Frequently Asked Questions
Tongue tie, also called ankyloglossia, is a medical condition. The lingual frenum is a small fold of mucous membrane that extends from the floor of the mouth to the midline of the underside of the tongue. A tongue tie is simply a lingual frenum that is tight enough to restrict the movement of the tongue.
A tongue tie is fibrous tissue that can be long, short, thick or thin. The lingual frenum stretches from underneath the tongue to the floor of the mouth. Each one looks unique and the position of the frenum underneath the tongue also varies. Some are positioned in the front and some further back. It is not the look of the tissue that matters though, but rather the function and symptoms that the attached tissue is causing.
The frenum is a remnant of tissue that was part of an infant's facial structure during early pregnancy. Usually it disappears or reduces to a very slight, elastic membrane which does not limit the tongue in its movements or disrupt function. Similar webs of tissue also occur in the lip and cheeks, which like a tongue tie, can be released with a laser. When the frenal attachments cause problems, it is because the tightness, thickness or width of the frenum affects function.
Tongue tie is very common, but often not diagnosed even when it causes problems. All individuals have a lingual frenum, but for some the frenum is tighter. It is more common in boys.
When the lingual frenum is normal, it should be elastic and should not interfere with the movements/proper positioning of the tongue. Newborns, infants and children should not have a problem with sucking, eating, clearing off food with their tongue, swallowing and speech. When the lingual frenum is short, thick, tight or broad it can result in various issues with function, feeding, speech and airway.
Since a tongue tie is a structural anomaly, the structural defect must be physically corrected. Early intervention is recommended to avoid the formation of incorrect habits of using the tongue in feeding and speech. The tongue tie is released using a minimally invasive laser. Stitches are not needed, and there is minimal to no bleeding.
Release of the frenum by a laser causes little pain. Topical anesthetic is used to soothe the tissue prior to the procedure, which takes less than a minute. Revision by laser causes very little pain as well. Over the counter pain medication (Motrin, Tylenol, etc) may treat post-operative sensitivity effectively.
Oral exercises following a tongue tie release is crucial to its success. The treating doctor reviews the exercises following the procedure. Collaboration with a speech pathologist, lactation consultant or a chiropractor may also be recommended for optimal success.
Tongue tie may be diagnosed by family doctors, dentists, lactation consultants, ENT doctors, surgeons, or speech-language pathologists. Checking for the presence of a tongue tie should be part of every newborn examination to avoid the possibility of infant feeding problems.
No. it is never too late. Adults with problems report the following improvements: ability to chew better, not biting their tongues or cheeks when chewing, a sense of space in the mouth, improvements with speech, not having to think before they speak, relief of tight, clicking jaw, tension headaches and migraine, improved oral and dental health, and ability to control a lower denture! However, the strong oromuscular habits acquired while the tongue tie was present will be harder to get rid of in adults. Speech therapy after surgical revision is strongly recommended.