Lip Tie vs. Tongue Tie: A Function-First Frame

The mouth has multiple frena — lingual, labial, and buccal. Why release decisions should follow functional assessment, not appearance alone.

Direct answer

There are seven frena in the mouth: four buccal (cheek), two labial (lip), and one lingual (tongue).

Reviewed by Angie Lehman, RDH, COM — Founder, Oral Myofunctional Therapy of York · Last updated July 13, 2026

Upper lip ties can affect lip function, just as tongue ties can restrict tongue mobility — but the decision to release should follow thorough assessment by a knowledgeable professional.

Definition

Tongue tie (ankyloglossia) involves a short, tight, or deeply embedded lingual frenulum that limits mobility and may affect Oral Rest Posture, chewing, swallowing, posture, and breathing.
Lip ties involve labial frena; impact is judged by lip seal, rest posture, and function — not by how "dramatic" the tissue looks in a photo.
Many providers only recognize severe ties visually. Ties are often missed for years when speech seems fine. Diagnosis should be based on function.
When release is indicated, a dentist or physician performs frenectomy/frenuloplasty. A functional plan — including myofunctional support and, when appropriate, bodywork collaborators — should be in place around the procedure.

When to use this guide

Use this guide when comparing "lip tie" vs. "tongue tie" recommendations online.
Use it before scheduling a release without a functional assessment and therapy plan.

Failure modes

Releasing tissue based on appearance alone without a function plan.
Assuming speech-only screening catches all restrictive patterns.
Skipping post-release support so old compensations return.

Proof & sources

Tongue Tie brochure (© 2021): seven frena; lip ties can affect lip function; functional assessment before release; interdisciplinary team including bodyworkers.
TOTs (Tethered Oral Tissues) specialty training is part of the practice's advanced credential display.
Therapy-before-and-after-frenectomy guide on this Learning Center details sequencing.

Function check · educational

Tongue-tie is about function — not appearance alone.

Many providers only recognize severe ties visually. Diagnosis should be based on function: speech, Oral Rest Posture, growth, chewing, swallowing, breathing, and posture. This is not a diagnosis.

Knowledge check · 1/1

Release decisions for lip or tongue ties should primarily follow:

Action

If a provider mentioned a lip or tongue tie, start with function — book a consultation so assessment and therapy planning come before any procedure decisions.

Book a Functional Assessment Back to Learning Center

Common questions

Does every lip or tongue tie need surgery? +

No. Decisions should follow functional assessment. Some restrictions are managed with therapy and monitoring; others benefit from release plus therapy.