What are the other Names for this Condition? (Also known as/Synonyms)

• Ankyloglossia
• Tongue-Tie

What is Tongue Tie? (Definition/Background Information)

• Tongue Tie or Ankyloglossia is a congenital condition wherein the frenulum at the base of the mouth below the tongue is abnormally small/short, thereby restricting movement of the tongue. It occurs due to an abnormal growth during fetal development
• The frenum or frenulum is a fibro-muscular tissue that is present at various body sites, such as below the tongue (called lingual frenulum), below the lip (labial frenulum), inside the cheek (buccal frenulum), or in the genitalia (genital frenulum)
• Tongue Tie can result in feeding difficulties in infants, speaking difficulties, poor oral hygiene, and change in profile of the jaw (jaw protrusion), over a long duration. It is a common condition that is correctable through surgery, when needed
• The severity of the condition can vary from one child to another. In some cases, only a mild restriction of the tongue is observed; while, in other cases, the tongue cannot be projected beyond the teeth of the lower jaw due to the presence of a prominent lingual frenulum
• The treatment measures for Tongue Tie include a lingual frenectomy, a surgical procedure to remove the abnormal frenulum, and/or speech-therapy. With adequate treatment, the prognosis is typically excellent

Who gets Tongue Tie? (Age and Sex Distribution)

• Tongue Tie is a fairly common condition that is seen in between 4-11% of the individuals worldwide
• Most cases are diagnosed in infants and young children; although, it may be diagnosed at a later stage in adults too
• Both males and females are affected, but the condition is more frequently observed in males
• Racial, ethnic, or geographical predominance is not observed

What are the Risk Factors for Tongue Tie? (Predisposing Factors)

The risk factors for Tongue-Tie or Ankyloglossia may include:

• A positive family history of the condition may be a risk factor
• Male children have a higher risk for Tongue Tie than female children

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Tongue Tie? (Etiology)

• The exact cause of development of Tongue Tie is not well-established
• However, it is believed that the detachment/separation of the frenulum does not take place normally during fetal development, resulting in a Tongue Tie

What are the Signs and Symptoms of Tongue Tie?            

The signs and symptoms of Tongue Tie may include:

• Chewing and eating difficulties; the condition can also make it difficult to swallow
• Speaking difficulties; difficulty in pronouncing certain syllables or words
• Difficulty in breastfeeding (for both the baby and the mother), which can increase the child’s susceptibility to infections
• During breastfeeding, the child may not be able to latch on to the breast; he/she may constantly spill breastmilk from the mouth
• The infant’s ‘cry’ may sound restricted, different, or abnormal
• Difficulties in brushing and flossing one’s teeth
• Bad breath

The symptoms vary according to severity of the abnormal tissue growth. Excessive frenulum growth can cause more severe symptoms than a milder case of Tongue Tie.

How is Tongue Tie Diagnosed?

Tongue Tie may be diagnosed using the following methods:

• A complete physical and oral examination (examination of the mouth). In many cases, an oral exam is sufficient to establish a diagnosis
• Assessment of medical history including the presence of any underlying conditions, family history, etc.
• Ultrasound imaging studies of the mouth
• In young children, a screening tool is used to establish certain scores, based on which the healthcare provider diagnoses Tongue-Tie and its severity. In this test, the range of motion of the tongue, its appearance, and other parameters are noted

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Tongue Tie?

Complications due to Tongue Tie may include:

• Breastfeeding difficulties can cause increased susceptibility to infections
• Painful nipples in breastfeeding mothers
• Low weight gain in infants and babies
• The condition can accelerate dental decay and result in gingivitis and periodontal disease
• Longstanding Tongue Tie can cause temporomandibular Joint (TMJ) arthritis
• Protrusion of lower jaw (prognathism)
• Emotional stress and reduced self-esteem due to speech difficulties, especially in older children and adults
• Cosmetic issues
• Complications that result from the surgical procedures used to treat the condition

How is Tongue Tie Treated?

The treatment for Tongue Tie may include:

• A ‘wait and watch’ approach may be undertaken by the healthcare provider for mild cases
• In some cases, the condition may be referred for speech-language pathology (SLP) therapy
• A surgical correction of the condition, called lingual frenectomy, may be performed for severe cases. Any of the following techniques may be employed:
  • Conventional scalpel method (surgical knife method)
  • Soft-tissue laser surgery
  • Electrocautery or thermal cautery
• Following surgery, certain tongue exercises are recommended to increase its mobility and decrease scarring

It has been noted than in some rare cases, the condition resolves on its own.

How can Tongue Tie be Prevented?

Currently, there are no available measures to prevent Tongue Tie. However, if it is associated with a genetic disorder, then the following may be considered:

• Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus during pregnancy) may help in understanding the risks better during pregnancy
• If there is a family history of the condition, then genetic counseling will help assess risks, before planning for a child
• Active research is currently being performed to explore the possibilities for treatment and prevention of inherited and acquired genetic disorders

What is the Prognosis of Tongue Tie? (Outcomes/Resolutions)

The prognosis of Tongue Tie is generally excellent with appropriate treatment (including surgery).

Additional and Relevant Useful Information for Tongue Tie:

Please visit our Dental Health Center for more physician-approved health information:

https://www.dovemed.com/healthy-living/dental-health/