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Tongue tie


Tongue tie is the improper positioning of tongue tissue in the mouth, which restricts the tongue's free movement.

Alternative Names


Causes, incidence, and risk factors

Tongue tie occurs when the tissue on the underside of the front of the tongue is positioned too far forward on the tongue, making it difficult to move the tongue. This tissue is called the lingual frenulum.

If the tissue reaches the tip of the tongue, a V-shaped notch may be seen.

Tongue tie may cause feeding problems, tooth problems, and speech problems.


  • Can't stick the tongue forward
  • Difficulty feeding
  • Excessive attachment of tongue to bottom of the mouth
  • V-shaped notch in tip of tongue

Signs and tests

A doctor can diagnose this condition during a physical exam. The exam will show that the tongue tissue is attached too far forward.


Surgery is seldom necessary but if it is needed, it involves cutting the abnormally placed tissue. If the child has a mild case of tongue tie, the surgery may be done in the doctor's office. More severe cases are done in a hospital operating room. A surgical reconstruction procedure called a z-plasty closure may be required to prevent scar tissue formation.

Expectations (prognosis)

Surgery, if performed, is usually successful.


The complications are rare, but recurrence of tongue tie, tongue swelling, bleeding, infection, and damage to the ducts of the salivary glands may occur.

Calling your health care provider

If you are concerned that your child may have tongue tie, have your health care provider examine it during a routine well-baby examination.


Wyllie R. Common lesions of the oral soft tissues. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 312.

Review Date: 11/2/2009
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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