Appearance Concerns, Health Impacts, and Effective Solutions
When we think of oral health, many of us picture things like cavities or braces. But there’s a less obvious issue affecting many adults that goes far beyond aesthetics— adult lip tie.
If you’ve noticed a thin upper lip, a flat philtrum, or persistent chapped lips, it could be an adult lip tie. Frequent licking of the lips is not just a bad habit without cause.
Adult lip tie, also known as a restricted maxillary labial frenulum, is a condition that often flies under the radar. It can profoundly impact not just your appearance but also your overall well-being.
What is an Adult Lip Tie?
An adult lip tie occurs when the frenulum, the tissue that connects your upper lip to your gums, is too tight or restrictive. You may also have heard it called a tethered oral tissue.
It may reach all the way down to your tooth line and or invert under the gum. Thus creating a space between your two front teeth. Tethers can appear very wide and fat or be long and thin.
When smiling, the red part of your lip appears thin and is often pulled up towards the nose. This exposes the teeth and gum ridge in an exaggerated way.
This can cause a variety of both functional and cosmetic concerns.
While we often think of lip ties as a childhood issue, many adults unknowingly live with this condition. Facing long-term repercussions, from difficulties with basic functions like chewing and swallowing to self-esteem issues related to their appearance.
Why was my lip tie never identified?
Actually, it probably was. Often as an infant or toddler, the lip tie will be observed by the mother. She will consult with the pediatrician.
A very typical response to a mother’s inquiry regarding lip ties is “It will break on its own.” So the child will not have any intervention for that tie. You simply return home and wait for a facial injury to occur. This injury will bust open your lip and voila the tie is corrected.
Congratulations! You are lucky, you survived childhood without falling and smashing your face. You are now an adult with a lip tie!
In this article below, the authors took a look at what knowledge parents have regarding lip ties. This provides insight into how little professional contact parents receive when identifying and treating a lip tie.
Parental information centered around breastfeeding infants and most information came from social media!
https://pubmed.ncbi.nlm.nih.gov/37674624
Bacon BR, Carr MM. Maxillary Frenulum and “Lip Tie”: What Parents Understand. OTO Open. 2023 Sep 5;7(3):e71. doi: 10.1002/oto2.71. PMID: 37674624; PMCID: PMC10478164.
Given the data in this report and the all too common, wait-and-see approach, many people arrive into adulthood with their tethers very much intact!
The Aesthetic Impacts: More than Skin-Deep
Flat Philtrum and Thin Upper Lip
One of the most common concerns with adult lip ties is the appearance of a flat philtrum (the area between your upper lip and nose) and a thin upper lip.
These features often lead individuals to feel self-conscious about their facial profile, especially in today’s world where full, balanced lips are highly desired.
Creatively, many with this condition turn to expensive makeup or cosmetic treatments, trying to enhance their naturally thin lips.
Nevertheless, photos are still avoided or taken with closed lips and a quaint tiny smile. Making sure not to expose the teeth and gums is still at the forefront of the mind even with the best makeup job.
Chapped Lips
Another surprising but common side effect of an adult lip tie is persistent chapped lips.
Due to the restricted movement of the upper lip, an open-mouth posture at rest is common to see. It is harder for the lips to rest together and be sealed as they are intended to be.
Many people compensate by over-using lip balms or licking their lips, only to end up in a vicious cycle of dry, cracked skin. The struggle for moisture can be unrelenting and uncomfortable, causing stress and anxiety for the person with an adult lip tie.
Toothy Smile and Photo Anxiety
Those with a lip tie often display a “toothy” smile. This happens because the restricted upper lip doesn’t move freely over the teeth, leading to excessive gum or tooth exposure when smiling or laughing.
As noted earlier, this results in shying away from photos, social gatherings, or any situation where they feel their smile is on display. Photo anxiety, in particular, is something many adults with lip ties silently endure.
Below we see some images to display the more typical lip shape and philtrum groove vs. the flat philtrum and thin upper lip:
Functional Challenges: The Hidden Struggles
Open Mouth Chewing and Air Swallowing
Because of the restriction caused by an adult lip tie, many people find it difficult to keep their mouths closed while chewing. Most are unaware they even do it. This is referred to as functional compensation.
In this instance, air is being allowed into what otherwise would be a tightly sealed mouth. That air is being swallowed into the stomach with the food.
Compensations allow you to get the job done in as close an approximation as possible. But all compensations come with pesky side effects.
Functional compensations like swallowing air may contribute to problems like gas, bloating, and reflux. These are not pleasant side effects. Most adults with lip ties will rely on medications to reduce the unpleasantness of these problems.
Open-mouth chewing, often seen as just a bad habit, can be an unconscious result or compensation for the lip tie. This restriction makes it awkward to chew with the mouth closed.
As we noted with lips at rest, the lips at work need to be together. When working for chewing they should be firmly pressed together. Any gaps created by the lip pulling up and away from the lower lip will allow air to seep in and be swallowed with the food.
