Tongue-Tie and Open Bite

Quick answer

A tongue tie and an open bite are two different problems that often appear in the same person, and a tongue tie can be one of several causes of an open bite. An open bite is a condition in which the front teeth do not meet when the jaw is closed, leaving a visible gap. A restricted lingual frenulum can hold the tongue low and forward, which pushes the front teeth apart instead of letting them come together, though thumb sucking, a forward-resting tongue posture, and skeletal jaw growth can produce the same gap on their own. Releasing a tongue tie helps only when restricted tongue movement is genuinely driving the open bite, which is why the assessment has to come before any procedure.

At a glance

• An open bite means the front teeth fail to overlap vertically when the jaw is closed; the normal overlap is about 1 to 3 mm.
• A tongue tie limits how far the tongue can lift, touch the roof of the mouth, and sweep side to side; many adults cannot touch the palate at all.
• Tongue thrust habit alone rarely opens the bite permanently; a persistent forward-resting tongue posture is the more common driver.
• Most frenectomy sites are comfortable within 7 to 14 days, with reattachment risk peaking roughly 2 to 4 weeks after surgery.
• Frenectomy billing codes are CPT 55110 for the lip and 55120 for the tongue; insurers often classify one as medical and the other as dental.
• The American Academy of Pediatric Dentistry recommends a child's first dental visit by the first birthday, well before most orthodontic open-bite concerns are visible.

What causes an open bite

An open bite is a dental relationship in which the upper and lower front teeth do not overlap when the mouth closes. The gap can sit behind the front teeth, between the front and back teeth, or at the sides, and the cause matters more than the appearance because each cause responds to a different treatment.

Four things commonly produce the same-looking gap:

1. A restricted tongue. If the tongue cannot seat on the roof of the mouth, it rests low and forward against the lower incisors. That forward pressure at rest is the mechanism most often blamed on tongue tie.
2. Persistent thumb or finger sucking. The thumb presses directly on the upper incisors, which flares and tips them forward. The front teeth then cannot meet.
3. A forward tongue posture without a tie. Some people have a perfectly mobile tongue that simply sits forward at rest. This is a posture habit, not a mechanical restriction.
4. Skeletal growth. A vertical jaw pattern or a mismatched jaw relationship can leave the front teeth apart regardless of what the tongue does.

The mechanical restriction case is the one where a release is genuinely relevant. That distinction is why providers often use a tongue range of motion test and a functional versus anatomical tongue tie assessment before recommending anything.

Tongue thrust vs tongue tie: how to tell them apart

Patients often use "tongue thrust" for any forward tongue movement, but the two behave differently and only one of them is a structural restriction.

Feature	Tongue tie (restricted frenulum)	Tongue thrust habit
Range of motion	Tongue cannot touch the roof of the mouth or barely reaches it	Full elevation and side-to-side movement
Tongue at rest	Held low by the tight band	Seats on the palate most of the time, slides forward when speaking
Speech impact	Substituted or distorted sounds, especially with a tight frenum	Generally normal articulation
Effect on the bite	Open bite or narrow arch with crowding	Often no bite change at all
Responds to a release	Often improves	Does not improve

Two simple checks help separate them at home. First, open your mouth wide and try to touch the roof of your mouth with the tip of your tongue while saying "ah" — if you cannot reach it, or feel a tight band pulling, the frenulum is limiting you. Second, watch yourself swallow: if the tongue rides up and forward behind the front teeth instead of lifting, you have a posture pattern rather than a fixed restriction. A fuller breakdown of the difference is in our tongue thrust vs tongue tie guide.

Importantly, tongue thrust during speech is common in young children and does not by itself predict an open bite. The finding that matters is where the tongue rests when the mouth is closed and still.

Does a frenectomy fix an open bite?

Sometimes, and only sometimes. The comparison below separates what a release changes from what it leaves alone.

