what are the signs?HOW TO FIX ITaftercarefollow-ups

lip & tongue tie release

Dr. Tran’s most asked question must be, what is a tongue tie? A tongue is considered tied when the attachment underneath it (called the "lingual frenum" or “lingual frenulum”) is too short or inelastic. The lingual frenulum helps to hold the tongue to the floor of the mouth as it moves around. Sometimes, this attachment does not separate completely in-utero, causing the tongue to be tethered, which prevents it from having full range of motion.

The attachment under the lip (called the "labial frenum" ) most often affects the upper lip versus the lower lip. If an upper lip is tied, it may affect your baby's ability to form a proper seal while feeding.

don't worry— it's totally normal

It is normal to have a lingual frenulum, everyone has one! So you cannot diagnose it based on looks alone. Usually, this should not bother the baby, but if it is tight, they will fuss even from the most gentle pull. The biggest problem a tongue-tie can cause is with tongue function. The earliest sign of impacted tongue function is, of course, with breastfeeding.

what are the signs?

infants & babies

If your baby is tongue-tied, they may experience the following:

  • Falling asleep while attempting to nurse
  • Sliding off the breast while latching/feeding
  • Leaking/spilling milk from mouth while feeding
  • Reflux & gassiness
  • Leaking/spilling milk from mouth while feeding
  • Becoming frustrated at the breast
  • Open mouth posture
  • Disorganized tongue movement
  • Tongue thrusting
  • Upper lip curling inward
  • Chewing/gumming of the nipple
  • Colic


You might notice the following feeding and/or dental issues:

  • Difficulty swallowing certain textures of foods
  • Choking/gagging on select solid foods
  • Speech delay
  • Development of a tongue thrust
  • Mouth breathing
  • Narrow upper jaw
  • High palatal vault (roof of mouth)
  • Dental crowding
  • Retruded lower jaw
  • Teeth grinding (bruxism)
  • Early signs of cavities (caries)

ages 3 and up

A tongue-tied toddler won't "grow out of it." Instead, they learn to compensate. With compensations, the airway can be largely impacted, resulting in:

  • Sleep/breathing issues
  • Forward head posture
  • Speech articulation issues
  • Mouth breathing
  • Tongue thrust
  • Low oral tone
  • Narrow upper and lower jaw
  • High palatal vault
  • Severe early childhood caries

how to fix it correctly

Dr. Tran is able to fix an infant tongue tie by releasing the restriction using her LightScalpel CO₂ Laser. It is important that the release is done accurately to ensure a full release, which is why she has chosen this particular tool.
The amazing benefits of the LightScalpel CO₂ laser includes:

  • Minimal discomfort
  • Little to no bleeding during the procedure, providing a clear view for complete release
  • Faster healing
  • Bactericidal properties
  • Increased precision, allowing for complete removal of the tie.

Nothing is of greater priority than providing the highest quality of care to our families, so Dr. Tran took a big leap and invested in what she believes is currently the best. For the older kiddos, a different technique may be needed to get a full release. Please visit our page on functional frenuloplasty to get the scoop!


the stretches

The goal of stretching after the tongue and/or lip tie release is to prevent reattachment. YEP! You heard right. It can certainly reattach. The stretches will keep the wound open and allow the fibers to grow with length, resulting in more elasticity post-release.

how often

Wound healing is a constant process, so the stretches must start at least 4 hours after the release and continue on every 4 to 5 hours for at least 2 weeks. Read below on how Dr. Tran keeps close follow-ups to ensure proper wound care.

pain management

Dr. Tran believes this is dependent on the age of the baby, and hopes your baby can get through it without the use of medication. There are some great natural remedies out there! Please consult with Dr. Tran prior to giving your baby any medication.

aftercare resources

Dr. Tran has learned from the best! Why reinvent the wheel? These are Dr. Tran’s favorite resources and videos to refer to when it comes to aftercare:

Post-release aftercare instructions and videos by Dr. Bobby Ghaheri

Pre- and post-release mouth massages/suck training by Dr. Chelsea Pinto

Sleeping Tongue Posture Hold video by Michelle Emanuel, OTD, OTR/L


Healing happens very quickly in infants- they are new and fresh with cells that proliferate at a great speed! Dr. Tran believes it is important to follow-up frequently, because nothing is more frustrating than having to go through the procedure twice. After the procedure is completed, she expects to see the baby within the first week. Subsequent follow-ups will be dependent on what Dr. Tran observes with your baby's healing, however she does recommend coming back at:

  • 1 week
  • 2 weeks
  • 6 weeks

The other goal of these frequent follow ups is just being able to support her families. Dr. Tran is here for you and wants to make the process as easy as possible for you and your baby. Let’s be honest, no baby, mother, or family is the same. We all have different personalities and things that make us who we are, so Dr. Tran listens and does her best to figure out what can be done to make the process easy and successful for your baby.

Dr. Tracy Tran prides herself on going the extra mile. Quite literally. Experience your doctor’s care from the comfort of your home in a concierge appointment or from her accessible locations across the LA county area.
Get in touch for pricing and availability.