tongue and lip ties
TONGUE TIE
Tongue Tie is also known as: Ankyloglossia, Restricted Lingual Frenum and Tethered Oral Tissue (TOT- refers to all ties – lip, cheek, and under the tongue.)
It is the string of tissue that stretches from under the tongue to the floor of the mouth. It is a physical limitation that affects tongue mobility, function, and rest posture.
Tongue tie is present at birth and has a strong genetic link.
There are varying degrees of tongue-tie, so the importance of having a test or validated protocol that evaluates the tongue and lingual frenum is crucial. This will ensure an accurate diagnosis and indicate whether or not the need to do a frenotomy (or small “cut” under the tongue) or frenectomy (tongue-tie release surgery for children and adults) is recommended.
In infants, surgery is usually indicated when the lingual frenum restricts the tongue’s movement and compromises breastfeeding. A lactation consultant may also be indicated for consultation. In older children and adults, the indication is made when the tongue is visibly restricted, is unable to adequately reach the palate, or when possible distortions in speech are caused by limitation of the elevation of the tongue tip (especially in producing the sound of the “L” and “R”) that could not be corrected in speech therapy.
TONGUE TIE SYMPTOMS
Tongue tie presents symptoms to a low-postured tongue, such as Mouth breathing, open mouth posture, and a tongue thrust swallowing pattern.
It is often thought to only affect breastfeeding and speech but now known to cause many other symptoms.
Symptoms in Children
•Gagging or choking on foods
•Open mouth chewing, messy or noisy eating
•Picky eating
•Easy gagging
•Delayed development of speech
•Ear infections
•Teeth grinding
•Snoring /Sleep Disordered Breathing
Poor dental and facial growth and development
•High risk of cavities
Symptoms in Adults
Chronic headaches or migraines
• Neck/shoulder pain and tension
• Forward head posture
• Jaw pain
• Clenching and bruxism
• Snoring and Sleep apnea
• Ortho problems or relapse
• Digestive issues – bloating, burping, reflux
• Extensive restorative dental treatment
Symptoms in Infants
Difficulty breastfeeding
• Difficulty latching onto breast or bottle
• Reflux/excessive spit-up
• Ear infections
• Poor weight gain
• Mother may have painful, sore nipples
• Low milk supply
HOW CAN WE HELP?
Orofacial Myofunctional Therapists are well- suited to screen tongue-ties and determine the need of a frenectomy, or tongue-tie release surgery. If a frenectomy may be necessary, you/your child will be referred to an appropriate provider to perform the procedure.
In the case of infants, a pediatrician and a lactation consultant may also be involved.
Orofacial Myofunctional Therapy (OMT) helps to prepare for frenectomy to achieve the best results. Pre and post frenectomy exercises are crucial for surgical success, faster healing, prevention of reattachment of the frenum, and restoring the normal functions of the tongue. Without proper care even after the surgical release, there is a very high chance of reattachment of the frenum and poor control of the tongue, as the muscles were not utilized properly.
OMT should be started 6 weeks before frenectomy to attain best care and results.