Emily Maeve Milord is a licensed social worker and wellness freelance writer. She graduated with a Master of Social Work (MSW) degree in 2020 from Aurora University, where she specialized in both health care and gerontology. Emily has clinical experience working with older adults and adults with disabilities in hospital, nursing home, and social service agency settings. Emily also has a background in psychology, receiving her B.A. in psychology from North Central College in 2018.
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Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.
In a person’s mouth, the upper lip is attached to the gums by connective tissue. In some people, however, this tissue can be too tight and short, restricting the lip’s ability to move normally.
When this happens, it is called a lip tie. Lip ties can cause issues for breastfeeding babies and can lead to dental problems in young children. Read on to learn about what exactly a lip tie is.
Table of Contents
- What Is a Lip Tie?
- Types of Lip Ties
- How Are Lip Ties Diagnosed?
- Lip Tie Complications
- Lip Tie vs. Labial Frenulum vs. Tongue Tie
- How Does a Lip Tie Affect Kids?
- How Is a Lip Tie Treated?
- How Does a Lip Tie Affect Breastfeeding?
- When to See a Doctor?
- Key Takeaways
What Is a Lip Tie?
We all have a piece of tissue that lies behind our upper lip. This tissue is called the frenulum (or maxillary labial frenulum). This frenulum helps our lips move freely. Sometimes this tissue is too thick, short, or tight, and when this is the case, it is called a lip tie. A lip tie can make it difficult for a baby to breastfeed, which may result in the baby having trouble gaining weight.
Lip tie symptoms in infants
- The main symptom of a lip tie is difficulty with breastfeeding
- Slow weight gain in babies
- Taking a long time to feed
- A baby who wants to nurse frequently
- Smacking or clicking noises during feeding
- Breast milk leaking from the mouth during feeding
- Reflux from swallowing excess air
Lip tie symptoms in children and adults
- Difficulty with brushing teeth
- Misaligned teeth
- A space between the front teeth
- Receding gums
- Difficulty with speech
Types of Lip Ties
There are four different classes of lip ties, Class 1 being the mildest and Class 4 being the most severe. The classes of lip ties depend on where the frenulum is attached.
- Class 1: Mucosal— The mucosal is when the tissue is attached at the top of your gums, called the mucogingival junction. There is minimal visible attachment.
- Class 2: Gingival— This type occurs when tissue is attached farther down in the gums.
- Class 3: Papillary – A papillary lip frenulum is when the tissue is attached at the gums between your front teeth.
- Class 4: Papilla penetrating— This is where the tissue crosses over the bone and extends backward into the palate.
How Are Lip Ties Diagnosed?
Lip ties are typically diagnosed through physicals. They are sometimes diagnosed by dentists. A physical exam with a doctor will examine your infant’s mouth to check for lip movement and any unusual attachments of tissue. If your baby is having difficulty with breastfeeding, a doctor may observe to see if the baby is having trouble with their latch.
Lip Tie Complications
Lip ties may not always cause problems, but occasionally they can lead to complications, especially in infants. However, babies that have trouble with breastfeeding may experience malnourishment or dehydration. You may need to switch to bottle-feeding with breast milk or formula if they are having trouble.
Lip ties can also give rise to dental issues in children. This is because having a lip tie can cause food to become trapped in the teeth due to the upper lip. Bacterial buildup in this area can also cause the gums to recede.
Lip ties can also cause breastfeeding issues: The mother may experience soreness, cracks, or itching in the nipple area. The breastfeeding woman may also experience pain during or after nursing.
Lip Tie vs. Labial Frenulum vs. Tongue Tie
Understanding the difference between a lip tie, a labial frenulum, and a tongue tie can be confusing if you’re unfamiliar with mouth anatomy, so let’s break it down.
