The procedure took about a minute. Someone handed you an aftercare sheet, mentioned reattachment, and sent you home — and now you are holding a baby who is fussier than usual, or driving a seven-year-old back to school, wondering what is actually supposed to happen next.
A tongue tie release is a structural change. It removes a restriction. What it cannot do is teach the tongue what to do with the space it just gained. That gap — between new range of motion and new habit — is where most of the disappointment after a frenectomy lives, and it is the part of the process almost nobody explains in advance.
A Release Changes What Is Possible, Not What Is Habitual
A restricted frenulum does not just limit the tongue. It shapes everything the tongue learned to do around that limit.
If the tip could not reach the palate, the jaw learned to do some of the lifting. If the tongue could not elevate for a swallow, the swallow was built another way — often with the tongue pushing forward against the teeth. If the tongue could not rest on the roof of the mouth, it rested low in the floor of the mouth instead, and the lips learned to sit apart to make room for breathing. Months or years of practice went into those arrangements, and they are motor habits now, not consequences of the tissue.
Cutting the tissue does not undo any of that. The day after a release, the tongue has more room and exactly the same instruction set it had the day before. This is why "her tongue moves more but nothing else changed" is such a common experience a few weeks out, and why it is not a sign the procedure failed.
The First Weeks Belong to the Provider Who Did the Release
Pain management, what the healing site should look like, bleeding, changes in feeding, and whether a specific aftercare routine is prescribed are all decisions for the dentist, ENT, or oral surgeon who performed the release, together with your pediatrician. We will not give you wound care instructions here, and you should not take them from an article. If something about the site worries you, call the office that did the procedure.
What belongs in this guide is the functional question underneath — and the reason the two keep getting confused.
The Stretching Question, Stated Honestly
If you have searched for this at all, you have run into the stretching argument. It is worth laying out the actual evidence, because the two sides are further apart than either camp admits.
In August 2024 the American Academy of Pediatrics published a clinical report, Identification and Management of Ankyloglossia and its Effect on Breastfeeding in Infants, lead-authored by Jennifer Thomas, MD, MPH, FAAP, in Pediatrics. Among its recommendations to clinicians: "Do not recommend post frenotomy stretching exercises in which the parents open the wound several times to prevent reattachment." The same report tells clinicians to "offer comprehensive care for infants with tongue-tie by collaborating with lactation consultants, speech-language pathologists and other specialists," and to "reserve frenotomy for cases where significant functional impairments are observed and nonsurgical interventions have failed." Co-author Maya Bunik, MD, MSPH, is quoted plainly in the AAP's release: "most difficulties with breastfeeding, including pain, are not due to ankyloglossia."
Two studies published in 2025 point the other way. Miller and colleagues at a single academic center ran a prospective cohort study of 88 infants, average age 50 days, all released in-office with scissors, and compared three groups: 36 families who were taught stretches and did them, 27 who were taught and did not, and 25 who were never asked to. Recurrent ankyloglossia appeared in 5.6%, 40.7%, and 16% of those groups respectively. A revision procedure was needed in 5.6%, 37.0%, and 32%. Persistent feeding difficulties ran 0%, 14.8%, and 16%. The authors concluded that "stretching exercises improved patient-reported feeding difficulties, the development of recurrent frenulum, scarring, and need for revision procedure," and added the line every parent should read twice: "Postoperative regimen adherence may be challenging for caregivers."
One detail in those numbers deserves flagging, because the study's own design cannot explain it away: the group that was told to stretch and did not fared worse than the group never asked to stretch at all. That is not what a clean treatment effect looks like. It is what you see when families were not randomly assigned and the groups differ in ways the study cannot separate — which is exactly the situation here.
