What is Tongue-Tie?

If you look under your tongue in the mirror, you’ll notice a small piece of tissue that connects your tongue to the bottom of your mouth–the frenulum. Around 10% of babies are born with a condition commonly known as tongue-tie, where the frenulum is shorter or thicker than average, limiting the motion of their tongue. If severe, this condition can interfere with a child’s ability to eat and speak as well as impact their oral health.

Tongue-tie is a congenital condition, known as ankyloglossia, in which the lingual frenulum connecting the tongue to the floor of the mouth may be shorter, thicker, or tighter than normal restricting the motion of the tongue.

In mild cases, treatment may not be necessary, however, it is possible for the condition to present difficulties later in the child’s life as they continue to grow and develop.

In mild cases, symptoms may not interfere with day-to-day activities but can worsen with age.

Mothers may notice their infant having difficulty latching or pain during nursing as the tongue-tie can prevent an adequate seal while breastfeeding causing the child to use their gums to feed. Other signs in infants may include breastfeeding for long periods, constant hunger, trouble gaining weight, or a clicking sound while feeding.

If the condition is not treated in childhood, the patient will adapt to living with the condition. Limited tongue mobility can lead to the following symptoms:

Tongue-tie limits the tongue’s movement which can impact the way a person eats and swallows. This can affect the amount of saliva in the mouth which is crucial to helping wash away debris, oral bacteria, and plaque. In severe cases, tongue-tie can increase a patient’s risk for gum disease, tooth decay, and cavities.

As the child grows, speech impediments may occur as the restriction of the tongue can prevent proper articulation and may develop a lisp. Certain sounds such as “T”, “D”, “S”, “Z”, “Th”, “N”, “L” can be difficult to enunciate.

Sleep apnea is a condition in which the body stops breathing repeatedly during sleep. One of the causes of sleep apnea can be an underdeveloped palate commonly associated with patients with tongue-tie. Patients with tongue-tie can be at an increased risk of sleep apnea. Signs of sleep apnea include daytime sleepiness, morning headaches, memory problems, and difficulty concentrating.

If the movement of the tongue is restricted, the mouth will adapt to accommodate the limited range of motion. This can lead to improper development of the jaw, mouth, and palate which may impact tooth alignment. If these bones are narrower or smaller than average, you may be at risk of temporomandibular joint pain and dysfunctions which can include severe jaw and neck pain, headaches, popping sound when moving your jaw, and difficulty opening and closing your jaw.

Although treatment is preferred as soon as possible during childhood, adults can still seek treatment to increase their quality of life. In mild cases, myofunctional therapy may be recommended which includes exercises to help improve control and strength of the tongue.

Surgical treatment is often used to treat tongue-tie. The procedure is known as frenotomy and is a quick and simple surgery. During the procedure, the area is numbed with a local anesthetic and the lingual frenulum is cut, freeing the tongue.

Complications are rare but can include bleeding, infection, scarring, and damaged salivary glands.

Following treatment, your doctor may recommend certain exercises that involve moving or holding your tongue in certain positions to strengthen the muscle.