Frenectomy vs no frenectomy for an open bite:

Outcome	With a release	Without a release
Tongue range of motion	Usually improves within 4 to 6 weeks	Unchanged; restriction remains
Existing front-tooth gap	May begin to close as the tongue seats on the palate	Gap may persist or widen
Thumb-sucking related gap	No meaningful effect	Habit intervention is what works
Crowding or arch width	May modestly improve	Unchanged
Skeletal jaw pattern	Unchanged	Unchanged
Time to see change	3 to 6 months of observation	Not applicable

A release works by removing the restriction, not by moving teeth. Any tooth movement that follows comes from the tongue changing position over months of repetition, which is why orthodontists often sequence the procedure before or during alignment. If braces are already in place, timing and coordination matter, and both scenarios are covered in our guides on frenectomy before braces and frenectomy after braces.

What to do next: a step-by-step plan

1. Document the tongue's range of motion. Note whether it can touch the palate and whether a tight band is visible or palpable under the tongue.
2. Get a dental or orthodontic assessment. Ask the clinician to look at tooth position, jaw growth pattern, and the resting tongue posture together rather than evaluating the gap alone.
3. Check for other causes. Confirm whether thumb sucking, a pacifier habit, a tongue-forward posture, or a skeletal pattern is contributing.
4. Ask what the release is expected to change. A good provider explains which findings would improve with a release and which will not.
5. Plan the recovery window. Book the procedure so you can follow a frenectomy stretch protocol for several weeks afterward, since reattachment is most likely in the first month.
6. Re-evaluate on a timeline. Allow3 to 6 months of post-release observation before judging whether the bite is changing.

How long until an open bite closes

The timeline depends on the cause and on the age of the patient.

• Structural restriction, released early. Tongue mobility typically improves within4 to 6 weeks, and the front teeth begin to move back toward each other over the following 3 to 6 months.
• Thumb habit stopped. Front teeth that tipped forward often begin to move back within 6 to 12 months of the habit stopping, and the gap closes more completely in children than in adults.
• Adults. Teeth move slowly through bone, and any closure in an adult open bite is gradual over many months rather than weeks. Many adults see positioning improve without a complete closure of the gap.

If the open bite does not begin shifting after a release and a few months of targeted posture work, the driving force is probably not the tongue frenulum, and an orthodontic assessment is the right next step. In children, it is worth seeking that assessment early, since the tongue tie and orthodontics relationship is easier to correct while the jaws are still growing.

Frequently Asked Questions

Can a tongue tie cause an open bite?

Yes. A tongue that cannot lift to the roof of the mouth rests forward and can push the front teeth apart, particularly during the years when the front teeth are erupting.

Is every open bite caused by a tongue tie?

No. Thumb sucking, a forward tongue posture without restriction, and skeletal jaw patterns are all common causes, and a release does nothing for those.

How do I tell if I have a tongue tie or a tongue thrust habit?

A tie limits tongue movement and keeps it from touching the palate; a thrust habit allows full movement but the tongue slides forward when speaking or swallowing.

Does the gap close after frenectomy?

Sometimes. It closes when the tongue position changes after the release; gaps caused by a thumb habit or jaw growth usually do not.

How long does a frenectomy take to heal?

Most sites feel comfortable within 7 to 14 days, tissue reattachment is most likely in the first 2 to 4 weeks, and scar softens over roughly 3 months.

Should I get braces at the same time as the release?

It depends on the plan. Many orthodontists release first so the tongue can seat before tooth movement begins, which is why the sequence is worth discussing before booking.

References

• American Academy of Pediatric Dentistry, "Management of the Developing Dentition and Occlusion in Pediatric Dentistry," The Reference Manual of Pediatric Dentistry.
• American Academy of Otolaryngology–Head and Neck Surgery, clinical practice guidance on ankyloglossia and tongue tie evaluation.
• Cochrane Database of Systematic Reviews, "Tongue-tie and breastfeeding" (Arya et al.), reviewing the quality of evidence for frenotomy in breastfeeding outcomes.
• Mayo Clinic, patient education resources on ankyloglossia (tongue tie) and its effects on feeding and speech.
• Cleveland Clinic, health library articles on frenectomy, tongue tie, and open bite in children.

Medical disclaimer

This article is general health information and is not medical advice. It cannot diagnose your condition or replace an evaluation by a qualified dentist, orthodontist, pediatric dentist, or oral surgeon. Causes of open bite and tongue tie vary widely between individuals, and treatment decisions should be based on your own examination. Reviewed by the frenectomyguide.com editorial team · Last updated 2026-10-31.