How We Decide: Treating Symptoms, Not Appearance
If you’re reading this, your family may be struggling with feeding, speech, sleep, or something that just doesn’t feel right. Many parents come to us tired, worried, and hoping for answers. We take those concerns seriously, and we want you to know how we think about tongue and lip ties before you ever walk through our door.
Our approach is simple. We listen first, and we treat symptoms, not appearance. What you’re seeing at home matters, so every visit starts with a thorough functional assessment of how your child’s tongue and lips work. When a tie is contributing to your child’s symptoms, we’ll recommend a release. When something else seems more likely, we’ll tell you honestly and help you figure out what comes next.
What we look at
We focus on how the tongue and lips work, and on the symptoms your child is having.
For infants, that may include:
- A shallow latch
- Painful nursing
- Poor weight gain
- Clicking during feeds
- Long feeds
- Gas, reflux, or colic symptoms
For older children, that may include:
- Speech concerns
- Picky or slow eating
- Choking, gagging, or packing food in the cheeks
- Mouth breathing
- Snoring
- Restless sleep or waking up tired
These symptoms may be related to a tie, but they also have many possible causes. Sorting that out is the purpose of the assessment.
How the assessment works
We start by listening. We want to hear what you’re seeing at home, what you’ve already tried, and what worries you most.
Next, we look at function: how your child’s tongue and lips move, and how that connects to the symptoms you’ve described. How a tie looks is only one piece of the picture.
Then we talk it through together. We’ll share what we found, whether we think a release is likely to help, and which other providers might be part of the plan.
When we recommend a release
If your child is struggling and a tie is limiting how the tongue or lips work, a release may be an important part of helping. We recommend one when that limitation is likely contributing to the symptoms you’re seeing, and your observations at home are a big part of how we make that call.
If a release is the right next step, it’s done in our office while your child is awake, with no sedation or general anesthesia. Aftercare guidance and follow-up visits are included.
When we don’t
Most families who come to us are dealing with real symptoms, and we take them seriously. Still, not every tie needs a release. If your child’s tongue and lips are working well, or if the symptoms seem more likely to have another cause, we’ll tell you that honestly. A tie that only looks tight is not, by itself, a reason to treat.
When we don’t recommend a release, it’s not because we doubt what you’re seeing. It’s our honest guidance that something else is more likely behind the symptoms right now. Some families feel relieved, and others feel disappointed because they were hoping for a clear answer. Either way, we’ll explain what we found and help you plan next steps, which may include other members of your child’s care team.
Not needing a release now doesn’t mean the answer stays the same forever. As children grow, a tie that isn’t causing problems today can start to cause symptoms later. Sometimes, after working with a therapist for a while, a family and their therapist decide it’s worth addressing. We’re always happy to see your child again and reassess.
Working with your child’s other providers
Feeding, speech, and sleep concerns often involve more than one piece. We partner with pediatricians, lactation consultants, and feeding, speech, occupational, and physical therapists. A release, when it’s recommended, is one part of a bigger plan.
If you’re a referring provider, your observations are an important part of our assessment. You can reach our office by phone at 205-419-4333 or by fax at 205-419-4320.
Our doctors
Dr. Richard Baxter, DMD, MS, FAAPD, is a board-certified pediatric dentist and board-certified laser surgeon. He is the author of the book Tongue-Tied, publishes peer-reviewed research, and trains other doctors through lectures and courses. Dr. Brigitte Trego is a board-certified pediatric dentist. Together, they care for children from birth to 18.
Next steps
New patients are usually seen quickly. Families come to us from all over Alabama, from other states, and from other countries.
If you’re not sure whether a visit makes sense, we offer a free pre-screen. Email photos and a symptom sheet to info@TongueTieAL.com with the subject line “Pre-Screen Request.” The pre-screen is not a diagnosis or an exam, but it can help you decide whether to come in. You can find details at tonguetieal.com/pre-screen.
Frequently asked questions
Does a tie that looks tight always need to be released?
Not always. Appearance alone doesn’t tell us whether a tie is causing problems, so we look closely at how the tongue and lips work and at the symptoms you’re seeing. When a tie is contributing to those symptoms, we’ll recommend treating it.
Can you tell me over email or video whether my child needs a release?
We don’t offer virtual consults. The free pre-screen can help you decide whether an in-person visit makes sense, but it isn’t a diagnosis. A recommendation about a release comes only after a functional assessment in our office.
We've already been told my child has a tie. Can we get a second opinion?
Yes, and we’re glad you’re here. Getting another set of eyes is a normal part of care. We’ll listen to your concerns, do our own full functional assessment, and give you our honest opinion. Please call to schedule an in-person consult.
Is there anything to know ahead of time for a young baby?
Infants under 6 months need the vitamin K shot (not oral drops) at least 12 hours before a release. Releases are done awake in our office, with no sedation or general anesthesia.
Let’s talk about your child
Call us at 205-419-4333 to schedule a consult, or request a free pre-screen at tonguetieal.com/pre-screen.
Alabama Tongue-Tie Center
2480 Pelham Pkwy, Pelham, AL 35124
Phone: 205-419-4333 | Fax: 205-419-4320
info@TongueTieAL.com