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Agave Pediatrics Tongue & Lip Tie Program

We follow a holistic approach to the diagnosis and treatment of tongue and lip ties. The majority of our patients are infants and young children, but we treat tongue and lip ties in people up to 18 years of age, and your experience at Agave will be highly individualized.


Our multidisciplinary team includes pediatricians, nurse practitioners, and lactation consultants, as well as bodywork and feeding therapy services. This lets us gather a comprehensive understanding of how tongue and lip ties are affecting your child, allowing us to provide the best chances of resolving symptoms.

Consults can be booked at any of our 5 locations, with frenectomy procedures carried out at our Goodyear, Glendale, and Chandler locations.

Collage of parents with infants

Signs & Symptoms

What is a tongue tie/lip tie?

The lingual frenulum (tongue tie/ankyloglossia) is the small band of tissue that connects the underside of the tongue to the floor of the mouth, and the labial frenulum (lip tie) is the tissue that connects the upper lip to the gum-line. When the tissue is too tight, short, or thick, these oral ties restrict movement, affecting breastfeeding parents, infants, and children in a variety of ways:

Breastfeeding parents - nipple pain, cracked nipples, flattening of nipples, clogged ducts, mastitis

Infants - poor latch, clicking, leaking, choking/gagging, reflux, gas, long feed times, frustration, poor weight gain, difficult transition to solids

Older children - speech delay/difficulties, snoring, sleep apnea, teeth grinding, dental plaque, pocketing food, messy eating, long feed times



If you are considering the possibility of tongue or lip tie in your child who has feeding, speech, or sleep problems, you have come to the right place. With proper support and prompt treatment, these problems can be improved over time and positively resolved. From the time you schedule a consultation to your final follow-up appointment, you and your child will be cared for with the utmost skill and compassion by each of our specialists.

An initial consult with one of our specialist nurse practitioners can be booked for any one of our five locations. Please call us for more information and to schedule a consultation.


Procedure, Exercises, & Aftercare

If clinically indicated in the consult, a frenectomy procedure will be recommended. On the day of the procedure, Dr. Agarwal will assess your child once again, and will discuss the procedure and possible complications with you.


During the procedure, a CO2 laser is used to release and cauterize the tissue under the tongue or lip. As the tissue is being released, it is continually checked for any bleeding and appropriate range of motion such as lift and extension. The procedure involves little to no pain for the child, has improved feeding and speech for many children, and Dr. Agarwal has completed over 10,000 of these procedures.

After the procedure, Dr. Agarwal will show you the results, and exercises, wound care, and pain management will be reviewed with you. You will also be seen by a lactation consultant who will assist you with breastfeeding or bottle-feeding (if appropriate for your child), and will answer any additional questions you may have.

A follow-up appointment is scheduled 2 weeks after the procedure to evaluate the healing process and address any issues that have not improved. We also offer a free post-procedure clinic at our Glendale, Goodyear, and Chandler locations. Please contact us for more information.



Breastfeeding support sessions (lactation services) are provided at our locations around the valley by our in-house IBCLCs. As soon as you notice breastfeeding difficulties, we recommend making an appointment.

In the lactation session, the IBCLC explains how to stimulate suckling, adjusts the infant's position and helps with correct latch, teaches parents how to tell the infant is transferring milk, and more. 




Bodywork is an important part of the tongue and lip tie program. Torticollis, plagiocephaly, and other musculoskeletal problems can lead to breastfeeding difficulties even in infants without oral ties.


Gentle release of muscle tightness and tension through myofunctional therapy, craniosacral therapy, and Osteopathic Manipulative Medicine (OMM) can help treat these problems.

The Agave Approach

Agave staff collage

Holistic Pediatric Lens

Agave Pediatrics, under the direction of Dr. Agarwal, has developed a clinically successful, evidence-based, compassionate, and thorough approach to the treatment of oral ties.

Lip Ties are Different 

New evidence on this topic continues to emerge but current research does not support the necessity of performing both tongue and lip tie procedures at the same visit. In fact, many children never undergo release of the upper lip tie because of the improvement noted to feeding or speech after a tongue tie procedure alone.

Multidisciplinary Approach

Our team of MD and DO physicians, lactation consultants, speech pathologists, and nurse practitioners specializes in diagnosing and treating children of varying ages with tongue ties and lip ties - not just in Phoenix, but all over the state of Arizona!

Do No Harm

With this concept as our guiding principle, Agave Pediatrics consistently follows a well-established protocol for the treatment of tongue and lip ties, and will not perform frenectomy procedures unless clinically necessary.

Education & Research

Our team has been very active and instrumental in disseminating information and educating providers about tongue tie all over the world.

Collage of parents with children


Click the button below to view some of the recent testimonials from satisfied families. Please feel free to browse through these & numerous other accolades, testimonials, and praise that we have accumulated over more than a decade of tongue and lip tie management that are available on video, our companion site or social media.

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