If you’re here, chances are someone has mentioned the words “tongue tie” to you — maybe a dentist, a lactation consultant, your pediatrician, or a friend in a parenting group — and now you’re not sure what to do with that information. Is it a big deal? Does your child actually have one? And if they do, does it need to be treated?
You’re not alone in feeling a little lost here. Tongue tie gets talked about a lot, but it’s rarely explained well. So let’s slow down and walk through what actually matters.
It’s Not Just About How the Tongue Looks
One of the biggest points of confusion is that a tongue tie isn’t really about appearance — it’s about function. A piece of tissue under the tongue (called the lingual frenulum) can look tight to one provider and totally fine to another, because looking at it only tells part of the story. What really matters is what the tongue can do: Can it lift easily? Can it move side to side? Can it rest comfortably against the roof of the mouth?
A tongue can look pretty flexible and still not be functioning the way it needs to. And a tongue tie that looks more restrictive on the surface doesn’t automatically mean it’s causing problems. This is exactly why “just looking” isn’t enough — and why so many parents get conflicting opinions from different providers.
Everyday Signs Worth Paying Attention To
You don’t need special training to notice when something seems off. A lot of parents pick up on small things long before anyone uses the words “tongue tie.” Here are some of the more common signs that are worth mentioning at your child’s next appointment:
- Feeding challenges as an infant — trouble latching, long or exhausting nursing sessions, clicking sounds while feeding, or reflux-like symptoms
- Picky eating or texture struggles — especially avoiding certain textures well past the age most kids move past that stage
- Messy eating — food or liquid frequently escaping the mouth, or a lot of chewing with the mouth open
- Mouth breathing — especially if it happens during the day, not just at night
- Snoring or restless sleep — tossing and turning, sleeping with the mouth open, or waking up tired despite a full night’s sleep
- Speech sound difficulties — particularly with sounds that require more precise tongue movement (like “r,” “l,” “s,” or “th”)
- Trouble with straws or blowing bubbles — activities that require good tongue coordination and control
None of these on their own means your child definitely has a tongue tie that needs treatment. But if a few of these sound familiar, it’s a good reason to get a proper evaluation rather than guess.
Why Different Providers Might Tell You Different Things
This is one of the most frustrating parts for parents, so it’s worth explaining clearly. Your pediatrician, your dentist, and a myofunctional therapist are all looking at different pieces of the puzzle:
- A pediatrician is typically screening for medical concerns and overall development. Tongue function isn’t usually their primary focus, so a tongue tie can sometimes get overlooked in a general checkup.
- A dentist may notice a tongue tie during an oral exam and flag it, particularly if it seems to be affecting things like dental alignment, palate shape, or hygiene.
- A myofunctional therapist looks specifically at how the tongue and surrounding muscles are functioning — how they work together for breathing, swallowing, chewing, and speech — and whether that function is contributing to the symptoms you’re seeing.
None of these perspectives are wrong. They’re just different lenses. If you’ve gotten mixed messages, it’s usually not because someone made a mistake — it’s because each provider is trained to look at a different part of the picture.
What a Myofunctional Evaluation Actually Involves
If you’re considering an evaluation, it can help to know what to expect so it feels less intimidating.
A myofunctional evaluation typically starts with a conversation about your child’s history — feeding as an infant, sleep habits, breathing patterns, speech development, and even things that might seem unrelated, like frequent colds or digestive issues. These details actually matter, because oral function connects to a lot of systems in the body.
From there, the evaluation looks closely at how your child’s tongue, lips, and jaw are working together — things like tongue posture at rest, how they swallow, and how well the tongue moves and coordinates with everything around it.
Based on what’s found, you’ll get a clear recommendation for next steps. Sometimes that means starting myofunctional therapy. Sometimes it means a referral to another provider first, like an ENT or a dentist trained in tongue tie release. And sometimes it means working with more than one provider at the same time, since a tongue tie release alone doesn’t always fix the muscle patterns that developed around it — that’s often where myofunctional therapy comes in.
You Don’t Have to Figure This Out Alone
If your gut is telling you something isn’t quite right, that instinct is worth listening to. You don’t need to have all the answers before reaching out — that’s exactly what an evaluation is for.
If you’d like to talk through what you’re noticing and find out whether an evaluation makes sense for your child, [reach out to schedule a consultation]. We’re happy to help you sort through what you’re seeing and figure out the right next step together.
