What Does a Tongue Tie Look Like? Signs and How to Tell

If you’ve ever asked, “What does a tongue tie look like?” you’re not alone. Many parents notice feeding challenges before they ever see a clear visual sign. Others spot a heart-shaped tongue or a tight string of tissue and wonder if something is wrong.

Tongue tie, medically called ankyloglossia, is more common than many people realize. While some cases are obvious, others are subtle or hidden. This guide explains what a tongue tie looks like, how to compare it to normal anatomy, what a lip tie looks like, and when to seek an evaluation.

What Is the Frenulum in the Tongue?

Underneath every tongue is a small band of tissue called the lingual frenulum. The frenulum in the tongue acts like a guide rope, anchoring the tongue to the floor of the mouth while still allowing it to move freely.

In a normal tongue:

  • The frenulum is thin and flexible
  • The tongue can lift easily toward the roof of the mouth
  • The tongue can extend past the lower lip
  • Side-to-side movement is unrestricted

When the frenulum is unusually short, thick, tight, or positioned too close to the tip of the tongue, it may restrict movement. That restriction is what we call a tongue tie.

What Does a Normal Tongue Look Like When Lifted?

When a normal tongue is lifted:

  • It rises high and broadly toward the palate
  • The underside appears smooth
  • There is no pulling or dimpling at the tip
  • The tongue maintains a rounded shape

A healthy tongue can also stick out beyond the lips and move freely from side to side. These movements are essential for effective breastfeeding, bottle feeding, speech development, chewing, swallowing, and proper airway posture.

If lifting the tongue creates tension, a notch, or limited elevation, it may suggest restriction.

What Does a Tongue Tie Look Like in Babies?

Tongue ties vary in appearance. Some are clearly visible, while others require functional assessment.

Anterior Tongue Tie (The Classic Heart Shape)

This is the most recognizable type.

Signs include:

  • A heart-shaped tongue when crying or sticking out
  • A visible tight band near the tip
  • Difficulty extending the tongue outward
  • Tongue that appears anchored or tethered

The heart shape occurs because the center of the tongue is pulled back by the tight frenulum while the sides move forward.

This type is easier to see during crying, yawning, or when the tongue is extended.

Posterior Tongue Tie (The “Hidden” Tie)

A posterior tongue tie is less visible. Instead of a thin string near the tip, the restriction lies further back under the tongue.

It may appear as:

  • A thick or tight base under the tongue
  • Limited lifting without obvious heart shape
  • Tongue that appears flat or unable to elevate

Posterior ties often cannot be diagnosed by appearance alone. They are identified through functional evaluation, including how the tongue lifts, cups, and coordinates during feeding.

This is why a baby may struggle even when the tongue looks “normal” at first glance.

What Does a Lip Tie Look Like?

A lip tie involves the labial frenulum, the tissue connecting the upper lip to the gums.

A normal labial frenulum:

  • Is thin and flexible
  • Allows the upper lip to flange outward easily

A restrictive lip tie may:

  • Appear thick or tight
  • Attach low on the gum line
  • Prevent the lip from flanging upward
  • Cause a tight or strained “baby lip tie smile”

Lip ties can affect latch and feeding mechanics, especially when combined with a tongue tie.

What Is Ankyloglossia?

Ankyloglossia is the medical term for tongue tie.

It describes restricted tongue movement due to a tight lingual frenulum. While the word sounds complex, it simply refers to functional limitation of the tongue.

Diagnosis is not based on appearance alone. It requires assessing:

  • Tongue elevation
  • Tongue extension
  • Lateral movement
  • Feeding function
  • Compensation patterns

This is why two tongues that look similar may function very differently.

Signs the Tongue May Be Restricted (Beyond Appearance)

Often, the clearest signs of a tongue tie are functional, not visual.

In Infants:

  • Clicking or smacking sounds during feeds
  • Frequent unlatching
  • Shallow latch
  • Painful breastfeeding
  • Flattened or creased nipples
  • Gassiness or reflux-like symptoms
  • Falling asleep quickly during feeds
  • Prolonged feeding sessions

In Older Children:

  • Speech articulation challenges
  • Picky eating or texture sensitivity
  • Gag reflex issues
  • Mouth breathing
  • Snoring or restless sleep

In Adults:

  • Jaw tension or TMJ discomfort
  • Speech concerns
  • Difficulty sticking tongue out
  • Chronic mouth breathing
  • Orthodontic relapse

A tongue tie in adulthood is often overlooked, especially if feeding issues were never identified in infancy.

Can Tongue Tie Affect Sleep and Airway Development?

Yes.

Proper tongue posture plays a critical role in palate development and airway growth. When the tongue cannot rest fully against the roof of the mouth, it may contribute to:

  • Narrow palate
  • Mouth breathing
  • Snoring
  • Sleep-disordered breathing
  • Orthodontic crowding

This is why early identification can have long-term benefits beyond feeding alone.

How to Check at Home

While a professional evaluation is essential, you can observe:

  • Does the tongue lift high when crying?
  • Can it extend past the lower lip?
  • Is there a heart-shaped tip?
  • Does feeding involve clicking or loss of suction?

If multiple signs are present, it is worth scheduling a consultation.

When to Seek a Tongue Tie Evaluation

If feeding is painful, stressful, prolonged, or ineffective, or if your child shows signs of speech or airway concerns, a trained provider should assess function.

Appropriate specialists may include:

  • An International Board Certified Lactation Consultant (IBCLC)
  • A pediatric dentist trained in oral ties
  • An ENT experienced in functional evaluation

During your appointment, ask:

  • Is this an anterior or posterior restriction?
  • How is tongue function being assessed?
  • What are the risks and benefits of treatment?
  • Is follow-up therapy recommended?

A thorough evaluation focuses on function, not just appearance.

Final Thoughts

A tongue tie does not always look dramatic. Sometimes it is obvious, like a heart-shaped tip. Other times, it is subtle and hidden beneath the surface.

The key is not just how it looks — but how it functions.

If you suspect a restriction, trust your instincts. Early evaluation can bring clarity, reduce stress, and support better feeding, speech, and long-term oral development.

If you would like a professional assessment, schedule a consultation to determine whether your baby’s tongue movement is within normal limits or may benefit from further care.

Healthy Tongues, Healthy Lives

At Colorado Tongue Tie, our goal is to support the well-being of families by addressing restricted oral tissues (ROTs). We cater to patients across all ages, from infants to adults, with an understanding of the diverse needs at each life stage. Our treatments, utilizing cool laser technology, are designed to be as efficient and comfortable as possible. We're dedicated to providing a caring environment, recognizing that each patient's journey towards better oral health is unique.