The second 2025 study, a prospective observational study of 212 neonates in Barcelona by Valle-Del-Barrio and colleagues, is more sobering still. Their team recommended exercises six to eight times daily for 15 days. They note at the outset that "there is no published evidence to support performing tongue exercises to prevent this readhesion. We routinely recommend that parents perform them." They then found a global readhesion rate of 33.5% — against the 2.6% to 13% the literature had reported — with 15.6% of families still symptomatic and 14.1% going on to a second procedure. Readhesion was higher among families who did not perform the exercises correctly. And only 59% of families managed the advised frequency at all.
So: two 2025 cohort studies suggesting the stretches help, a 2024 AAP recommendation against the aggressive version of them, and no completed randomized trial to settle it. The honest position is that this is your releasing provider's call, made for your child, and you should follow the protocol they give you. What we would add is that this argument has swallowed a separate and more important question.
Wound Stretching and Function Therapy Are Not the Same Thing
Keeping a healing wound from closing over is wound management. It is about the first two weeks, and it belongs to the provider who created the wound.
Teaching a tongue to lift to the palate without the jaw helping, to move side to side independently, to cup and groove, to hold a resting posture behind the upper teeth, to seal the lips, to breathe through the nose, and to swallow without pushing forward — that is motor learning. It has nothing to do with the wound. It is about the next several months, and it is the work a Qualified Orofacial Myologist is trained to do.
Families routinely finish the two-week aftercare protocol, hear nothing more, and assume the process is complete. It is the halfway point at best.
What the Functional Work Actually Involves
Therapy after a release is not one exercise repeated until something changes. It is a sequence, and the order matters more than the effort.
The early targets are the movements the restriction made impossible: tongue tip elevation to the palate while the jaw stays still, lateral movement to each side, and cupping the tongue — the shape that matters both for managing food and for the /s/ and /l/ sounds. Only once those movements are available does the work shift to the habits built around their absence: resting tongue posture on the palate, consistent lip seal, nasal breathing, and retraining the swallow. Our guide to myofunctional therapy exercises walks through what each of those stages looks like in practice and how a program is sequenced.
This is also why therapy before a release is often worth the trouble. Starting the movement work in advance means the tongue is already learning the pattern when the restriction lifts, rather than beginning from scratch on a sore mouth.
What the Evidence Says About Combining Release and Therapy
A 2022 systematic review by González Garrido and colleagues in the International Journal of Environmental Research and Public Health pulled together the 11 studies that existed on myofunctional therapy for tongue tie and appraised their quality. Its summary sentence is the useful one: "surgery is more effective than myofunctional therapy, although better results are achieved if both are combined." The reported improvements span maternal pain, infant weight gain, duration of breastfeeding, tongue mobility, strength and endurance, sleep apnea, mouth breathing, snoring, quality of life, clenching teeth, myofascial tension, pain after surgery, and speech sound production.
The authors then apply the brakes themselves: "These findings must be taken with caution because of the small number of articles and their quality." ASHA's own evidence map summary of the same review puts the limit more bluntly — "due to a lack of evidence, the effects of myofunctional therapy alone are unknown."
Read together, the direction of the evidence favors pairing a release with functional retraining, and the strength of that evidence is modest. Anyone promising you a specific outcome from either one on its own is going past what has actually been shown.
It Looks Different Depending on Age
Infants. Feeding is the whole question, and it is a team one. If latch or milk transfer is still difficult after a release, the next step is a feeding assessment with a lactation consultant and your pediatrician — not a second procedure by default. The AAP's point that most breastfeeding difficulty is not caused by tongue tie cuts both ways: it is a reason to be careful before a release, and a reason to keep looking after one. Our page on feeding therapy for infants covers what that assessment weighs.
Children. Speech is the most common hope after a release and the one most often disappointed. A 2024 prospective study by Melong, Bezuhly, and Hong in the Ear, Nose & Throat Journal followed 25 children, average age 3.7 years, referred to a pediatric otolaryngologist for speech concerns believed to be caused by tongue tie, and found no significant change in articulation standard scores or in rated intelligibility one month after release — with 87.9% of their recorded errors age-appropriate to begin with. A 2022 systematic review by Wang and colleagues in the International Journal of Paediatric Dentistry reviewed 16 studies and concluded that "there was no clear connection between ankyloglossia and speech disorders." If a specific sound is the concern, it needs articulation therapy on its own terms; our guides to the /l/ sound and to articulation disorders cover that work, and myofunctional therapy for kids covers how readiness and home practice shape a child's plan.