- Labial frenulum – the piece of connective tissue that attaches your upper lip to your gums
- Lip tie – when your lip frenulum is too short or tight and restricts movement
- Tongue tie – A condition that restricts tongue movement. It refers to when the band of tissue that attaches your tongue to the floor of your mouth is short and rigid.
How Does a Lip Tie Affect Kids?
Some medical professionals have argued that a lip tie can put children at greater risk for cavities because bacteria can build up in the area behind the upper lip because of the lip tie. In general, however, a lip tie is not a cause for concern in kids.
How Is a Lip Tie Treated?
A lip tie does not always require medical treatment. If a baby has trouble with breastfeeding, it’s best to contact a lactation consultant who specializes in breastfeeding.
Another treatment for lip ties is lip tie revisions. Lip tie revisions involve a doctor loosening the labial frenulum by cutting it with a laser, scalpel, or scissors with local anesthesia.
How Does a Lip Tie Affect Breastfeeding?
A lip tie can affect breastfeeding because the baby may have trouble latching on to the nipple during feedings. This may result in more feeding sessions being necessary, an underweight or dehydrated infant, and sore and irritated breasts in the mother.
When to See a Doctor?
You should see a doctor if your infant is having trouble breastfeeding or trouble eating from a spoon. It is vital to ensure that your baby grows normally and has an appropriate weight for optimal development. You may want to see a dentist if your own lip tie or your child’s lip tie is causing dental issues, such as cavities or gum recession.
Lip ties are diagnosed when there is a short or tight lip frenulum, which is the tissue that connects your upper lip to your gums.
Lip ties can cause various issues, such as trouble breastfeeding, fatigue in the mother, and slow weight gain in infants. Some medical professionals believe lip tie can lead to dental problems in childhood.
Most of the time, babies can adjust to having a lip tie; seeing a lactation consultant or pediatrician can help parents determine possible solutions and treatments. Occasionally, when lip tie is more severe, a doctor can do a lip revision, which involves making an incision in the lip frenulum to loosen the upper lip.
A lip tie is not always a cause for concern, unless it interferes with breastfeeding. If you are concerned that your child or infant has a lip tie or has trouble breastfeeding, it is time to reach out to a doctor.
- Baxter, R. T., Zaghi, S., & Lashley, A. P. (2022). Safety and efficacy of maxillary labial frenectomy in children: A retrospective comparative cohort study. International orthodontics, 20(2), 100630. https://doi.org/10.1016/j.ortho.2022.100630
- Mohan R., Soni P.K., Krishna M.K., Gundappa M. (2014). Proposed classification of medial maxillary labial frenum based on morphology. Dental Hypotheses, 5(1), 16-20. http://www.dentalhypotheses.com/text.asp?2014/5/1/16/128108
- Nakhash, R., Wasserteil, N., Mimouni, F. B., Kasirer, Y. M., Hammerman, C., & Bin-Nun, A. (2019). Upper lip tie and breastfeeding: A systematic review. Breastfeeding Medicine: the official journal of the Academy of Breastfeeding Medicine, 14(2), 83–87. https://doi.org/10.1089/bfm.2018.0174
- Potock, M. (2015, March 10). Just flip the lip! The upper lip-tie and feeding challenges.
- Shah, S., Allen, P., Walker, R., Rosen-Carole, C., & McKenna Benoit, M. K. (2021). Upper Lip tie: Anatomy, effect on breastfeeding, and correlation with Ankyloglossia. The Laryngoscope, 131(5), E1701–E1706. https://doi.org/10.1002/lary.29140
- Tongue-tie (ankyloglossia). Johns Hopkins Medicine. (2022, April 12). Retrieved July 12, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/tongue-tie-ankyloglossia
- Townsend, J. A., Brannon, R. B., Cheramie, T., & Hagan, J. (2013). Prevalence and variations of the median maxillary labial frenum in children, adolescents, and adults in a diverse population. General Dentistry, 61(2), 57–61. https://pubmed.ncbi.nlm.nih.gov/23454324/
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