Smiles 4 Keeps. Our friendly pediatric dentists provide gentle kid’s dentistry using a variety of dental services.

We have three convenient office locations in Northeast Pennsylvania catering to many areas. Here is the contact information, office hours, and business addresses for each of our office locations:

Bartonsville: 3361 Route 611, Bartonsville, PA 18321 – Phone: 570-629-1142;
Hours: Mon & Fri 9:00 am – 5:00 pm
Scranton: 313 Mulberry St., Scranton, PA 18503 – Phone: 570-346-7760;
Hours: Mon, Tues, Wed 9:00 am – 5:00 pm | Thurs – Fri: 8:00 am – 4:00 pm
Wilkes-Barre: 900 Schechter Dr, Wilkes-Barre, PA 18702 – Phone: 570-822-4181;
Hours: Mon- Fri 9:00 am – 5:00 pm

Painful Tooth Eruption: What to do If Your Child’s New Tooth Hurts

Baby teeth are also called primary teeth or deciduous teeth. The process when a child’s baby tooth goes through the gums and becomes visible above the gum line is called tooth eruption.

This process occurs when the child is just a little baby, and it continues through childhood and the teenage years. Each one of us will have two sets of teeth in life: baby teeth and permanent teeth.

A Few Facts About Tooth Eruption in Babies and Kids

  • Typically, girls will experience tooth eruption earlier in life than boys. Every child is different, though.
  • Baby teeth are smaller in size and whiter than the permanent (adult) teeth.
  • By the time a child is 2 to 3 years old, all of the primary teeth should have erupted. Later on in this blog post, we provide 2 lists depicting the approximate ages when baby teeth should erupt, and the approximate ages when adult teeth should erupt.

Signs and Symptoms Associated With the Eruption of Baby Teeth

When your baby starts the phase of tooth eruption, there will be certain signs and symptoms that you’ll notice. The signs and symptoms include:

  • loss of appetite
  • increased saliva production in the mouth (may lead to increased drooling)
  • baby will place objects or fingers in the mouth
  • baby will bite on objects or fingers
  • irritation of the mouth
  • inflamed gums
  • tender gums
  • difficulty eating and chewing
  • minor bleeding when the tooth finally erupts through the gums
  • crankiness or agitation in general
  • interrupted sleep patterns or naptimes
  • redness on the cheek where the tooth is erupting

Those are the typical symptoms and signs associated with baby teeth eruption. If you notice your baby running a fever, vomiting, or having diarrhea, call your doctor as soon as possible. Also, if your child develops an earache or has signs of pain, he or she should be evaluated by your doctor to rule out infection.

When To Expect Baby Teeth to Erupt

We get asked this question quite often: When will my baby’s teeth start to come in? The following list will give you that answer! This list shows when your child’s primary teeth should erupt through the gums. Keep in mind, though, that eruption time differs from child to child.

  • upper and lower central incisors: 6 to 12 months of age (sometimes the upper central incisors erupt after the lowers)
  • upper and lower lateral incisors: 7 to 16 months of age
  • upper and lower cuspids (the canine teeth): 16 to 23 months of age
  • upper and lower first molars: 13 to 19 months of age
  • upper and lower second molars: 20 to 33 months of age

A baby will typically get all of his or her teeth by their third birthday.

As a parent or caregiver, you should notice that your baby is in the teething phase when he or she is approximately 6 months old.

Any time after the child’s third birthday, he or she will start losing their baby teeth, in which case the adult teeth will then begin to erupt.

When to Expect Adult Teeth to Erupt for Kids

Kid’s permanent, adult teeth will begin to erupt around the age of 6. The following list details when adult teeth will erupt for most kids. Just like baby teeth, the eruption time varies from child to child.

  • upper and lower central incisors: 6 to 8 years old
  • upper and lower lateral incisors: 7 to 9 years old
  • upper and lower cuspids (canine teeth): 9 to 12 years old (sometimes it takes longer for the upper cuspids to come in)
  • upper and lower first bicuspids (premolars): 10 to 12 years old
  • upper and lower second biscuspids (premolars): 10 to 12 years old
  • upper and lower first molars: 6 to 7 years old
  • upper and lower second molars: 11 to 13 years old
  • upper and lower third molars (wisdom teeth): 17 to 21 years old

How to Relieve Tooth Eruption Pain

young girl patient with tooth eruption
young girl patient at Smiles 4 Keeps

It is heartbreaking to see your child in pain, regardless of whether the pain is low, mild, or intense. Tooth eruption pain occurs when the new tooth is close in proximity to the gum line and begins to cut through the gum. A child can continue to feel discomfort or pain until the tooth is in the final position in the mouth.

