Holistic Pediatric Lens

A holistic, pediatric lens: this is the consistent and primary tool through which we view your child - we see the whole child. While the research estimates vary, tongue tie is probably more common than recognized. Some studies indicate that as many as 5-20% of children may be affected by ankyloglossia (tongue tie) and many cases are familial.

Agave Pediatrics, under the direction of Dr Rajeev Agarwal, has developed a clinically successful, evidence-based, compassionate and thorough approach to the treatment of tongue tie and upper lip tie. With well over a decade of experience and having completed over 10,000 successful corrective procedures, our conservative model of care is highly sought after.



Our multi-disciplinary team of doctors, lactation consultants, speech pathologist and nurse practioners specializes in diagnosing and treating children of varying ages with tongue ties and lip ties not just in Phoenix, but all over the state. We have performed thousands of corrective procedures with astounding success, facilitating healthy breastfeeding for babies and mothers as well as improved speech and dental health for older children. 

We have pioneered the concept of pre-procedure consult and post-procedure follow up in our care protocols. In addition we offer specialty post-frenectomy clinics and  use cutting edge laser technology to perform the frenectomy. Many other practitioners  do not do pre or post procedure consults and follow up. They may also use scissors or electro-cautery, which may increase the risk of bleeding, or pain  after the procedure, when compared to the laser method.


Dr. Agarwal at Agave Pediatrics has performed thousands of theses procedures and has an impeccable safety and success record. Our team at Agave Pediatrics is committed to remaining advocates of infant and child health. 


Do No Harm

Do No Harm: With this concept as our guiding principle, Agave Pediatrics consistently follows a well-established protocol for the treatment of tongue ties. Our model of care includes a coordinated, well-rounded approach by our multi-disciplinary team which has achieved a high rate of success in improving lives of children diagnosed with tongue tie.


Specialists on our Tongue Tie Team include pediatricians, nurse practitioners, speech language pathologists, lactation consultants, and our all-important tongue tie schedulers and coordinators.

Parent education about the procedure, including aftercare, are important components of our program.


The parents are an essential part of their child’s treatment!  We have a balanced approach that allows time for parents to absorb information and receive ongoing support as the treatment process moves forward.

We believe that most feeding difficulties in a child diagnosed with both tongue tie and a lip tie, often arise primarily from the tongue. In respect to corrective procedures, we  believe in the concept that “less in more”. We usually perform a tongue tie procedure first and do the lip tie two weeks later, only if needed. Such children are followed by close observation to see if a lip procedure is needed. One procedure alone is often all that such children need for successful management. ..

Education & Research

Our team has been very active &  instrumental in disseminating information and educating providers about tongue tie all over the world. This  has been achieved through on site training in our clinics, as well as participation in national & international conferences

Agave has also been conducting original research in the tongue tie field. The team members of Agave are working on several IRB approved  clinical and translational research projects, including: genetics and diagnostics of tongue tie as well as development of a novel oral manometer to aid in oral dysfunction diagnostics. Collaborative research partners include Phoenix Children's Hospital, Arizona State University and leading companies like LightScalpel and PADT, Inc.


Please visit our Events & Health Care Professional  pages for more information about upcoming clinics, meetings and conferences where the Agave team will be presenting its work and research findings.


Photo May 14, 10 34 50 AM.jpg

Lip Ties are Different

While an upper lip tie may cause problems, research indicates the tongue as the primary contributor to feeding challenges, speech difficulties, and oral motor dysfunction. Agave providers take all procedures involving children very seriously and we approach the surgical correction of oral ties with a conservative, necessity-based model of care.


A lip tie may or may not need correction. New evidence on this topic continues to emerge but current research does not support the necessity of performing both procedures, ie tongue and lip tie, 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. In roughly 50% of patients, this “watchful waiting” results in improved feeding or speech without having undergone an upper lip tie procedure. Two or more surgical wounds in a child’s mouth, with limited options for pain management, may increase a child’s risk of poor feeding related to pain and subsequent dehydration, oral or feeding aversions, bleeding, and reattachment to at least one site as parents must perform double the amount of wound care exercises. These are well-defined risks and all the more reason to take caution when making surgical decisions.


We have a large number of satisfied parents, of kids who were treated for tongue and / or lip tie ,who have provided testimonials over the years. We  also have a Facebook group page devoted to kids who have had a frenectomy or may be candidates for the procedure. Here is the link to  Phoenix tongue and lip tie support group.


Check out our testimonials page for what some of the parents of children treated @ Agave are saying. 

twins with parents.jpg