Lip Tie in Babies: When Treatment Helps

A lip tie is the small band of tissue connecting the upper lip to the gum above the front teeth. Almost every baby has one — it is a normal part of anatomy. It only becomes a problem when it is so tight or thick that it interferes with something: nursing, the way the lip moves, or later, the spacing of the front teeth. Most lip ties need nothing at all. The question is never “is there a tie?” but “is it causing a problem?”

Signs that deserve a closer look

In babies, the signs I take seriously are trouble latching or staying latched during nursing, clicking sounds while feeding, poor weight gain, or a lip that cannot flange outward. In toddlers and older children, I watch for a large gap between the front teeth that the tie seems to be holding open, or difficulty moving the lip normally. If you are seeing any of this, it is worth an evaluation — ideally around the first dental visit, by the first birthday or when the first tooth appears.

I also get asked about tongue tie in the same breath — the band under the tongue — because the two often get discussed together. They are separate structures with separate jobs: the lip tie affects the lip, the tongue tie affects tongue movement. A baby can have one, both, or neither causing trouble. When feeding is difficult, I evaluate both, because fixing the wrong one — or only one of two real problems — leaves parents frustrated.

What treatment involves, in general terms

When a tie is genuinely causing problems, releasing it — a frenectomy — is a brief procedure that frees the lip so it can move normally. It is quick, and babies typically feed soon after. But I want to be direct with parents: a frenectomy helps only when the tie is the actual cause of the difficulty. Releasing a tie that was never the problem changes nothing and puts the baby through something unnecessary. That is why I evaluate function first — how the baby feeds and moves — not just how the tissue looks.

My approach in the office

In my office we go slowly and never force anything, even with the littlest patients. I look at the whole picture: feeding history, weight gain, how the lip and tongue move together, and what the regular checkup shows over time. Sometimes the answer is treatment; often the answer is watchful waiting, because many ties stretch and loosen as the baby grows. Either way, you leave with a clear plan. We are at 54 Warren St in Tribeca (Mon–Fri 8am–7pm, Sat–Sun 9am–4pm); call 212-561-5303.

Frequently Asked Questions

Does every lip tie need to be released?

No — most do not. I only recommend treatment when the tie is clearly interfering with feeding, movement, or dental development.

Will a lip tie cause a gap between the front teeth?

It can contribute to one, but many gaps close on their own as permanent teeth come in. I watch it over time rather than rushing to treat.

Is the procedure painful for the baby?

It is brief, and babies typically settle and feed soon after. I will walk you through exactly what to expect beforehand.

Can a lip tie affect breastfeeding?

A restrictive one can make latching harder. But feeding trouble has many causes, so I evaluate the whole picture before blaming the tie.