Lip tie, or maxillary frenulum, is a common finding in the neonate and infancy. A lip tie causes the most issues during breastfeeding. The upper lip is utilized in breastfeeding to allow the infant to create a sealed suction on breast. This seal enables the infant to not slide off the breast while feeding and also drain a breast completely. In older children, a lip tie can cause cavities on upper teeth because of food pouching on either side of the tie, inability to clear a spoon and gaps between teeth. A lip tie can also be alleviated with the same procedure as a tongue tie, a frenectomy, which will release the lip allowing its free movement.

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A lip tie  most often involves the maxillary or upper lip frenulum but can also affect the mandibular or lower lip frenulum: 

• Appears as a web of tissue connecting the lip to the gum tissue

• If connected to low on the gum tissue/ gingiva, it will limit mobility of the lips

The clinical features of lip tie include:

• Unable to lift lip 

• Frenulum insertion in between or even on the other side of the two central teeth or on an infant to the ridge of the gum pad

• Difficulty latching due to upper lip curling in not creating a suction to breast for feeding

• Inability to clean a spoon as lip is not able to lower enough to contact spoon

• A gap between teeth due to lip tie insertion (in adult teeth or primary teeth)

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Lip ties may be present with several different variations​

• It can appear as an upper or lower lip tie

  • Upper​

    • Most common​

    • Can cause gaps in teeth

    • Unable to drain breasts completely leading to blebs, clogged ducts or even mastitis

    • Causes breastfeeding issues as infant is not able to obtain an adequate suction to hold on to breast​

  • Lower​

    • ​Not as common​

    • Causes gum recession on bottom front teeth

    • Can cause crowding if tissue is pulling teeth out of line