Understanding Tongue Tie and Its Implications
What is Tongue Tie?
Tongue tie, or ankyloglossia, is a condition present at birth where the tongue remains attached to the mouth’s bottom due to a tissue called the lingual frenulum being too short or tight. This can affect essential oral functions, impacting everything from feeding in babies to speech and breathing in older individuals.
The signs and symptoms of tongue tie can vary significantly among individuals. Some individuals might display just one symptom, while others could experience a combination of many. It’s essential to recognize these signs early on, especially in infants, as tongue tie can affect their ability to feed properly.
- Struggling to latch during feeding
- Not gaining weight or even losing weight
- Making clicking sounds or milk leakage while nursing
- Frequent breaks during feeding
- Longer feeding times
- Mothers experiencing pain while breastfeeding or a decrease in milk supply
- A heart-shaped appearance of the tongue when extended
For Children and Adults:
- Restricted tongue movement
- Difficulty sticking the tongue out beyond the lower front teeth
- Challenges with certain speech sounds like “T”, “D”, “Z”, and others
- Potential dental hygiene issues
- Struggles with activities such as licking lips or playing wind instruments
- Dental procedure concerns related to gagging reflex
- Misalignment of the jaw and teeth
Why Does It Happen?
While the exact cause is still a mystery, some cases seem to have a genetic connection. Typically, during early development, the tissue connecting the tongue should naturally disappear. In cases of tongue tie, this doesn’t happen fully, causing the tongue to remain attached.
The decision to treat tongue tie largely depends on the severity of the condition and the manifested symptoms. In many cases, especially when the symptoms are mild, a wait-and-watch approach may be recommended. However, if tongue tie is causing significant feeding or speech problems, interventions might be necessary. Some treatments are:
- Frenotomy: Suitable for infants with feeding problems, this procedure involves a quick cut to the frenulum. With advanced techniques, this is now often done using a Dental LASER. The procedure is generally painless, with babies often feeding right after to ease any minor discomfort.
- Frenuloplasty: Used when the frenulum is too thick for a frenotomy, this more detailed surgical procedure involves cutting and then stitching the tissue. It’s typically recommended for older children or adults. Exercises before and after surgery are crucial to ensure the tongue gains full mobility.
- Speech Therapy: For those facing speech challenges due to tongue tie, therapy can help in improving speech patterns and articulation.
- Lactation/Feeding Consultation: Mothers struggling with feeding because of their baby’s tongue tie can benefit from a lactation consultant’s insights, providing techniques to make feeding easier.
- Jaw and Dental Alignment: Tongue tie can contribute to issues such as encouraging underbites or the jaw not growing enough. This can result in adult teeth not having enough room when they grow in. Addressing both tongue tie and orthodontic issues together encourage the best results; it’s no good to wear braces if your jaw still doesn’t provide enough room for your teeth and they move back to their original positions.
Tongue tie can impact an individual’s life from infancy to adulthood. The symptoms can vary, and while some of its causes remain unknown, genetic factors might be involved in certain cases. Treatments range from consultations to surgeries, depending on the severity. Always consult with healthcare professionals if you suspect or have been diagnosed with tongue tie to ensure the best care and outcome.
The following are some more symptoms we may experience:
- Poor latch, unable to sustain a latch
- Colic & excessive gassiness
- The baby often loss suction whilst feeding and sucks in air
- Difficulty with adequate milk intake
- Poor weight gain
- A clicking sound may be heard whilst the baby is feeding
- Falling asleep on the breast
- Extended nursing episodes
- Unable to develop a deep enough latch
- Early weaning from the breast
- Tongue cannot be moved sideways
- Tongue cannot protrude beyond the baby’s lips
- Tongue tip may be notched or heart-shaped
- Restricted mobility interferes with bottle feeding
- Gap between the front teeth
- When extended, the tongue tip may look flat or square instead of pointed
- Difficult for babies to attach to the breast or bottle correctly as it is harder for them to maintain a good seal
- Restrict movement of the upper lip preventing it from being able to flange or ‘pull out’
- Inability to chew age appropriate solid foods
- Gagging, choking or vomiting foods
- Persisting food fads
- Difficulties related to dental hygiene
- Persistence of dribbling
- Delayed development of speech
- Deterioration in speech
- Behaviour problems
- Dental problems starting to appear
- Loss of self confidence because they feel and sound ‘different’
- Airway issues
- Mouth breathing
- Inability to open the mouth widely affects speech and eating habits.
- Always having to watch their speech
- Inability to speak clearly when talking fast/loud/soft
- Difficulty talking after even moderate amount of alcohol
- Clicky and/or painful jaws
- Protrusion of the lower jaws
- Multiple effects in work situations.
- Effects on social situations, eating out, kissing, relationships
- Dental health, a tendency to have inflamed gums, and increased need for fillings and extractions
- Sensitivity about personal appearance
- Emotional factors resulting in rising level of stress
- Tongue tie in the elderly often makes it difficult to keep a denture in place.
- Often associated with posture issues, abnormal head tilt and neck & shoulder pain