Ashley Rainbolt, DDS
You may have been hearing more about tongue ties lately. There is a growing level of awareness of tongue ties, and new research is coming out about how important the function of the tongue is to optimal health.
What is a tongue tie?
The cord of tissue under the tongue that attaches the tongue to the floor of the mouth is known as the lingual frenum. A tongue tie (ankyloglossia) occurs when the lingual frenum is too tight and interferes with normal mobility and function of the tongue. The appearance of the lingual frenum alone is not enough to diagnose a tongue tie. The process of diagnosing a tongue tie requires an in-depth history of symptoms as well as a physical functional examination. The most obvious tongue ties are known as anterior tongue ties because the frenum attaches close to the tip of the tongue. Posterior or submucosal tongue ties occur when the restrictive frenum attaches farther back on the tongue and can be more difficult for the untrained eye to see. However, these posterior tongue ties can contribute to the same problems as the more noticeable anterior tongue ties.
How common are tongue ties?
Research suggests that the incidence of tongue ties is between 4-12% of the population. However, this only accounts for anterior tongue ties. It is also important to remember that just because a condition is common does not mean that it is normal.
What are the signs or symptoms of a tongue tie in an infant?
In an infant, a proper latch for breastfeeding requires proper mobility of the tongue. If a tongue tie is present, the latch can be affected in a negative way. The following are common symptoms of tongue tie in breastfeeding mothers and infants.
INFANT SYMPTOMS:
Poor, shallow latch
Falls asleep when attempting to latch
Slides off nipple when attempting to latch
Colic and/or reflux symptoms
Clicking or smacking noises when feeding
Gagging, choking, coughing when feeding
Poor weight gain
Gumming or chewing of nipple when nursing
Unable to hold a pacifier in his/her mouth
Lip blisters and/or milk-coated tongue
Frustration at the breast
MOTHER SYMPTOMS:
Creased, flattened or blanched nipples after nursing
Cracked, bruised or blistered nipples
Bleeding nipples
Severe pain when infant attempts to latch
Poor or incomplete breast drainage
Infected nipples or breasts
Plugged ducts, engorgement, mastitis
Nipple thrush
How does a tongue tie affect older children and adults?
When the tongue muscle is tethered down, it cannot assume the normal resting position in the palate (roof of the mouth). Therefore, the tongue is prevented from molding a broad, flat palate - giving way to formation of a high, narrow palate. A high, narrow palate can contribute to many problems such as teeth crowding, nasal obstruction, airway disorders, and TMJ disorders. The tongue tie can also increase the risk of dental decay (cavities), teeth grinding, gum recession, speech problems.
How are tongue ties treated?
A frenectomy is a simple procedure that is performed by a physician or dentist to release the restrictive frenum and allow more ideal tongue function. However, the body creates compensations for a tongue tie. These compensations must be addressed to achieve ideal function. Depending on the specific needs of the tongue-tied individual, a collaborative approach with other healthcare providers such as chiropractors, lactation consultants, myofunctional therapists, physical therapists, speech-language pathologists or feeding therapists may be needed to achieve an optimal outcome.
The tongue is an important muscle. If the tongue is prevented from normal function and movement, it has the potential to negatively affect every organ system in the body. If you think you or your child is suffering from issues related to an undiagnosed tongue tie, an evaluation by a trained medical or dental professional is warranted.
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