Your Child May Not Need a Release

By Sheyda Maghsoudi, DDS

Surgery Should Solve a Specific Problem, Not a Hunch

Here’s How To Tell the Difference

If you’ve spent time in parenting groups, you’ve likely heard about tongue-tie. Some parents are told their baby needs a quick procedure; others read that tongue-tie is overdiagnosed. Both can be true. The real question isn’t whether a tongue looks tied. It’s whether it’s causing a problem.

What Is Tongue-Tie?

Everyone has a small band of tissue under the tongue called the lingual frenulum. In some children it’s short, tight or thick enough to limit how the tongue moves. That’s tongue-tie, or ankyloglossia. But how the frenulum looks matters far less than how the tongue works. Many babies with a visible frenulum feed, speak and grow perfectly well.

A visible frenulum alone doesn’t mean treatment is needed.

When a Release May Help

A frenectomy releases the tight tissue, often in minutes with a laser. It’s worth considering when the frenulum is clearly linked to symptoms:

Infants: trouble latching, clicking while feeding, poor weight gain, long feeds, or nipple pain for the nursing parent

Older children: difficulty with certain speech sounds or moving food around the mouth, or a tongue that can’t lift or extend past the lips

Why “Overdiagnosis” Is In the News

In 2024, the American Academy of Pediatrics reported that tongue-tie diagnoses rose almost tenfold between 1997 and 2012, and noted that most breastfeeding difficulties, including pain, are not caused by tongue-tie. Positioning, milk supply, reflux, or a baby who needs a few more weeks to coordinate are common culprits, and a release won’t fix those. As a pediatric dentist who performs laser frenectomies, I often tell parents that not treating is the right answer.

What a Good Evaluation Looks Like

A thorough assessment looks at function, not just appearance. A 2026 evidence-based guideline in Pediatric Dentistry recommends exactly that, with decisions shared between parents and a team of providers. Before any procedure, ask:

What specific problem will this solve?
Have other causes been ruled out?
Who will support us before and after?
What aftercare and results should we expect?

The Bottom Line

Tongue-tie is real, but it isn’t the answer to every feeding or speech challenge. If you’re unsure, a functional evaluation with a pediatric dentist can help you decide with confidence. The best treatment is the one your child actually needs.