Tongue tie is an oral condition present at birth that limits the tongue’s range of motion. This is because an abnormally thick or tight band of tissue ties the bottom of the tip of the tongue to the mouth’s floor. But tongue tie does not just make it difficult for a person to stick out their tongue. It can also interfere with a number of other things, such as breastfeeding, eating, speech and even dental health.
Research suggests that between 4% and 11% of newborns have a tongue tie. While it is possible for tongue ties to not cause any problems, some cases will need to be corrected with surgery. Now that we have answered the question “What is tongue tie?”, we will discuss the common symptoms, risk factors and treatments.
What Causes Tongue Tie?
The lingual frenulum refers to a web of tissue that attaches the tongue to the floor of the mouth. In most cases, the tissue separates before babies are born, allowing the tongue to move freely. However, with a tongue tie, the lingual frenulum does not separate and remains attached to the bottom of the tip of the tongue. The exact reason for this is largely unknown, but research suggests that tongue tie may be the result of genetic factors. It is also worth noting that this condition is more common in boys than girls.
Symptoms
Signs that a person has a tongue tie include:
- Difficulty moving their tongue from side to side
- Difficulty lifting their tongue
- Difficulty sticking their tongue out
- Their tongue appears heart-shaped or notched when they stick it out
During breastfeeding, tongue ties can impact prevent babies from latching on to the breast properly. A baby with a tongue tie may:
- Struggle to latch on to the breast or stay attached for a full feed
- Be unsettled or appear to be constantly hungry
- Struggle to gain weight as quickly as they should
- Make a clicking noise during feeding which indicates that they need support with the positioning and attachments
- Feed for a long period of time, take a short break and then feed again
Complications
This condition can affect a person’s oral development and lead to a range of complications, including:
- Unclear speech – People may have difficulty coordinating tongue movements to make certain sounds, such as ‘l’, ‘r’, ‘t’, ‘d’, ‘z’, ‘s’, and ‘th’
- Breastfeeding problems – To successfully breastfeed, babies need to keep their tongues over the lower gums while sucking. But with a tongue tie, a baby may chew as opposed to sucking on the nipple. This can lead to poor nutrition for babies
- Poor oral health – Later in life, tongue tie can make it challenging to sweep food debris from the teeth, leading to inflammation of the gums, tooth decay and a potential gap between the two bottom front teeth
- Difficulties with other oral activities – This includes licking ice cream, kissing and playing certain instruments, such as the flute, clarinet or trumpet
When To See A Doctor
It is advisable to seek medical advice if:
- Your baby is having trouble breast-feeding due to a potential tongue tie
- A speech-language pathologist believes that a tongue-tie is affecting your child’s speech
- Your older child is experiencing tongue issues that make it difficult for them to eat, speak or reach their back teeth
- You are struggling with your own symptoms of tongue tie
Treatment
While treatment is not always necessary, surgery may be required if a tongue tie interferes with breastfeeding, eating, speech or other oral activities.
Tongue tie division is a very simple procedure that involves cutting the piece of skin that attaches the underside of the tongue to the floor of the mouth. This procedure is usually quite quick and almost painless. It can be carried out by doctors, nurses or midwives. Plus, it can immediately improve breastfeeding.
Very Young Babies
Generally, the procedure is done without anaesthetic for babies that are only a few months old. There is no need to worry about pain as there are very few nerve endings or blood vessels in this area. Some babies even sleep through the procedure while others may cry a little.
Older Babies
For older babies, a general anaesthetic is usually required so they sleep through the procedure and do not feel pain. Sharp, sterile scissors with blunt ends are used to free the tongue. Babies may get an ulcer under their tongue, but the good news is that it will not bother your baby and should heal in 1 to 2 days.
Older Children and Adults
As people get older, an untreated tongue tie may not cause any problems. In some cases, the tightness may resolve naturally as the mouth develops. But if a tongue tie affects speech and eating, it is a good idea to speak to your doctor.
If tongue-tie division is performed on a child or adult, it will usually be done under general anaesthetic. Stitches may be used to close the incision and they will dissolve on their own.
Other Oral Ties
There are other oral ties that can be found at birth, including:
- Upper lip ties – This soft tissue ties the anterior gums to the upper lip and can cause feeding problems, tooth decay and other dental problems
- Buccal ties – Also known as cheek ties, this is an abnormal tie that extends from the cheeks to the gums
Get Support From our Tongue Tie Specialists
Our talented team of ENT doctors excel at diagnosing and treating tongue ties in babies, older children and adults. We will determine whether you or your child has a tongue tie and will advise on whether tongue tie correction surgery is required. We can even perform the surgery on the same day as your consultation. Get in touch with us to book your appointment at our specialist tongue tie clinic today.