TONGUE-TIE (ANKYLOGLOSSIA) IS A CONDITION WHERE YOUR CHILD’S TONGUE IS STICKED TO THE BOTTOM OF THEIR MOUTH. SYMPTOMS INCLUDE DIFFICULTY BREASTFEEDING AND SPEAKING. A SIMPLE SURGICAL PROCEDURE CAN CURE THE PROBLEM.

What is tongue tie?

Tongue tie, also known as ankyloglossia, is a condition in which a person’s tongue remains stuck to the floor of their mouth. This occurs when the lingual frenulum (a thin strip of tissue connecting your tongue and the floor of your mouth) is shorter than normal. A short frenulum can restrict the movement of your tongue.

Ankyloglossia is most common in newborns and young children, but it can also occur in adults. It is associated with breastfeeding (breastfeeding) difficulties and speech problems. Tongue tie is a congenital condition, meaning people are born with it.

What is the difference between anterior tongue tie and posterior tongue tie?

Anterior tongue tie is at the front of your child’s mouth, near the tip of his tongue, just behind his lower teeth and gums. It usually looks like a fine mesh. Posterior tongue tie (sometimes called “hidden” tongue tie) is located further back, where the floor of the mouth meets their tongue, making it difficult to see.

Anterior tongue ties are more common than posterior tongue ties.

Who does tongue tie affect?

Anyone can develop tongue tie. In some cases, ankyloglossia is hereditary (meaning it runs in families). Tongue tie mostly affects newborns and young children. However, it is possible for older children and adults to have this condition.

How common is this condition?

Ankyloglossia occurs in up to 10% of newborns (depending on the study and definition of tongue tie).

Does tongue tie go away?

In some cases, children learn to adjust to tongue tie as they grow older. But if ankyloglossia is causing problems, it’s best to treat it early, as some symptoms worsen with age.

SYMPTOMS AND CAUSES

What are the symptoms of tongue tie?

Tongue tie symptoms range from mild to severe. Your child’s tongue may appear heart-shaped or have a notch in it. In most cases, ankyloglossia is mild enough that the symptoms do not affect daily life.

Newborn tongue tie can cause:

• Difficulty latching on while breastfeeding.
• Breastfeeding for a long time.
• Constant hunger.
• Trouble gaining weight.
• A clicking sound while your child is breastfeeding.

If you are breastfeeding, your child may also have symptoms related to tongue tie:

• Cracked, painful nipples.
• Pain during nursing.
• Insufficient milk supply.

Symptoms of tongue tie in young children may include:

• Difficulty speaking with sounds that require your child’s tongue to touch the palate or upper front teeth. Tongue tie does not affect the number of words your child has or says, only their pronunciation.
• difficulty swallowing
• Difficulty moving their tongue against their palate or from side to side.
• Difficulty licking ice cream.
• Difficulty playing a wind instrument.
• Problems sticking their tongue out and up.

Adult tongue tie can cause:

• Mouth breathing.
• Inability to speak clearly.
• Difficulty kissing.
• jaw pain
• Language pressure.

What causes tongue tie?

During fetal development, the tongue and floor of the mouth fuse together. Over time, the tongue separates from the floor of the mouth. Finally, only a thin band of tissue (lingual frenulum) connects the bottom of the tongue to the floor of the mouth.

As the baby grows, the small band of tissue under the tongue becomes smaller and thinner. In children with ankyloglossia, the band of tissue remains thick, making it difficult to move the tongue.

DIAGNOSIS AND TESTS

How is tongue tie diagnosed?

Ankyloglossia in babies is usually diagnosed by a pediatrician or lactation consultant.

Dentists often diagnose tongue tie in older children and adults.

Does tongue tie affect speech?

The true impact of tongue tie on speech is not fully understood. Your child’s tongue must be in contact with the palate when pronouncing the linguistic sounds “t”, “d”, “z”, “s”, “th”, “n” and “l”. When their tongue is severely restricted and cannot reach the roof of their mouth, your child may have problems with articulation (pronunciation).

Speech therapy is helpful for many children with ankyloglossia. Tongue tie surgery may also be necessary for optimal results.

TONGUE TIE TREATMENT

How does tongue tie affect breastfeeding?

To create an adequate seal while breastfeeding, your baby needs to extend his tongue above his jawline. This is not possible if your baby has tongue tie. They often try to use their gums to hold the nipple in their mouth while breastfeeding. This can be painful.

Is tongue tie surgery necessary?

In some cases, tongue tie is not severe enough to cause noticeable symptoms. Babies and toddlers who have a tongue tie but do not have problems feeding, swallowing, or speaking may not need treatment.

If your child has a tongue tie and is having trouble feeding, their doctor may perform tongue tie surgery and cut the tongue frenulum. This is called a frenectomy (also known as a frenulectomy, frenotomy, or tongue-tie section). In babies, it is usually done without sedation.

Tongue tie surgery causes minimal discomfort for babies. Young children and adults may receive pain medications or general anesthesia before the procedure.

As with any surgical procedure, the tongue tie procedure carries risks of complications, including:

• Bleeding.
• Infection.
• Scar.
• Injury to the salivary ducts in your mouth.

What happens if I don’t treat tongue tie?

If left untreated, moderate to severe cases of tongue tie can cause problems including:

•  Nutritional problems that may cause inadequate weight gain or malnutrition . (Breastfeeding a baby with a tongue tie is often more difficult than bottle feeding.)
• Speech impediments that can cause problems at school.
• Difficulty eating certain foods.

Can I prevent tongue tie?

Because people are born with tongue tie, there is no way to prevent it. In more serious cases of tongue tie, early diagnosis and treatment is the key to a successful recovery.

What can I expect if my child has tongue tie?

Most babies and children with tongue tie recover completely with minor surgery and/or speech therapy. Some may not need treatment at all.

What questions should I ask my healthcare provider?

If your baby has tongue tie, here are some questions you may want to ask healthcare professionals:

• How can I make sure my child is getting adequate nutrition?
• Could tongue tie be the cause of my child’s breastfeeding or feeding difficulties?
• Is frenectomy the right treatment for my child?
• Is it necessary to have a frenectomy immediately or can it wait?
• If my child has a frenectomy, what postoperative complications should I watch out for?

Tongue tie is a relatively common condition that can lead to potential feeding problems or speech problems. People with congenital tongue tie can recover over time without treatment. However, in most cases, tongue tie surgery is necessary. During this simple procedure, your child’s surgeon clips the lingual frenum, allowing his tongue to move freely and without restriction. Tongue tie surgery is a simple way to relieve ankyloglossia symptoms. Ask your child’s doctor about treatment options and timelines  .