A frenectomy is a quick procedure that releases a tight lip or tongue tie so a child can move the tongue and lips freely. At Smile Arc Pediatric Dentistry in San Diego, our board-certified pediatric dentists use a gentle CO2 laser to help babies and children feed, speak, swallow, and sleep more comfortably, with care guided by function, not appearance.
When feeding is a struggle, speech is hard to understand, or sleep is restless, a lip or tongue tie may be part of the reason. These tight tissue attachments are common, affecting up to about 10 percent of children, and they can quietly hold back something as basic as a comfortable latch or a clear word. At Smile Arc Pediatric Dentistry in San Diego, Dr. Nikki Shafiei and our team evaluate lip and tongue ties carefully and, when a release will truly help, perform a gentle laser frenectomy. We care for infants, children, and teens across San Diego, 4S Ranch, Rancho Bernardo, and the surrounding North County communities.
What Are Lip and Tongue Ties?
Every child is born with small bands of connective tissue, called frenums, that anchor the lips and tongue. In some children one of these bands is short, tight, or thick enough to limit movement. These are known as tethered oral tissues.
- Tongue tie (ankyloglossia): the band beneath the tongue is tight enough to restrict normal tongue movement.
- Lip tie: the band connecting the upper lip to the gums is tight enough that the lip cannot flange outward normally.
These tissues are leftover from early development that would normally have receded before birth. When they remain restrictive, they can affect how a child eats, speaks, and breathes.
Signs Your Child May Have a Tongue or Lip Tie
Because symptoms change with age, the signs look different in a nursing infant than in a school-age child.
In babies:
- Shallow or painful latch, sliding off the breast or bottle
- Clicking or smacking sounds while feeding
- Falling asleep quickly while eating, or seeming hungry again right away
- Slow weight gain, reflux, or gassiness
- Snoring, noisy breathing, or mouth breathing
In nursing mothers:
- Creased, flattened, or blanched nipples
- Painful latch, cracked nipples, or recurring plugged ducts
In older children:
- Speech that is hard to understand, or difficulty with certain sounds
- Trouble moving from purees to textured foods, or being a very slow eater
- Restless sleep, grinding, or sleeping with the mouth open
How We Decide If a Frenectomy Will Help
This is where careful judgment matters most. We evaluate function, not appearance. A tie that looks dramatic may cause no problems, while a subtle one may be holding a baby back from feeding well. We only recommend a frenectomy when releasing the tissue is likely to improve feeding, comfort, speech, or oral function.
This measured approach matters especially for lip ties, where releasing the tissue is not always necessary or helpful. We will tell you honestly when watching and waiting, or starting with therapy, is the better first step. The goal is the right care for your child, not a one-size-fits-all recommendation.
Gentle Laser Frenectomy at Smile Arc
When a release is the right choice, our pediatric dentists use a CO2 (carbon dioxide) laser. Compared with scissors, a laser offers real advantages for children:
- Little to no bleeding, because the laser seals tissue as it works
- Quicker, more comfortable healing
- Greater precision for a complete release
- Usually no sutures and no general anesthesia (laughing gas is available for anxious children)
The laser release itself is remarkably fast, often just seconds, which makes the visit easier for babies and parents alike.
What to Expect the Day of Treatment
We keep the day calm and well explained. A typical visit includes:
- A consultation with the pediatric dentist and time for all of your questions
- Before-and-after intraoral photos
- Swaddling for infants and a topical numbing gel for comfort
- Eye protection for your child during the brief laser release
- For breastfeeding and bottle-fed infants, the chance to feed right afterward
- A hands-on demonstration of the gentle stretches you will do at home
Because of laser safety guidelines, parents wait in the consult room for the few seconds of the release itself, then rejoin their child right away.
Aftercare and Healing
Healing well is a partnership. We send you home knowing exactly what to do:
- Comfort dosing with children’s Tylenol or Advil, based on your child’s weight
- Simple stretches done at home for two to three weeks to prevent reattachment
- A one-week follow-up at Smile Arc to check healing and technique
Because muscles often need retraining after a release, we frequently coordinate with a team of specialists such as lactation consultants, feeding therapists, speech therapists, bodyworkers, and myofunctional therapists. We will let you know which, if any, your child may benefit from. A frenectomy works best as one part of a supported, team-based plan, which is also why it connects to our broader airway-focused pediatric dentistry and mouth breathing care.
Frenectomy Cost and Insurance in San Diego
Cost is one of the first questions parents ask, and few practices answer it openly. Every child is different, so the figures below are general ranges to help you plan, not a quote. We provide an exact estimate after your child’s evaluation and review it with your benefits.
An in-office laser frenectomy generally runs about $500 to $1,500. Procedures performed in a hospital under general anesthesia can cost considerably more, which is one reason an office-based laser release is often the gentler and more affordable path when it is appropriate.
Coverage varies. A frenectomy is often covered when it is medically necessary, for example when it affects feeding, speech, or oral health, and it may fall under medical or dental insurance depending on your plan. Our team helps you understand your coverage and offers flexible payment options. See our financial and insurance page or call us, and we will walk you through it.
Schedule a Lip or Tongue Tie Evaluation in San Diego
If feeding, speech, or sleep has been a struggle, a careful evaluation can tell you whether a lip or tongue tie is part of the story, and whether a gentle release will help. Help your child feed, speak, and rest more comfortably. Call (858) 277-8086 or request a visit online.
Conveniently located in the 4S Ranch and Rancho Bernardo area, proudly serving San Diego, Del Sur, Carmel Mountain Ranch, Poway, Carmel Valley, and Rancho Penasquitos.
Reviewed by Dr. Nikki Shafiei, board-certified pediatric dentist and Diplomate of the American Board of Pediatric Dentistry.
Frequently Asked Questions
How much does a frenectomy cost in San Diego?
An in-office laser frenectomy generally ranges from about $500 to $1,500, while a hospital procedure under general anesthesia costs more. The exact figure depends on your child’s needs, so we provide a personalized estimate at the evaluation and check it against your insurance.
Does insurance cover a frenectomy?
Often, yes, when the procedure is medically necessary because of feeding, speech, or oral-health concerns. Depending on your plan, coverage may come through medical or dental insurance. We recommend verifying with your specific plan, and our team is glad to help.
Is a laser frenectomy painful for my baby?
It is generally well tolerated. The release takes only seconds, numbing gel is applied first, and most infants can feed immediately afterward, which is soothing. Mild fussiness or soreness for a day or two is normal and manageable with weight-based comfort dosing.
Will my child simply outgrow a tongue or lip tie?
Some mild restrictions improve as a child grows, especially lip ties, which is why we evaluate function rather than appearance. When feeding, speech, or oral-function problems are clearly present, waiting often prolongs the difficulty, so an evaluation helps you decide between monitoring and treatment.
Can an ENT or another provider do a frenectomy instead?
Yes. A frenectomy can be performed by a pediatric dentist, an ENT, or an oral surgeon. Our pediatric dentists are experienced with infant and child laser releases and coordinate with lactation, feeding, and speech specialists, which is especially helpful for the youngest patients.
Why is therapy recommended before and after the procedure?
Releasing tight tissue restores mobility, but muscles often need retraining to use that new range of motion. Working with a lactation, feeding, or speech specialist before and after helps your child build lasting habits, so the results hold.