Teens and adults. The compensations have had longer to set, so the posture and swallowing work usually takes longer, and the goals are more often airway, jaw comfort, and orthodontic coordination than feeding. See myofunctional therapy for adults for how a program runs once growth is finished.
What Bloom Does and Does Not Do
Bloom does not perform releases, does not decide whether you need one, and does not direct wound care or pain management. Those belong to the dentist, ENT, or oral surgeon doing the procedure and to your pediatrician, and we will say so rather than guess.
What Laura Friedman, MS, CCC-SLP, QOM provides is the functional half: evaluating tongue mobility and oral function before and after a release, building the retraining sequence, and coordinating with the provider who performed the procedure, the lactation consultant, and the orthodontist. Sessions run in person at our Dallas office or through online myofunctional therapy nationwide.
Frequently Asked Questions
What happens right after a tongue tie release?
The first week or two belongs to the provider who performed the release. Pain management, how the wound looks, feeding changes, and whether any specific aftercare routine is prescribed are decisions for the dentist, ENT, or oral surgeon who did the procedure, together with your pediatrician. The functional work — teaching the tongue to use its new range of motion — starts once that provider says healing is on track, and that is the part measured in months rather than days.
Are post-frenectomy stretches necessary?
This is genuinely contested, and your releasing provider makes the call. The AAP's 2024 clinical report advises clinicians to "not recommend post frenotomy stretching exercises in which the parents open the wound several times to prevent reattachment." Two 2025 studies point the other way: a prospective cohort of 88 infants found recurrence in 5.6% of families who did the stretches as instructed versus 40.7% of those who did not, and a 212-neonate observational study found readhesion was higher when exercises were not performed correctly. No completed randomized trial settles it. What is not contested is that wound stretching and tongue function therapy are different activities with different purposes.
How common is reattachment after a tongue tie release?
Published figures vary widely. The literature has historically reported readhesion in 2.6% to 13% of cases, but the 2025 Barcelona study of 212 neonates found a global rate of 33.5%, much of it asymptomatic — 15.6% of families still had symptoms and 14.1% went on to a second procedure. That spread is a good reason to be guided by your provider's examination of your own child rather than by an average.
Will my child's speech improve after a tongue tie release?
Not by itself. The 2024 study of 25 children referred for speech concerns attributed to tongue tie found no significant change in articulation scores or rated intelligibility a month after release, and 87.9% of the errors recorded were age-appropriate anyway. A release can remove a structural limitation; it does not teach a sound. Speech sound errors need articulation therapy whether or not a release happens.
How long does myofunctional therapy take after a release?
There is no fixed schedule — it depends on age, on how long the tongue has been compensating, on cooperation, and most of all on home practice. Programs are measured in months of short daily practice rather than a set number of sessions. In the Barcelona study, only 59% of families managed the exercise frequency they were advised to do, which is a useful reminder that a realistic plan beats an ambitious one.
Does Bloom perform tongue tie releases?
No. Laura Friedman is a speech-language pathologist and Qualified Orofacial Myologist, not a surgeon. Bloom does not perform frenectomies, decide whether one is needed, or direct wound care. What Bloom provides is the functional side: evaluating tongue mobility and oral function before and after a release, building the retraining program, and coordinating with the rest of the team.
Not Sure What Comes Next?
Whether the release was last week or last year, the functional question is the same one: is the tongue actually using the range of motion it now has? Schedule a free consultation with Laura Friedman, MS, CCC-SLP, QOM — in person in Dallas or online nationwide — for an honest read on where things stand and what, if anything, still needs work.