Reflux and Digestive Discomfort
Swallowing too much air due to open mouth chewing can lead to digestive problems like acid reflux or GERD (gastroesophageal reflux disease).
This is particularly troubling for adults with lip ties, as they may not make the connection between their restricted lip movement and the digestive discomfort they’re experiencing.
When we have a symptom that we have lived with for many years, we normalize it. A comment at the neighborhood BBQ “Oh, no thanks, I can’t eat that it repeats on me all day!” met with “Yeah me too!” It brings with it a sense that this is true for everyone.
Unfortunately, without addressing the root cause of lip tie, these symptoms will persist and worsen over time. As with all compensation they break down over time and eventually don’t work as well anymore.
The symptom, whether it be gas, bloating, GERD is the red flag pointing to a hiccup in the harmonious flow of your digestive tract. It is not the source of the issue. If all other sources of cause have been ruled out, check for a lip tie.
Digestion begins in the mouth, start there!
These physical issues can significantly impact daily life, from stepping out of the family photo, to spending money on ant-acid treatments, to declining invites to gatherings centered around food.
Emotional and Financial Costs
Makeup Costs and Self-Esteem
Many adults with lip ties invest heavily in makeup to cover or enhance their thin upper lip. While makeup can offer a temporary fix, it often becomes an expensive and frustrating process.
Constantly applying lipstick, lip liner, or even considering fillers doesn’t address the underlying issue and can lead to more feelings of dissatisfaction over time.
The emotional toll can be even greater—feeling embarrassed in social settings or avoiding pictures can take a hit on confidence and self-esteem.
Declining the girls’ trip because rooms will be shared, and you might be seen without your make-up on. Adults with lips ties have social anxiety due to this worry and often feel a weight lifted once the tie is identified and they begin the journey to releasing it.
What Can Be Done About Adult Lip Ties?
The good news is that solutions are available. Addressing adult lip tie involves a combination of medical and therapeutic options.
Lip Tie Release (Frenectomy)
One of the most effective treatments for adult lip tie is a simple surgical procedure known as a frenectomy, which releases the tension of the frenulum and allows for greater lip mobility.
This procedure is controversial due to lack of research studies. Adult lip tie is under-reported, often occurs with other ties (tongue tie), and is often thought to have little impact on function.
Any research in past or recent years centers on infants and the impact upon breastfeeding. This is why taking the time to find an expert familiar with adult lip tie is crucial.
Just as we discussed young mothers being told not to worry about their young children with ties. Adults too are pacified by the medical community and pushed away from addressing the ties.
Research is very particular. It’s difficult for a professional in the field to design a research study in which they would only be addressing the surgical release of a single lip tie. Because they don’t happen in a vacuum.
It would be against the ethics of therapists and doctors to isolate a condition and treat just that for a research study. Hence the lack of research to support the surgical procedure.
Surgery is not the first step for this reason. First, we develop an oral motor treatment plan with either an SLP (Speech Therapist) OT (Occupational Therapist), or RDH (Registered Dental hygienist) trained in myofunctional therapy to address tethered oral tissues.
Myofunctional Therapy
For many adults, myofunctional therapy—exercises that help retrain the muscles around the mouth and face—can make a world of difference.
These exercises not only improve the function of the lips but can also reduce issues like open-mouth chewing and air swallowing. Even improving the overall balance of the facial profile.
Often this therapist will have a team of other professionals that they refer to in order to address the whole patient.
The therapist may identify other tethered oral tissues and develop a combined plan. They can provide correct chewing mechanics to align the muscles for more efficient swallows. Most therapies will instruct on the importance of rest posture and maintaining breathing through the nose.
Many patients feel improvement in the first month of therapy.
The therapist will work with you to identify the right time for the surgical release. By providing evaluations that highlight the medical impact your tie is having on your oral and overall health, the therapist and doctor can better support your chances for insurance to cover your therapy and surgical release.
Approximately two weeks of healing are required after the surgical release has been performed. At this time you will have an open wound that needs direct attention 4-5 times a day. Following the protocols from your therapist and doctor, you will recover easily from the release surgery. Typically returning to work the next day.
Your therapist will stay with you past the recovery period and work on an individualized myofunctional program to restore your lips’ appearance and function to it’s fullest potential.
Breaking Free from the Constraints of a Lip Tie
If you suspect you may have an adult lip tie, it’s worth consulting a specialist who understands the full range of impacts, from appearance to digestion.
Follow this link to find a team near you. But remember all are not created equal. Ask good questions about their experience level. Set up 2-3 consultations to see who you feel most comfortable working with.
Treating a lip tie isn’t just about improving how you look. It’s about enhancing how you feel, function, and thrive in everyday life.
Whether through surgical release, therapeutic interventions, or a combination of both, there’s hope for those who have unknowingly struggled with adult lip tie.
Check out our other articles on adults with tethered oral tissues here:
https://lynnstiedtogetherhub.com/blog/
Your smile and comfort should be effortless—lip tie treatment can make that possible.