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Tongue Tie Treatment: What You Need to Know

A child's mouth being examined by a dentist for tongue tie.

While many people are familiar with the expression ‘being tongue tied’, when someone is too shy to speak, tongue tie, or ankyloglossia, is actually a medical condition.

Tongue tie (ankyloglossia) affects many babies at birth. Although some babies improve with minimal or no treatment as they learn to accommodate their tongue tie, others may require surgery.

A child's tongue tie being examined by a dentist.

What Is Tongue Tie (Ankyloglossia)?

When the tissue known as the lingual frenulum, which attaches the tongue to the bottom of the mouth, is too short, it limits the movement of the tongue.

This condition can be inherited, and is more likely to occur in babies that have other conditions affecting the mouth or face, including a cleft palate.

Cause of Tongue Tie

During fetal development, the tongue and the base of the mouth fuse together. The tongue then starts to separate until only the thin piece of tissue, or lingual frenulum still attaches the two. Instead of shrinking and thinning, the lingual frenulum of a child with tongue tie stays thick.

The location or severity of the tie can vary.

A posterior tongue-tie is under the front of the tongue but less visible compared to an anterior tongue tie. An anterior tongue tie is at the very tip of the tongue, just behind the gums and teeth. Although posterior tongue ties may seem less severe than anterior tongue ties, the middle portion of the tongue that is affected is responsible for suction. This means it can have a significant impact on a child.

Anterior tongue-ties are more common than posterior tongue-ties.

Symptoms

Many babies won’t show any symptoms. As your child grows, the tissue may stretch, or your child may learn to adapt. However, there are some common symptoms.

Restricted tongue movement can lead to personal or social problems throughout life, as it impacts eating and speaking.

A newborn may have difficulty latching when breastfeeding, or needs to breastfeed for a longer time, and may be constantly hungry. Weight gain may be insufficient, as your baby has difficulty eating. Your baby may also make a clicking sound while feeding. Bottle fed babies are unlikely to show these symptoms, as it is easier to feed from a bottle.

As they grow, you may notice gaps between the front lower teeth, or speech problems, having difficulties making sounds that require touching the roof of the mouth or upper teeth with the tongue (such as the ‘t’ sound). Your child may have difficulty swallowing and licking, and other activities that use the tongue.

Adults may have issues breathing through the mouth, speaking clearly, and kissing. They may also experience jaw pain.

A young girl is getting her tongue tie checked by a dentist.

Having Tongue Tie Diagnosed

If you notice symptoms, you can ask your doctor or dentist; even if you don’t notice any, this condition may still be diagnosed by a professional.

A pediatrician or lactation consultant will often diagnose tongue tie in an infant, while dentists often diagnose it for older children or adults.

How Is Tongue Tie Treated?

If your child is having difficulty breastfeeding or exhibits any other symptoms of tongue tie, you can visit a dentist to ask about treatment options.

While some situations resolve on their own, in many cases, having tongue tie treated will improve function and lifestyle concerns significantly.

A close up of a woman's mouth with tongue out.

Surgical Treatment

If having a tongue tie causes speech problems or personal concerns for a child, a frenotomy or frenuloplasty may be done.

Frenotomy

In a frenotomy, the lingual frenulum is simply snipped to allow more tongue movement.

Frenetomy complications are rare but include infection, bleeding, and damage to the tongue or salivary glands. The lingual frenulum may also scar or reattach to the tongue.

Frenectomy or Frenuloplasty

This is a more involved procedure and is completed with general anesthesia with surgical tools. The frenulum is completely removed, and the surgical site is closed with absorbable stitches or sutures.

Tongue Exercises

After a frenotomy surgery, you will be given exercises and stretches to extend the tissue that was cut to prevent it from regrowing tightly. Tongue exercises need to be done daily for several weeks.

Specialist Support

For additional support, you can talk to a lactation consultant about breastfeeding problems, or a speech therapist about speech problems.

A close up of a child's tongue out.

Impacts on Dental Health

Tongue-tie also has negative impacts on dental health and can cause issues. It can lead to dental occlusion, or misalignment of the teeth and bite. Orthodontic treatments may be necessary to correct misalignments.

Talk to a Dentist

A frenotomy is a common dental procedure; your dentist can advise if you or your child could benefit from one and guide you on treatment. At Century Stone Dental, we will take time to answer your questions and concerns, and offer a treatment plan.

Dr Christopher Sims
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