Lip & Tongue Ties

Being tongue tied isn’t just a figure of speech - it’s a real medical condition that can affect newborn babies and cause problems throughout a person’s life.

Dr. Nagel is Tethered Oral Tissues Specialty Training certified, which means that she has the knowledge and experience to identify and address any problems occurring with what is frequently referred to as being “tongue-tied”. Tethered oral tissue of the tongue affects how people speak, as well as how they eat. There are different types of oral tissues that can be the cause of tethered oral tissue, and it take a specially trained staff to be able to observe an issue like this, as well as be able to rectify it.

With our training we are able to:

  • Present research to patients that will help dispel any myths revolving tethered oral tissues, as well as define the various different tissues that can be tethered
  • Help patients and their families understand how to identify and treat tethered oral tissue and also present them with educational resources
  • Effectively locate and devise a plan for treatment of tethered oral tissue

With this training, you can rest assured that we will be using the best and most modern techniques to bring your little ones the care they deserve.


Nursing can be enjoyable! But the most common symptom of a lip or tongue tie in newborns is difficulty breastfeeding.

Baby may have a weak latch, excessive gas or reflux, demand frequent feedings, poor weight gain, and excessive fussiness.

Mothers will often experience pain, infections such as thrush or mastitis, cracked/bleeding nipples, and compromised supply.

Toddlers and Children

As we grow, being able to properly move the lips and tongue is critical.

Toddlers will exhibit poor feeding behaviours, such as gagging, packing, expelling, vomiting, reflux and not eating age-appropriate foods.

Speech is often delayed and certain sounds are difficult to produce when the tissues cannot move freely, leaving you with a frustrated child unable to communicate.

Tongue and lip movement also contribute to how the face grows and airways develop. Children with lip and tongue ties have increased risk of allergies, tooth-grinding (sleep bruxism), mouth breathing, crowded teeth, sleep apnea, and will often need corrective braces or orthodontics in the future.

Also, if the lip is tied, it can be very difficult to get a toothbrush around the front teeth, increasing the risk for food packing which is sure to cause cavities.


Children who grow into adults without having their lip and/or tongue tie released will continue to experience these symptoms, which are much more difficult to correct once fully grown. However, releasing the tissues will still help significantly improve disordered breathing, improve orthodontic outcomes, and reduce the risk of cavities and gum disease.

Lip Tie

Tongue Tie

Frequently Asked Questions

When should a lip or tongue tie be released?

The earlier the better! Performing a release is much easier on infants because the tissues have less nerve endings and blood vessels, making the procedure virtually painless. Once the teeth begin to erupt, it’s much more difficult to release the tissues, meaning we may have to wait until the child is old enough to cooperate.

How can the team at Horizon Dental help?

Dr. Nagel is certified in TOTS – Tethered Oral Tissues Specialty training, which means that she has the knowledge and experience to identify and address the problems caused by lip and tongue ties. She is also trained to use a soft tissue laser to perform the release procedure, making it a very quick and easy experience for your child. Benefits of using a laser include: reduced post-operative pain and swelling, reduced bleeding, no need for stitches, and little to no anaesthetic injections.

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