How do you relieve pain associated with erupting teeth?

Here are a few ways:

  • Clean your finger and massage the gum in the area where the tooth will be erupting. This will help to ease the discomfort.
  • Buy and use an anesthetic cream. Orajel™ can be bought in most pharmacies. A topical analgesic, like benzocaine, can also be used.
  • Wet a clean cloth with cold water and let the baby suck and/or chew on it. Do this under adult supervision.
  • Use over-the-counter pain medications (acetaminophen or ibuprofen) formulated for kids. Follow the dosage instructions on the package. Do not use aspirin since kids cannot have it. Before giving any medication to your child, consult with his or her pediatrician or dentist.
  • Buy a teether for your child to bite on. They come in various shapes and sizes, including teething biscuits, rubber-like rings, and cool rings for teething. Do not buy one that is too small so your child does not choke. It is also a good idea to avoid using a teether filled with liquid; sometimes they can leak. Lastly, do not tie a teether around his or her neck since this poses as a strangulation hazard.
  • If your baby is constantly drooling, be sure to wipe the drool away frequently. The longer the drool stays on your baby’s face, the higher the chance he or she will develop a skin rash.

Things You Should NOT Do During the Tooth Eruption Phase

There are a few things you and your child should avoid doing during the tooth eruption phase.

Do NOT be aggressive when caring for the child’s teeth and gums.

Always be gentle when brushing and flossing your child’s teeth. Teach him or her to be gentle, as well.

After your child loses a tooth, a small wound may be apparent. During this stage, do not give your child a harsh rinse that contains alcohol or peroxide. Doing so may increase pain, harm the gums, and/or delay healing.

Also be sure to avoid giving aspirin to kids. Never apply aspirin directly to the gums. It can burn the tissue.

Do NOT prematurely pull the loose tooth or wiggle it aggressively.

You can typically encourage your young son or daughter to push gently on the loose tooth by using his or her tongue or clean finger. The key word here is “gently.”

Do not use this type of encouragement if the tooth isn’t very loose. You do not want to wiggle or pull the tooth out before it is ready. Doing so can cause unnecessary discomfort and pain for your child.

Wiggling or pulling the tooth out prematurely can also run the risk of leaving a tooth fragment behind, which can lead to infection.

If your child has an accident and knocks the tooth out early on, or if the accident promotes a tooth extraction, only a pediatric dentist should make this decision.

Do NOT avoid visiting the pediatric dentist on a regular basis.

As mentioned in previous sections, seek the advice and care from your pediatric dentist if you have any questions or before giving medications to your child.

It is always best to keep regularly scheduled appointments with the dentist. This allows the dentist to keep an eye on any changes and to keep track of tooth growth. The appointments also allow you the opportunity to ask questions face to face.

If your child has not lost any teeth by the time he or she is 8 years old, for instance, this is a good reason to schedule a dentist visit as soon as possible. Late tooth development can occur in some kids, and it should be monitored by a pediatric dentist.

If you notice that adult teeth are erupting behind the baby teeth, schedule an appointment with the dentist. He or she may think it is best to extract the baby tooth, if necessary, or provide suggestions on what to do next.

As always, if you have any questions at all, please call our pediatric dentists.

How to Care for Newly Erupted Teeth

What happens when the tooth erupts and you can see it above the gum line? What is the proper way to take care of newly erupted teeth?

Keep taking care of your teeth. Do not stop brushing and flossing. Just brush lightly in the area where the newly erupted tooth is.

You should also keep taking your child to the pediatric dentist as recommended (once every 6 months unless otherwise recommended).

Need to Schedule a Pediatric Dental Appointment?

If your child is ready for his or her first pediatric dental visit, call Smiles 4 Keeps. Our friendly pediatric dentists provide gentle kid’s dentistry using a variety of dental services.

