The wide-ranging symptoms, problems with lip and tongue-ties … and what to do about them

 At Innovative Dental Care, we are best positioned to provide therapy for little “tots” with TOTS. After all, our dentist, Dr. Summer, and our team are experienced and enjoy caring for children and their families throughout Omaha, Nebraska, and the greater metro area. TOTS stands for “Tethered Oral Tissues,” those conditions that include lip and tongue ties. Since we are experienced in diagnosing and caring for various pediatric and oral concerns, our team offers a variety of therapy options for resolving TOTS effectively.

It should also be noted that it is not “too late” to benefit from therapy as an older patient. Our team is also adept at diagnosing adults with TOTS. Many older patients may have unknowingly adapted to this condition. Or they don’t even realize that they have this condition. They may think that their functional challenges are due to something else entirely. Yet, tongue and lip ties may be the actual “source” of problems with speaking, eating, and other behaviors and symptoms; even TMJ-like symptoms can be rooted in longstanding problems with these issues. All patients, regardless of age, deserve to feel better and to get proper resolution of underlying conditions, not just symptom relief.

Tongue tie and lip tie explained

Known as “ankyloglossia,” tongue tie is characterized by overly short, exceedingly thick, or severely tight lingual frenulum tissues. These tissues reside at the base of the tongue and connect to the mouth or lower jaw floor. If the frenulum is not positioned correctly or of an adequate length or thickness, it can give rise to all sorts of problems. Some of these conditions may surprise you and include:

  • Problems with breastfeeding and getting proper nutrition during the child’s formative years
  • Painful swallowing
  • Food aversions
  • Difficulty with correctly or clearly pronouncing words
  • Acid reflux
  • Chronic jaw clenching, teeth grinding (bruxism)
  • Sleep-disordered breathing, sleep apnea, and airway resistance syndrome
  • TMJ-like symptoms, such as chronic tension headaches, neck pain
  • Thumb-sucking
  • Latent bed-wetting
  • ADHD-like symptoms; for instance, problems concentrating and following directions
  • Promotes misalignment and jaw abnormalities
  • Challenges to proper teeth cleaning: lingering food particles cause plaque, decay, and gum disease

Conversely, a lip tie affects the tissue that attaches the gums to the upper lip. If this maxillary labial frenulum (or lip frenulum) is too short or not correctly positioned, lip ties may also interfere with breastfeeding and cause issues such as acid reflux. Other signs of lip tie problems range from an inability for infants to gain weight, long feedings, and leaking of milk or smacking when feeding. Older children may be prone to misalignment, gum recession, and cavities.

As noted, adults, too, can have such tethered oral tissues. These problems can manifest similarly to those noted in children. Effects in adulthood may include:

  • Sleep-disordered breathing or sleep apnea
  • TMJ disorders due to adaptations such as incorrect swallowing patterns
  • Tooth misalignment
  • Problems pronouncing certain words due to limited tongue mobility
  • Poor oral health due to difficulties with keeping teeth clean
  • Increased risk and prevalence of tooth decay, gum disease, and tooth loss
  • Reduced quality of life due to avoidance of certain activities and foods; for instance, eating ice cream or popsicles can be a challenge due to restricted movement


As with all procedures, Dr. Summer will thoroughly evaluate your child’s mouth and consult with you before moving forward with recommendations. Options for TOTS therapy include:

  • Myofunctional exercises and therapies – We can advise on tailored exercises to “train” the tongue to move correctly. Depending on your child’s needs, we can also aid in altering destructive habits (such as persistent or excessive thumb-sucking) and problems with speech or language. Daily exercises can also improve airway function among pediatric and adult patients with conditions like sleep apnea.
  • Frenectomy – A process to release the frenulum. So, the tissue no longer restricts movement. We use gentle techniques and technologies to support optimal, comfortable therapy and healing.

Oral appliances can also aid in resolving related conditions and symptoms and may be incorporated into therapy plans with myofunctional exercises. Each patient is unique and requires a personalized and thorough evaluation. Call Innovative Dental Care today at (402) 933-8005 with your questions or concerns and to schedule an appointment with Dr. Summer.