04/18/2026
“But my pediatrician said my baby doesn’t have a tongue tie.”
This is one of the most common things we hear from families.
When we ask if a full oral motor exam was performed — including using a gloved finger to assess function inside the mouth — the answer is almost always no. In most cases, the mouth was simply looked at, and no restriction was identified.
Here’s the problem:
Tongue tie is not a visual diagnosis. It is a functional diagnosis.
Many providers — including pediatricians, lactation consultants, and even some speech-language pathologists — are not trained in performing comprehensive functional oral assessments. Identifying oral restrictions requires advanced training, clinical skill, and extensive hands-on experience.
It is not possible to accurately diagnose or rule out a restriction by appearance alone.
A proper evaluation must assess:
• Tongue mobility
• Range of motion
• Strength and coordination
• Functional impact on feeding
The presence of a visible frenulum alone does not determine a diagnosis. Many individuals have a visible frenulum with completely normal function.
At the same time, some of the most significant restrictions are not visible at all.
Submucosal (posterior) ties are often hidden beneath the tissue and can only be identified through skilled manual assessment. These are frequently missed — and can significantly impact feeding, cause ni**le pain, reduce milk transfer, and contribute to long-term issues with oral function, airway, and speech.
Every case is different.
A thorough assessment of both structure AND function is essential.
If you suspect a tongue or lip tie, seek out a provider who is specifically trained and experienced in functional oral assessments.
If you have questions, we’re here to help.
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