As with tongue ties, lip ties can cause a range of issues, and should as such be treated as serious conditions on the same scale as tongue ties. To get an overview of what a lip tie is, how it looks, and what the condition entails, we have gathered the most important aspects for you here.

What Is a Lip Tie?

Everyone has a piece of tissue that connects the gum line to the lip, what in professional circles are called the labial frenulum. This attachment can occur in different ways, these are classified into 4 categories ranging from 1 to 4. It is important to stress, that the classification does not relate to the severity of the tie, but the way it connects. A class 4 tie is not worse than a class 2 tie, it just connects differently.

For more information on lip tie classes, click here.

As everyone has lip ties, it goes without saying, that a lip tie is not an issue. The issue comes when the lip tie is so tight, it restricts the function of the frenulum.

Can a Lip Tie Affect Breastfeeding?

Optimal conditions for breastfeeding come when the baby can flange the upper lip outwards, so that the mucous membrane portion (the wet part) of the lip contacts with the breast. This allows for a better seal, which is integral for generating the needed suction for breastfeeding. When a lip tie tethers the lip down, the baby is not able to flange out the lip and get the needed latch for unrestricted breastfeeding. A tethered lip also means that the baby can open its mouth less, which will also make it harder to get a proper latch.

Often moms try to compensate for the lip tie by flanging out the lip herself. This method will not solve the problem, and quite often the baby will just readjust the lip to its preferred position. If you have to flange out the lip of your baby often during breastfeeding, it can be sign of a lip tie.

Can a Lip Tie Cause Speech Problems?

As with tongue ties, lip ties affect how the mouth can move, what we know as articulation. Voice and fluency, the other aspects of speech, are not affected by ties of any kind. What affects articulation, is the restriction of movement in the mouth from the lip tie. The lip tie can cause discomfort with opening the mouth and because of this lead to altered oral anatomy to reduce pain.

For more information on ties and their effect on speech development, click here.

Can a Lip Tie Cause Tooth Decay?

There is no direct link between lip ties and tooth decay. There is however a tendency that babies and children with lip ties also suffer from tooth decays. The reason is that some lip ties, often class 3 and 4, cover part of the teeth, offering a place for bacteria to hide. Because of the anatomy of the ties and the way it covers the teeth, it can be very hard, even impossible, to remove the bacteria.

A class 3 or 4 lip tie does not always equal tooth decay though, so if your baby or child does not suffer from any other symptoms, revising preemptively just because of tooth decay is not advisable. Try cleaning it out and if symptoms of tooth decay set in, get a revision then.

Can a Lip Tie Cause a Tooth Gap?

Whether a lip tie will cause a tooth gap is largely dependent of the type and size of the tie. Remember, that whether the frenulum is considered a tie is not based on the size or type, but on the restriction of function. As such, it is not so much the tie, but the frenulum that can cause a tooth gap. Tooth anatomy can be hard to predict, so it is very hard to know for sure if the frenulum will cause a tooth gap regardless of how to looks.

In some cases, the teeth will close the gap when come in, in other cases they won’t. In those cases where the frenulum is obviously wide, it can be preventive to perform a tie revision. This does not guarantee that there won’t be a tooth gap though.

What Causes a Lip Tie?

As with tongue ties, lip ties are present from birth. There is no research to back it up, but some studies show that tongue ties are hereditary, and as such it can be argued that lip ties might also be hereditary. There is also emerging evidence, that the MTHFR gene plays a role in the formation of the mouth and lips. The evidence is not conclusive yet, more research must be done, but it seems that the MTHFR mutation is more common for Caucasians and Asians, and less common in Amerindian and Black populations.

Does a Lip Tie Also Equal a Tongue Tie?

There is no clear evidence to determine either way. It is found that a larger part of babies with lip ties also suffer from tongue ties. It is not possible to know if this means that the two conditions are related. It can be because mothers that identify a tie is more focused on ties, and therefore also identify the other kind, or just be random, research has yet to suggest this.

If you do identify one of the conditions on your baby, it would make sense to get a check for the other condition as well, to be sure.

What Are the Symptoms of a Lip Tie?

As with tongue ties, there are several symptoms that indicates a lip tie.

Symptoms in the baby:

  • Difficulty latching
  • Make a clicking sound while latching
  • Choke or splutter on milk
  • Cluster feed
  • Have a hard time gaining weight
  • Be colicky

Symptoms in the mom:

  • Pain during latching
  • Damaged or distorted nipples
  • Mastitis or engorgement
  • Issues with low supply of milk

For information on symptoms of tongue ties, click here.

A way to test if your baby has a lip tie, is to feel the frenulum with your finger. Run the finger across the frenulum, if it feels hard or tight, it indicates a lip tie. If, based on the symptoms and the feeling of the tie, you suspect your baby of a lip tie, you should contact your local IBCLC (International Board Certified Lactation Consultant) who can the evaluate what the lip is doing on the breast.

To find the closest IBCLC to you, click here.

How to Treat a Lip Tie?

Treatment of a lip tie is basically the same as treatment of a tongue tie. As such, they are often released in the same session if the baby has both a tongue- and lip tie. To get your baby treated, you need to reach out to a local practitioner who specializes in tongue- and lip ties.

The procedure consists of a revision with laser, which takes no more than a couple of minutes, followed by 6 weeks of aftercare. Quite often, lip ties make wounds that are much easier to manage than tongue ties. As such, aftercare is easier, and reattachment is less common.

We have written several articles on tongue tie revisions, check out this one or this one for more information on the treatment process, and keep in mind that treatment of tongue- and lip ties are basically identical.

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