In infants, surgery is usually indicated when the lingual frenulum restricts the tongue’s movement and compromises breastfeeding or breathing. A lactation consultant may also be indicated for consultation. 

In older children and adults, the indication is made when the tongue is visibly restricted, is unable to adequately reach the palate, or when possible distortions in speech are caused by limitation of the elevation of the tongue tip (especially in producing the sound of the “L” and “R”) that could not be corrected in speech therapy.