Tongue-tie is the non-medical term for a relatively common physical condition that limits the use of the tongue, ankyloglossia. Before we are born, a strong cord of tissue that guides development of mouth structures is positioned in the center of the mouth. It is called a frenulum. After birth, the frenulum continues to guide the position of incoming teeth. As we grow, it recedes and thins.
- Tight frenulum
- Frenulum failing to recede
- Abnormal attachment of the base of the tongue (lingual frenulum) towards the tip of the tongue
- A new baby having trouble sucking leading to poor weight gain
- Nursing mothers experiencing significant pain while nursing or baby having trouble latching on
- Speech defects, especially articulation of the sounds - l, r, t, d, n, th, sh, and z.
- V-shaped notch at the tip of the tongue
- Inability to stick out the tongue past the upper gums
- Inability to touch the roof of the mouth
- Difficulty moving the tongue from side to side
- Dental problems
- Persistent gap between the two front teeth of the bottom jaw or row
Tongue tie often resolves on its own after two or three years of age. As a child grows and develops, the frenulum often continues to recede (normally it recedes before birth), lessening the abnormality. Unless feeding is a problem, it is recommended to wait at least a year before considering surgery. If tongue tie interferes with a baby’s feeding, early intervention is usually warranted.
Tongue-tie surgery (frenulectomy) is a simple procedure and there are normally no complications. For very young infants (less than 3 months old), it may be done in the out-patient consultation room of the ENT specialist. General anesthesia may be recommended when frenulectomy is performed on older children. While frenulectomy is relatively simple, it can yield big results. A few dissolvable stitches may be placed to re-approximate the mucous membrane of the tongue. The whole procedure takes approximately 15 minutes. Risks of frenulectomy are very low.
Parents should consider that this surgery often yields more benefit than is obvious by restoring ease of speech and self-esteem.
There is no way to prevent ankyloglossia.