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Important little things in your baby’s mouth

Lift the upper lip to assess for lip tie in a newborn baby. Photo by the author

By: Dr. Noorhidayah Zainal Aalam

Consider the marvels within your mouth—subtle tissues, the lingual frenum beneath the tongue and the labial frenulum connecting the gums to the inner lips. These seemingly small structures have incredible power, orchestrating the delicate movements of our oral muscles. While present in everyone, these frenums exhibit diversity in thickness and length from person to person.

Dr. Noorhidayah Zainal Aalam

However, when these structures are unusually short or tight from birth, they can impose limitations on the natural motion of the tongue and mouth, leading to a condition known as ankyloglossia or colloquially, ‘tongue tie,’ and ‘lip tie’ when referring to the labial frenulum.

Diagnosing tongue tie can be a challenge, escaping immediate detection at birth at times. Parents might observe peculiarities like a notched or heart-shaped appearance of the baby’s tongue during crying. Breastfeeding may show complications, manifesting as painful latching and challenges in achieving a deep latch during feeding sessions. For nursing mothers, this can translate into discomfort, including sore or cracked nipples and even a decrease in milk supply. Seeking guidance from certified lactation consultants becomes important in these scenarios, offering essential support and guidance to address these breastfeeding challenges effectively.

In addition to tongue tie, some infants may also contend with a lip tie, where the tissue connecting the upper lip to the gum restricts its movement, impacting the ability to create a secure seal during feeding. This limitation can result in dental issues, potentially leading to decay once the baby’s primary teeth emerge.

Unfortunately, these ties are frequently overlooked during routine check-ups for newborns by healthcare providers. As a proactive measure, it’s advisable for every child to undergo a comprehensive assessment by a dentist before their first birthday. This not only aids in early detection but also serves as an opportunity for crucial guidance on subsequent oral hygiene practices.

Children affected by tongue tie may face additional challenges too, such as difficulty articulating certain sounds like “t,” “d,” “l,” and “th.” It’s important to note that while tongue and lip ties do not cause speech delays, they can impact speech in certain ways.

Not every case of tongue or lip tie needs intervention. However, in instances where treatment is deemed necessary, healthcare providers might opt for a minor surgical procedure called a frenectomy to release the affected frenum. This procedure, when performed on newborns, is typically swift and minimally discomforting, often alleviating maternal nipple pain. For older children, the procedure may require general anaesthesia.

An array of healthcare professionals, including paediatric dental specialists, paediatricians, and experts in breastfeeding, are equipped to administer this treatment for tongue tie. For cases of lip tie, seeking evaluation and personalised consultation from a paediatric dentist is recommended. Patients can directly contact these professionals for assessment or inquire about referrals through their existing healthcare providers.

This proactive step not only empowers parents with valuable insights into their child’s oral well-being but also points to the significance of early intervention in addressing potential concerns like tongue and lip ties. Through this collective effort, we strive to champion a culture where every

child’s oral health is nurtured and safeguarded, ensuring they embark on a journey of a lifetime of healthy smiles.

The author is a Dental Lecturer and Clinical Specialist in Paediatric Dentistry at the Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya. She may be reached at

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