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What Makes
The Agave Approach 

Child smiling with open mouth

We are proud to offer a complete solution to issues related to oral ties. We have more than a decade long history with over 10,000 procedures performed with extremely high success rates. However, we also manage a significant proportion of referrals to us through careful observation without performing a procedure. Our team at Agave Pediatrics is committed to being advocates for your children and helping your family to get the best results. 

Our team has been instrumental in disseminating information and educating providers all over the world on our approach to tongue and lip ties through national & international conferences. 

Holistic Pediatric Lens

We view your child through a holistic pediatric lens and consider all potential diagnoses that may be causing feeding problems, speech difficulties, or other symptoms. For example, infant neck tightness (torticollis) can cause an infant to prefer feeding on one side, with feeding difficulties present only when feeding on the other side. Spit up (reflux) can be caused by the infant consuming air due to a poor seal around the breast, or can be caused by food allergies that can be passed through the milk. 

Our holistic approach is supported by our multidisciplinary team - we offer lactation support, speech and feeding therapy, and bodywork services in-house to rule out other diagnoses and treat any of the wider symptoms of tongue and lip ties.

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. We take all procedures involving children very seriously and approach the surgical correction of oral ties with a conservative, necessity-based model of care.


In roughly 50% of patients, “watchful waiting” after a tongue tie release results in improved feeding or speech without the need for 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.

Do No Harm

​Our conservative model of care is highly sought after, and includes a coordinated, well-rounded approach by our multidisciplinary team which has achieved a high rate of success in improving lives of children diagnosed with tongue and lip tie. We use CO2 lasers for our procedures as they lead to less bleeding and pain than electrocautery or scissors.
We believe in the concept that “less is more” when it comes to frenectomy procedures. We usually perform a tongue tie procedure first and will correct a lip tie two weeks later, only if needed. Any children with both tongue and lip tie are followed by close observation to see if a lip procedure is needed. One procedure alone is often all that children need for successful management.

Multidisciplinary Approach

Our team of doctors, lactation consultants, speech pathologist and nurse practitioners specializes in diagnosing and treating children of varying ages with tongue ties and lip ties, and are committed to remaining advocates of infant and child health. Having performed over 10,000 corrective procedures with astounding success, we facilitate healthy breastfeeding for infants and parents, as well as improved speech and dental health for older children. 

We pioneered the concept of pre-procedure consult and post-procedure follow up in our care protocols and also offer specialty post-frenectomy clinics. With in-house lactation support, feeding therapy, and bodywork, we are able to treat the wider symptoms of tongue and lip ties.


Child looking at office decor

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 devoted to parents of kids who have had a frenectomy or may be candidates for the procedure. 


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

Education & Research

Parent education about the procedure, including aftercare, is an important component of our program.We have a balanced approach that allows time for parents to absorb information and receive ongoing support as the treatment process moves forward.


Our team has also educated healthcare providers about tongue and lip ties 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, lip tie, and breastfeeding fields. The research team at Agave are working on several IRB-approved clinical and translational research projects, including the genetics and diagnostics of tongue/lip ties, relationship between tongue/lip tie and neurodevelopmental disorders, and 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.

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