There can be variations in the type of lip tie depending on the extent of attachment of the frenulum to the upper gum. The following are the various grades of lip tie created by Dr. Kotlov, a dental surgeon (10):
Grade 1: The attachment of the frenulum to the upper gum is minimal and not significant enough to cause any problems.
Grade 2: The frenulum extends further into the upper jaw but mostly attaches to the gingival tissue.
Grade 3: The frenulum tissue attaches to the ridge of the upper jaw gums and occupies the space between the two front teeth of the upper jaw.
Grade 4: It is an extreme case of lip tie where the frenulum tissue extends beyond the upper gum and almost reaches the upper palate of the mouth.