Surgical Laser Release for Tongue Tie or Lip Tie (Frenectomy)

The tongue controls your ability to speak, swallow, and chew properly. However, tongue-tie and lip tie, or its technical term ankyloglossia, or tethered oral tissues (TOTs), is a genetic condition where the tongue or lip is restricted from full functionality. This happens when the tissue connecting the underside of the tongue or lip to the mouth is too thick or tight. If you suspect you or your child is suffering from tongue-tie, our St. Louis, MO practice can help. Drs. Mike and Jeremy Frith have experience restoring normal tongue function for children and adults at Masterpiece Smiles. If you have questions about tongue-tie or our treatment options, please contact a member of our team today.

Signs and Symptoms of Tongue-Tie

Typically, this condition can be detected early in life through a simple physical examination. While some patients with tongue-tie do not suffer from noticeable symptoms, other patients may significantly benefit from laser removal of the restrictive tissues underneath the tongue or lip.

Physical signs and symptoms of lip tie could include:

  • Gap in between two front teeth (a diastema) on the top or bottom jaw
  • Gum recession on teeth right next to frenum
  • Cavity or tooth erosion on front teeth near the gumline

Physical signs and symptoms of tongue-tie could include:

  • Difficulty lifting the tongue or moving it from side to side
  • Inability to stick the tongue out past the front teeth
  • Inability to get the whole tongue in the roof of the mouth including the back, or posterior, portion of the tongue
  • Tooth decay (especially on the back teeth on the cheek side) where the tongue is supposed to reach, remove food from the cheeks, and clean the teeth
  • Delayed speech, or difficulty pronouncing certain sounds
  • Lisp
  • Food aversions
  • Difficulty speaking quickly
  • Difficulty chewing or swallowing properly
  • Jaw, neck or back pain
  • Forward, “slumped” posture
  • Tinnitus (ear ringing)
  • Heightened gag reflex
  • Sleep issues or snoring
  • Mouth breathing
  • Migraines (especially if the head pain begins or gets more intense when trying to hold the tongue to the roof of the mouth, or while opening as wide as possible and sticking the tongue to the roof of your mouth)
  • Crooked teeth from the tongue not being able balance out the forces from the cheek and lip muscles
  • Dental crossbite or crowded teeth
  • Narrow palate in the upper jaw
  • Open-mouth chewing
  • Frequent allergies or sinus infections
  • Bed wetting
  • Scalloped tongue
  • Frequently bitten tongue or the sensation of the tongue being “too big” for the mouth

In newborns, open mouth posture, mouth breathing and sleep apnea can also be early signs of tongue-tie. Additionally, infants with difficulty breastfeeding may have tongue-tie. If you had any of these symptoms as a baby there is most likely an undiagnosed tongue tie.

Common breastfeeding complications include:

  • Shallow or difficulty latching
  • Inability to sustain a latch
  • Long breast feedings
  • Less milk is consumed during feeding, leaving the mother’s breast feeling full and uncomfortable.
  • Irritability during feeds
  • Frequent dribbles or spills
  • Difficulties breast feeding: nursing is painful for the mother, or the nipples are bleeding or cracked due to the baby’s inadequate latch
  • Gumming or chewing on the breast
  • Inability to use bottle or hold pacifier
  • Colic
  • Reflux


The good news is that tongue-tie or lip-tie can be treated by Drs. Frith and our team at Masterpiece Smiles. A single outpatient procedure and pre- and post-procedure myofunctional tongue exercises are often enough for many people to experience full recovery. However, some patients may require two procedures or more depending on the depth and restriction of the tie. Your dentist can determine which is right depending on the severity of the tongue-tie.

Myofunctional Therapy (tongue exercising)

Body "Myofunctional Therapy is extremely important in acheiving the desire result. If the exercises are not done it is possible for the tissue to reattach almost as if the procedure was never done. It is best to do start myofunctional therapy exercises prior to treatment. This helps strengthen the tongue muscle to be stronger and ready for its new freedom. This helps prevent reattachment, improves healing, and results.

Frenectomy: This simple procedure can be performed at the dental office often with topical and local anesthetic.  Your dentist uses a special surgical laser to release the extra tissue and fascia that restricts the function and movements of the lip of tongue. The laser, in addition to releasing the tissue, also helps stimulate healing and reduce bleeding; usually, stitches are not needed. Your doctor will recommend certain myofunctional exercises that can introduce enhanced tongue movement to prevent the build-up of scar tissue. Our team will offer complete recovery instructions and resources, and can refer you to a myofunctional therapist for pre and post op therapy.


Complications from tongue-tie surgery are rare, but can occur. These include excessive bleeding or infection, scarring, or damage to the tongue or permanent numbness, however Dr. Jeremy Frith has been able to reverse permanent numbness with Prolozone on himself and others.

To help prevent complications, be sure to follow all pre and post-operative care instructions from our team, and reach out with questions if excessive bleeding or other unusual symptoms occur after the procedure.

Schedule Your Consultation with Drs. Mike or Jeremy Frith

If you believe that you or your child have tongue-tie, you don’t have to live with the frustrating and restrictive symptoms. Reach out to our St. Louis, MO practice to schedule your tongue-tie consultation and learn more about our professional treatment recommendations. Restoring your ability to eat, chew, swallow and speak normally may require just one to two appointments. Don’t wait; schedule your consultation today by calling 636-394-5200.