We have three convenient office locations in Northeast Pennsylvania catering to many areas. Here is the contact information, office hours, and business addresses for each of our office locations:

  • Bartonsville: 3361 Route 611, Bartonsville, PA 18321 – Phone: 570-629-1142;
    Hours: Mon & Fri 9:00 am – 5:00 pm
  • Scranton: 313 Mulberry St., Scranton, PA 18503 – Phone: 570-346-7760;
    Hours: Mon, Tues, Wed 9:00 am – 5:00 pm | Thurs – Fri: 8:00 am – 4:00 pm
  • Wilkes-Barre: 900 Schechter Dr, Wilkes-Barre, PA 18702 – Phone: 570-822-4181;
    Hours: Mon- Fri 9:00 am – 5:00 pm

A Few of the Best Sugar Substitutes for Your Child’s Teeth

Kids seriously love sugar. From cereals to candies, sugary beverages, and more — kids are bombarded with sweetness. And it’s easy for them to get addicted. But as you may know, sugar is definitely not good for your child’s teeth.

In fact, according to research published in the journal BMC Public Health, sugars are the only cause of tooth decay in kids and adults.

But guess what? You can help protect and save your kid’s mouth. Of course you want to teach them good oral hygiene, but you also want to be mindful about what they eat.

Read more

How to Protect Your Child from Cavities

Maybe your kids love candy a little bit too much, or they don’t take care of their teeth regularly, despite your best efforts. Cavities can be annoying, painful, and embarrassing for kids; not to mention how expensive they can be for you to fix. But there are things you, as parents, can do to protect your child from ever getting cavities in the first place.

Of course, you want to teach and encourage your child to brush and floss daily. However, even if your child takes care of his or her teeth and sees a dentist regularly, this won’t make them completely resistant to getting cavities.

You might think cavities are just something kids have to go through. After all, you had one or several cavities when you were younger. But this is not true. Children do not have to get cavities.

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How to Get Your Kids Excited About Their Dental Care


baby holding toothbrush
If you found this article, you’re probably researching different ways to get your child to enjoy the dentist office (or at least not put up a big fuss). Parents and caregivers don’t want their child to throw a tantrum every time a dental check-up is needed. That is also not a good way to start their foundation of a lifetime of healthy smiles.

In this article we will give you several ways to get your kids excited about their dental care. Regardless of whether they hate visiting the dentist or if you have a hard time getting them to brush their teeth, you can benefit from further reading.

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Are Dental X-Rays Safe for Children?

The X-ray has been vilified in the media, and while sensationalism is at an all-time high, there are legitimate concerns over the safety of some types of x-rays. When you hear mentions of “unsafe” or “extremely dangerous” x-rays, this is typically referring to older, outdated methods of using x-rays on patients.

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I’ve Heard about Space Maintainers? Are They Ok for My Child?

Things happen. Especially with children, things happen—scrapes, bruises, and of course, baby teeth falling out prematurely. Though the two former issues seem more immediate, baby teeth falling out are definitely an issue that needs to be dealt with as soon as possible.

The reason behind this is spacing. If the space between the remaining teeth goes on, untreated, then permanent teeth may come in at the wrong place or angle. Though this may seem like just a future cosmetic problem, incorrectly placed permanent teeth may cause poor periodontal health, pain, and discomfort.

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Young girl with dental hygienist at Smiles 4 Keeps

What to do if Your Child Has a Dental Emergency

Parents need to be prepared for anything, including dental emergencies. Knowing ahead of time what to do when your child has a knocked out tooth, an excruciating toothache, or any other dental problem will make it much easier to deal with the issue.

If an emergency is life-threatening, parents should call 9-1-1 and get to a hospital immediately. However, many situations can be taken care of at the child’s dentist’s office. Here are some common dental emergencies parents may face, as well as how to handle them.

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Group of kids smiling at Smiles 4 Keeps

Dental Sealants: Maximum Protection for Your Child’s Teeth


Brushing, flossing, and regular dental appointments will certainly go a long way toward protecting your child’s teeth from decay, but these habits won’t make them completely resistant to cavities. Dental sealants, however, can provide the maximum protection for your child’s teeth. They are a preventative treatment that can save your child’s teeth from painful, expensive decay.

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