A lip tie is a condition where the labial frenum — the small band of tissue connecting the upper lip to the gum above the front teeth — is abnormally thick, short, or low-attaching. This restricts the upper lip’s range of motion and can interfere with breastfeeding in infants, contribute to a gap between the front teeth, and affect oral hygiene and speech in older children and adults.

Signs of lip tie in infants include difficulty latching during breastfeeding, a shallow latch that causes maternal nipple pain, clicking sounds during feeding, excessive gas or colic from swallowing air, falling asleep at the breast before finishing a full feed, poor weight gain, and the upper lip appearing tucked inward rather than flanged outward during feeding. A lactation consultant or our office can evaluate the frenum directly.

A frenectomy is a minor surgical procedure that removes or releases the restrictive frenum tissue. The procedure can be performed with a scalpel, surgical scissors, electrosurgery, or laser, depending on the surgeon’s preference and the clinical situation. The goal is to release the tethering effect of the frenum so the lip can move freely through its full range of motion.

A frenectomy can be performed at any age. For breastfeeding-related lip ties, the procedure is commonly done within the first few weeks to months of life. For orthodontic-related frenectomies, the typical timing is during adolescence when orthodontic treatment is active. Adults can also undergo frenectomy at any time if the frenum is causing gingival recession, hygiene difficulties, or a persistent diastema.

Infants receive topical anesthetic before the procedure, and in very young babies the frenum has limited nerve supply. Most infants cry briefly during the procedure but can nurse immediately afterward, which provides comfort and demonstrates the improved latch. The discomfort from the procedure is comparable to a small mouth scratch and resolves quickly. Most parents report that the baby feeds better within the first day.

A lip tie involves the frenum connecting the upper lip to the gum, while a tongue tie (ankyloglossia) involves the lingual frenum connecting the underside of the tongue to the floor of the mouth. Both are tethered oral tissues that can restrict function. Many infants have both conditions simultaneously. The procedures to correct them are similar but address different anatomical structures. We evaluate both during every infant frenectomy consultation.

Yes. A thick, low-attaching labial frenum that extends between the upper central incisors physically prevents the teeth from coming together. Orthodontic treatment can close the gap, but without a frenectomy the frenum tissue may pull the teeth apart again after braces are removed. Orthodontists often coordinate with us to time the frenectomy during the active phase of treatment for the best long-term stability.

After frenectomy, the wound heals by secondary intention (from the edges inward). If the wound edges come together too quickly, the frenum can reattach in a position that partially restores the restriction. Stretching exercises involve gently lifting the upper lip to keep the wound open during the initial healing phase. For infants, this is done by the parent several times per day for two to four weeks. For older patients, the same principle applies with lip elevation exercises. These exercises are simple but essential for a successful outcome.

A lip tie can contribute to difficulty with sounds that require upper lip mobility, particularly bilabial sounds like “p,” “b,” and “m.” However, speech effects from lip ties are less common and less pronounced than those from tongue ties. If a speech-language pathologist identifies that lip mobility is contributing to an articulation issue, frenectomy may be recommended as part of a comprehensive speech therapy plan.

Both techniques achieve the same clinical result: complete release of the restrictive frenum. Laser frenectomy uses a diode or CO2 laser to vaporize the tissue, which minimizes bleeding. Surgical frenectomy with a scalpel or scissors provides tactile control and clear visualization. The choice often depends on the surgeon’s experience and the specific clinical situation. What matters most is the completeness of the release and proper post-operative stretching, regardless of the instrument used.

The frenum tissue does not technically regrow, but the wound can heal with scar tissue that recreates a partial restriction if post-operative stretching exercises are not performed consistently. This is called reattachment, and it is the most common reason for a revision frenectomy. Diligent stretching for the prescribed two to four weeks after surgery is the single most important factor in preventing reattachment.

No referral is required. Parents can call us directly at (503) 822-0096 to schedule an evaluation for their infant or child. Many of our patients are referred by lactation consultants, pediatricians, or orthodontists, but self-referral is welcome. We see patients from across the Portland metro area for lip tie assessment and frenectomy.

Frenectomy fees vary based on the complexity of the case and the patient’s age. Many dental insurance plans cover frenectomy procedures, and medical insurance may also provide coverage when the procedure is medically indicated for feeding dysfunction. We verify your benefits before the procedure and provide a clear cost estimate. Financing options through CareCredit and Cherry are available for any out-of-pocket balance. Treatment costs vary by complexity. Contact us at (503) 822-0096 for a personalized estimate with insurance benefits calculated.

Yes. A frenum that attaches near the gum margin of the upper central incisors can exert a pulling force on the marginal gingiva every time the lip is improved or moved. Over time, this chronic tension contributes to gingival recession on the labial surface of the affected teeth. Frenectomy eliminates this mechanical pull and allows the gum tissue to heal in a stable position. If recession has already occurred, a gum graft may be needed in addition to the frenectomy.

The actual surgical procedure takes approximately five to fifteen minutes. For infants, the entire visit including evaluation and procedure is typically 30 to 45 minutes. For older children and adults, the visit may take 30 to 60 minutes depending on whether sutures are placed and whether additional evaluation is needed. It is one of the quickest surgical procedures we perform.