Tongue Tie

What is it and how does it affect me?

What is ankyloglossia (Tongue tie)?

Ankyloglossia is often referred to as “tongue tied”, and it is described as an abnormal shortness of the frenum located under the tongue, limiting the tongue’s movement. It can interfere with oral development, feeding, speech and swallowing and can create associated problems.  Ankyloglossia affects 4.8% of the population, more often males than females (3:1 ratio).


When you open your mouth and elevate the tip of your tongue, you can clearly see your lingual frenum (also referred to as a frenulum); the band of tissue that attaches your tongue to floor of your mouth. In some cases, the frenum might be visible but too short to allow full tongue movement. In other cases, the shortened frenum might not be visible at all, and is then defined as submucosal ankyloglossia.

What are the causes of ankyloglossia?

The exact causes of ankyloglossia are unknown, but in most cases, there is a genetic predisposition.


What problems can it cause?

To experience what ankyloglossia feels like, try to talk and eat while keeping your tongue on the floor of your mouth. You can see it is challenging! Ankyloglossia can seriously affect people’s health at any age.


In infants: ankyloglossia can be associated with breastfeeding difficulties such as failure to thrive, latching onto the breast, expressing milk, nipple trauma to the mother and difficulty with the management of solids foods when introduced.


In children: associated with “sloppy” eating secondary to difficulty chewing the food and moving it in the mouth, impaired articulation, poor oral hygiene which may lead to a higher incidence of tooth decay, poor teeth alignment in the upper arch and/or the inward rotation of the lower teeth, changes in the development of the face and jaws and the emergence of compensatory incorrect habits such as a tongue thrust. 


In adults: associated with continued misarticulation of sounds, clicking or pain in the jaws, migraines, clenching/grinding of the teeth, effects on social situations (such as eating or kissing) and overall poor dental health (such as gingivitis which may lead to periodontitis also known as gum disease), dental crowding, cavities or extractions. 

How can we treat ankyloglossia?

Once a tongue tie has been diagnosed, a recommendation may be made to have the lingual frenum released through a frenectomy; also known as a frenulectomy or a frenotomy.  It’s a simple procedure that uses local anesthesia to remove the fiberous tissue.  It typically takes no more than 5 minutes using a scalpel, scissors or a laser. 


What is the role of the Orofacial Myologist with ankyloglossia?

With children, teenagers and adults, it is strongly recommended that you consult with an orofacial myologist prior to the surgery. Pre- and post-operative exercises are taught and given to support minimal scarring. Once the frenum is released by the oral maxillofacial surgeon and or periodontist, the tongue will be able to move more freely around the oral cavity.   


In addition, muscles of the tongue might be weak from being anchored to the floor of the mouth. These specific exercises are given to strengthen the muscles of the tongue to assist the tongue moving vertically and achieving appropriate tongue resting postures. This allows for the recapturing the dental freeway space which is essential!


Thirdly, an orofacial myologist can now eliminate a tongue thrust swallow pattern which typically accompanies a restricted lingual frenum. Improved chewing and swallowing skills are important for a person of any age. 


Furthermore, improper tongue placement, chewing and swallowing dysfunction and incorrect speech patterns will not self-correct. Over the years, individuals with ankyloglossia develop abnormal habits to compensate for the tongue being attached to the floor of the mouth. These habits are difficult to eliminate and the support of an orofacial myologist is advised.


Anyone diagnosed with ankyloglossia should seek the expertise of an orofacial myologist to ensure optimal health. Come and see us if you want to know more!