4 Vital Differences Between a Simple Snip and a Functional Tongue-Tie Release
There are clear reasons for a “quick snip” not being the resolution it promises, which I will continue to explore below. If feeding hasn't improved weeks after a procedure, it's often because the underlying oral mechanics were never retrained. Review why a simple snip may not fix tongue-tie to see what whole-body support was missing.
There is a significant difference between a basic “snip” of a frenulum and a comprehensive, functional tongue tie release.
Understanding the four key differences below is essential for any parent navigating the journey of tongue tie, or ankyloglossia.
1. A Quick Snip, or a Resolution with Functional Support
Let’s start with this: a visible frenulum does not equal a “tongue tie”.
A lingual frenulum is part of normal anatomy, the distinction is whether it is too tight or too short, or attached in a way which prevents the tongue moving optimally.
A simple snip often only addresses the anterior (the part closest to the tip of the tongue) portion of the frenulum. This may present as a thin, visible membrane at the front of the tongue. While this might look “better” to the naked eye, it often ignores the posterior component.
The Simple Snip: Only removes the front of a restriction, which may not be enough to improve feeding, or may make things more challenging.
The Functional Release: Addresses any tissues “tethered” or causing functional restriction of the tongue. Sometimes functional exercises are recommended to reduce tension before a full assessment can be carried out to ensure that a frenulotomy is necessary.
This may reduce tension, increase function and enable a practitioner to provide a more optimised procedure, completed fully, allowing the middle and back of the tongue to lift, movements that are vital for creating the vacuum needed to drink milk effectively at breast or bottle.
2. Anatomy vs. Function
A standard procedure focuses on what the tongue looks like (anatomy). A functional release focuses on what the tongue can do (function).
The Simple Snip: The goal is simply to “cut the frenulum”, which can range from a conservative “little snip” at the front to a full release with a skilled practitioner.
The Functional Release: The practitioner assesses how baby’s body is positioned and how the tongue moves during breastfeeding or bottle feeding. They do a functional oral examination to look for the ability to elevate, extend, and lateralise (move side to side). If a frenulotomy is needed to create function & movement to optimise feeding, the procedure isn’t considered “finished” until the tongue has achieved the physical range of motion necessary for a deep, pain-free latch, and the ability to maintain a seal.
3. The Role of “Pre-hab” and Bodywork
Would we fix a squeaky door by shaving the door, or by realigning the hinges to create a more functional solution?
A simple snip is usually treated as a standalone event. A functional release recognises that a tongue tie affects the baby’s entire body.
The Simple Snip: You arrive, the procedure is done, and you leave. Sometimes this may include watching a feed, sometimes feeding is not part of the support.
The Functional Release: Advocates for paediatric bodywork (such as cranial osteopathy or musculoskeletal (MSK) therapy).
Looking at the bigger picture of whole body and how feeding can be affected, bodywork with an osteopath or physiotherapist or chiropractor, before and after the release provides a holistic approach. Because tongue-tied babies often have significant tension in their jaw, neck, and shoulders, “unwinding” this tension through bodywork ensures the tongue can actually use the freedom of movement and optimised function.
4. Proactive Post-Frenulotomy Management vs. Reactive “Wait and See”
The mouth heals incredibly quickly. One of the biggest differences in a functional approach is the emphasis on what happens after the appointment.
Scenario: If a procedure were done to divide fused fingers, and healing was approached by encouraging them to be held together, with a change in muscular patterns and the way they are used, would an optimal, functional procedure of the two fingers have been achieved?
The Simple Snip: Parents are often told to “just keep an eye on it for bleeding or infection”. This frequently leads to the wound healing too tightly or the tissue re-attaching, resulting in the return or exacerbation of feeding struggles.
The Functional Release: Includes a specific programme of active management with exercises and checks that the tongue is lifting and moving well. Parents may be taught a combination of gentle stretches and oral exercises to ensure the wound heals in an “open” position (as the fused fingers would) preserving the newly optimised mobility and preventing the need for a second procedure, or further feeding issues from reduced function.
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