Ankyloglossia, more commonly referred to as tongue-tie, is a condition that occurs when the strip of skin (lingual frenulum) connecting a baby’s tongue to the floor of their mouth is more restrictive than usual. Typically, this strip of skin separates before birth, allowing the tongue free range of motion. With tongue-tie, the lingual frenulum remains attached to the bottom of the tongue, or is shorter, thicker or more restrictive than normal. Sometimes this exists all the way up to the tip of the tongue (anterior tongue-tie) while other times the restrictive nature is "hidden" behind mucosa at the base of the tongue (posterior tongue-tie) Similarly, a lip-tie occurs when the tissue that connect the upper lip to the gum tissue, called the maxillary labial frenulum, has less range of motion. This inhibits the upper lip ifrom being able to lift/curl properly due to it being tethered too tightly. The muscles of the tongue, lips, and cheeks are paramount in oral function and our office prides itself on completing a full functional assessment for those who may suspect an issue.
There are many signs and symptom of tongue-tie. During an initial exam we spend dedicated one on one time with the child and family to go through any signs/symptoms that your child may be experiencing and learning more about your particular child. We also complete a full anatomical and functional assessment of the head, neck and oral cavity during the appointment and then discuss findings and any recommendations, if needed, with the family.
Some common signs of tongue tie / lip tie can include:
• Restriction of the tongue’s movement, making it harder to breastfeed or bottlefeed
• Difficulty lifting the tongue up or moving it from side to side
• Heart-shaped or notched tongue presentation
• Difficulty achieving a neutral or inverted lip position during nursing or bottlefeeding
• Shallow / painful latch
• Incomplete breast drainage when nursing
• Clicking sound when feeding
• Ingesting excessing air when feeding
Treatment of Tongue-Tie/Lip-Tie
The treatment of tongue-tie for infants is a simple surgical procedure called a frenotomy. Dr. Kate will examine the oral tissues and functional relationship during her exam and discuss any recommended treatment. If necessary, our office utilizes the most up to date technology with a CO2 laser to release the frenulum free to restore function. This type of laser is a "cold" laser and is more gentle on the tissue than other types of lasers. Stitches are usually not necessary. Since there are few nerve endings or blood vessels in the lingual frenulum, only a topical or local anesthetic is used and there is little to no bleeding after the procedure.
Frenotomy for tongue-tie in older children and teenagers is similar to that for infants, although it can involve stitches in certain indications. Team based care is extremely important when restoring function and we work closely with other trained professionals including IBCLCs, pediatricians, chiropractors, speech and language pathologists, feeding specialists and others to provide appropriate treatment and support for our patients and their families.