Tongue Tied

Updated: Apr 16, 2020

Tongue and Lip Ties seem to be more prevalent in recent years. Many question why they have become a rising issue in neonatal health. According to Tongue Tie specialist, Dr. Alisa Sacker, MD, states that tongue ties are present in 25-30% of the population. Tongue Ties can also be referred to as Ankyloglossia. Ankyloglossia is a congenital oral condition that decreases mobility of the tongue, this is caused by an unusually short, thick lingual frenulum, which is a membrane connecting the bottom, midline of the tongue to the floor of the mouth. Think of it as a tight, rope-like connection between the bottom of the tongue and the floor of the mouth.

Why is tongue mobility so important? The tongue is involved in multiple actions that are conducive to everyday life. One main action is eating, which is why many tongue ties are discovered on newborn babies. A tongue tie can restrict the babies ability to suckle the nipple with their tongue, get a good latch, and properly intake the nutritious breast milk of their mother. Those who struggle with breastfeeding should have their baby’s examined by a professional to see if they have a tongue tie, especially if the baby is not gaining weight, is constantly fussy and cannot get comfortable, gets frustrated at the breast, naturally goes into extension, or if breastfeeding is painful for the mother, possibly leaving blisters on moms nipple or babies lips. Moms with tongue tied babies may also experience flattened or lipstick shaped nipples, decreased milk supply, clogged ducts, mastitis, and other infections. Tongue ties can also cause issues down the line with speech and pronunciation, the ability to eat solid food, snoring, difficulty with breathing (ie: mouth breathing), teeth crowding and a high palate. Many children with tongue ties are subject to the use of orthodontic spacers to widen the palate, spacers are extremely painful and costly. Taking care of the tongue tie while in the newborn stages of life can reduce the risk of all of these complications.

What does the revision process entail? Exactly what you might think, cutting that ropey connection between the tongue and floor of the mouth, the procedure is called a frenectomy. A frenectomy is typically performed with a CO2 laser or a diode and only takes a couple of minutes. CO2 lasers are usually the tool of choice as they result in less bleeding or no bleeding at all. After the oral tissues are separated exercises have to be performed daily to ensure the tissues do not reattach. The exercises include direct pressure and stretching of the tongue and floor of the mouth. If the frenectomy is performed while in newborn stages of life, when oral tissues are less strong and developed, the procedure and recovery time are less severe. If performed in a child, adolescent or adult, the procedure can require more recovery time, typically about a week, and there will be a lot more oral tissue to cut through, therefore more bleeding and scarring.

Unfortunately tongue ties are not the only ties that are present in the mouth. Other common oral anomalies include a connection between the top lip and gum line, known as a “lip tie,” as well as connections between the sides of the tongue and floor of the mouth known as “buccal ties.” Each tie has differences in severity, however, everyone should be able to lift their top lip and see a clear detachment of the top lip and gum line, as well as lift their tongue easily up and out of their mouth. Although many people do not get revisions if feeding is not affected, it is important to know if a tongue tie is present and be aware of the possible disparities that can develop if the tongue’s mobility is limited. Professionals who can make the distinction include trained pediatricians, dentists, lactation consultants, and pediatric chiropractors.

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