Around 10% of babies are born with a condition commonly known as tongue-tie, where the piece of tissue attaching the tongue to the bottom of their mouth, the lingual frenulum, is shorter or thicker than average, limiting the motion of their tongue. If severe, it can interfere with your child’s ability to eat, swallow, and speak and impact their oral health.
Tongue-tie is a congenital condition, known as ankyloglossia, that develops before your baby is born. During development inside your womb, the tongue and frenulum don’t form normally, and the frenulum may be shorter, thicker, or tighter than normal, restricting the motion of the tongue.
Signs & Symptoms
In mild cases, symptoms may not interfere with day-to-day activities but may worsen with age if left untreated.
Mothers may notice their infant having difficulty latching or pain during nursing as the tongue-tie can prevent an adequate seal while breastfeeding causing the child to use their gums to feed. Other signs in infants may include breastfeeding for long periods, tending to chew instead of suck during feeding, being fussy when trying to feed, seeming constantly hungry, trouble gaining weight, or a clicking sound while feeding.
If left untreated, a tongue-tie can impact the way your child eats and swallows. Your child may take longer to eat certain foods such as tough pieces of meat, chunky vegetables, or ice cream cones. This can also affect the amount of saliva in the mouth which is crucial to helping wash away debris, oral bacteria, and plaque. In severe cases, tongue-tie can increase your child’s risk for gum disease, tooth decay, and cavities.
As your child grows up, the limited movement of their tongue may prevent proper articulation and cause them to develop a lisp. Certain sounds such as “T”, “D”, “S”, “Z”, “Th”, “N”, “L” can be difficult to enunciate.
If your child is having trouble breastfeeding, contact your pediatrician. If your child is diagnosed with a tongue-tie at an early age, your doctor may recommend working with a breastfeeding specialist or a speech therapist as needed to reduce mild symptoms. If problems continue, surgery may be recommended.
Although treatment is preferred as soon as possible during childhood, adults can still seek treatment to increase their quality of life. In mild cases, myofunctional therapy may be recommended to help improve control and strength of the tongue.
There are two surgeries used to commonly treat tongue-tie:
A frenotomy is a quick and effective surgery completely safe for children. During the procedure a cut is made in the frenulum, freeing the tongue. This treatment is commonly performed without anesthesia in babies under 3 months because there are few nerve endings in the area.
For older children or if the frenulum is too thick, a frenuloplasty will be recommended. Anesthesia is used to numb and provide patient comfort. During the procedure, a cut is made in the frenulum to free the tongue. Stitches are used to close the incision and often dissolve on their own as the wound heals.
Complications are rare but can include bleeding, infection, scarring, and damaged salivary glands.
Following treatment, your child’s doctor may recommend certain exercises that involve moving or holding the tongue in certain positions to strengthen the muscle. Speech therapy may also be required to help retrain the muscles in their tongue.
If you believe your child is struggling to breastfeed or have noticed some of the symptoms described above, we encourage you to seek treatment. For more information on tongue-tie and how we can help or to schedule an appointment, contact Alameda Pediatric Dentistry today.