Does My Child Need Myofunctional Therapy After a Tongue Tie Release?
Most kids get better results when myofunctional therapy happens before and after a tongue tie release. The release gives the tongue room to move. Therapy teaches the tongue where to rest, how to swallow, and how to keep the lips closed. Without that retraining, many kids keep the same habits they had before the procedure.
Release Only | Release + Myofunctional Therapy |
Tongue can move higher | Tongue learns to rest on the roof of the mouth |
Old swallow habits often stay | A new swallow pattern is practiced until it sticks |
Healing tissue can tighten again | Exercises are timed to support healing |
Mouth breathing may continue | Lip seal and nasal breathing are trained day and night |
The Takeaway: A release changes the structure. Therapy changes the habit. Your child needs both to get the full benefit.
Pro Tip: Before you schedule a release, ask your provider who will do exercises with your child before and after. If nobody has a clear answer, sort that out first.
In this post:
Why isn't a tongue tie release enough on its own?
Does every tongue tie need to be released?
What does therapy look like before and after a release?
How can I tell if my child's release didn't fully work?
Frequently asked questions
Why isn't a tongue tie release enough on its own?
A release frees the tongue, but it doesn't retrain the muscles. Your child has spent years working around a tight tongue. The tongue learned to rest low. The swallow learned to push forward. The lips learned to stay open. Those patterns don't disappear the day of the procedure.
The research lines up with this. A 2022 systematic review found that a release works better than therapy alone, and that combining the two gives the best results (Effectiveness of Myofunctional Therapy in Ankyloglossia). The authors also note that research in this area is still limited, so more high-quality studies are needed.
In a survey of 348 patients who had a release plus myofunctional therapy, most reported being satisfied and having a better quality of life (Zaghi et al., 2019).
What I think: The release gives the tongue room to move. It doesn't tell the tongue where to go. I see kids in my Oklahoma City office who had a release years ago and still mouth breathe, still rest their tongue low, and still swallow the old way. Their parents did everything right. Nobody showed them the second half.
Right now I'm working with a 6-year-old who had a tongue tie release at age 2. The release worked, but nobody retrained the tongue afterward. Four years later, it still rests low in the mouth, and the palate (the roof of the mouth) is growing high and narrow. A tongue resting up against the palate helps it grow wide. Without that, it can grow narrow and high instead.
Does every tongue tie need to be released?
No. Whether a tie needs a release depends on how the tongue works, not how it looks. Some ties look tight but function fine. Others look mild but keep the tongue from reaching the roof of the mouth.
At an evaluation, I check:
How high the tongue can lift with the mouth open
Where the tongue rests when your child isn't thinking about it
How your child swallows water and food
Whether the lips close easily at rest
Sometimes therapy alone is enough. Sometimes a few sessions of therapy make it clear a release is needed. Either way, you get an answer based on function.
What I think: I would rather tell you your child doesn't need a procedure than send you for one you don't need. Being honest about what's needed is one of the core values of my practice. If a release will help, I'll tell you, and I'll refer you to the provider who fits your child best.
What does therapy look like before and after a release?
Therapy starts before the release, continues through healing, and keeps going until the new habits stick. Here is how I walk families through it:
Before the release: Your child learns the exercises while the tongue is still tight. This builds strength and awareness, so they already know what to do afterward. I also prepare you for the day itself: what to expect and what to have on hand at home.
Release day: The procedure is done by a provider I refer you to. I time the exercises around it.
Healing: I follow up personally after the release. For releases without stitches, families send me a daily photo so I can check that the tongue isn't losing the range it gained.
After healing: We keep working until your child meets four goals: lips closed at rest, tongue resting on the roof of the mouth, a correct swallow, and nasal breathing, day and night.
Kids do about 5 minutes of exercises twice a day at home. I make it fun with games and simple props like bubbles and kazoos.
What I think: I teach the exercises, but the progress happens at home. The parent is the coach. The kids who do best have a parent who gives quick reminders and checks on mouth posture at night.
How can I tell if my child's release didn't fully work?
If the old habits are still there months later, the muscles likely haven't been retrained yet. Watch for these signs:
Mouth open during the day or while sleeping
Snoring or noisy breathing at night
Tongue resting low or pushing against the teeth
Messy eating or loud chewing
The tongue feels tight again as healing finishes
Any one of these can be a sign the tongue still needs help learning its new job.
What I think: This happens often, and it can still be addressed. Some families come to me after a release was done. A release from years ago doesn't mean you missed your window.
The bottom line
A tongue tie release works best as one part of a plan, with myofunctional therapy before and after. The release creates room to move. Therapy builds the habits that keep the tongue up, the lips closed, and the breathing through the nose.
I'm Jennifer DeJonge, an orofacial myofunctional therapist in Oklahoma City. I see kids ages 4 and up, plus adults, in person in OKC and virtually anywhere in Oklahoma.
Thinking about a release, or already had one? Book your free evaluation and we'll find out what your child's tongue actually needs.
Frequently asked questions
Should therapy start before or after a tongue tie release?
Both. Starting before helps your child learn the exercises while the tongue is still tight, so they are ready to use their new range right after the release.
Can a tongue tie grow back after a release?
The tissue doesn't grow back, but it can tighten as it heals. Exercises timed during healing help the tongue keep the range it gained.
What age can my child start myofunctional therapy?
I see children ages 4 and up. Some younger kids start with a shorter, game-based program until they're ready for the full one.
Can adults have a tongue tie release and therapy?
Yes. Adults with a tongue tie can have the same mouth breathing, jaw tension, and swallowing issues kids do, and therapy works the same way.
Do you do the tongue tie release?
No. I refer you to a provider who fits your child's needs, and I coordinate the therapy around the procedure.
Can therapy be done virtually?
Yes. I see families virtually across Oklahoma, and in person at my Oklahoma City office.
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