Description

Tongue-tie (ankyloglossia) is a condition present at birth that restricts the tongue's range of motion.

With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue with the tip of the floor of the mouth. Depending on how much tissue restricts the movement of the tongue, it may interfere with breastfeeding. Someone who has tongue-tie might have difficulty sticking out the tongue. Tongue-tie can also affect eating or speaking.

Sometimes tongue-tie may not cause problems. Some cases may require a simple surgical procedure for correction.

Symptoms

The signs and symptoms of tongue tie include:

  • Difficulty lifting the tongue to the upper teeth or the movement of the tongue from side to side.
  • Problems to pull out the tongue past the lower front teeth.
  • A tongue that appears notched or heart-shaped when stretched.

When to see a doctor

Consult a physician if:

  • Your baby has signs of tongue tie cause problems, such as having trouble breastfeeding.
  • A speech-language pathologist thinks that the child's speech is affected by the tongue tie.
  • His eldest son is complaining of the tongue of the problems that interfere with eating, speaking or reaching to the back of the teeth.
  • You are concerned about your own symptoms of tongue tie.

Causes

Normally, the lingual frenulum is separated before birth, allowing the language of the wide freedom of movement. With tongue-tie, the lingual frenulum remains attached to the underside of the tongue. Why this happens is largely unknown, although some cases of tongue-tie have been associated with certain genetic factors.

Risk factors

Though tongue-tie can affect anyone, it is more common in boys than in girls. Tongue-tie is sometimes runs in families.

Complications

Tongue tie, it can affect a baby's oral development, as well as the way in which the child eats, speaks and swallows.

For example, tongue-tie can sometimes lead to:

  • Problems with breastfeeding. Breastfeeding requires a baby to keep the tongue over the lower gum while sucking. If you can not move your tongue or keep it in the correct position, the baby can chew on instead of sucking on the nipple. This can cause significant pain in the nipple and interfere with the ability of your baby to get breast milk. Ultimately, the poor of breastfeeding may lead to inadequate nutrition and lack of growth.
  • Difficulties in speaking. Tongue-tie can interfere with the ability to produce certain sounds, for example "t", "d", "z", "s" "j," "n" and "l."
  • Poor oral hygiene. For an older child or an adult, with the tongue-tie can make it hard to sweep away food debris from the teeth. This can contribute to tooth decay and inflammation of the gums (gingivitis).
  • Challenges with other oral activities. Tongue-tie can interfere with activities such as licking an ice cream cone, licking the lips, kissing or playing a wind instrument.

Diagnosis

The tongue tie is usually diagnosed during a physical exam. For babies, the doctor can use an assessment tool for the score of the different aspects of the language to their appearance and their ability to move.

Treatment

The treatment for tongue tie is controversial. Some doctors and lactation consultants recommend correcting immediately — even before a newborn is discharged from the hospital. Others prefer to take a wait-and-see approach.

The lingual frenulum may loosen with time, the resolution of the tongue tie. In other cases, the language of the tie persists without causing problems. In some cases, consultation with a lactation specialist can help with breastfeeding, and speech therapy with a speech-language pathologist can help to improve the sounds of speech.

The surgical treatment of tongue tie may be necessary for infants, children or adults, if the tongue tie causes problems. The surgical procedures include frenotomy and frenuloplasty.

Frenotomy

A simple surgical procedure called a frenotomy can be done with or without anesthesia in the children's room of the hospital or the doctor's office.

The doctor will examine the lingual frenulum, and then, using sterile scissors or cautery to cut the frenulum free. The procedure is quick and the discomfort is minimal, as there are few nerve endings or blood vessels in the lingual frenulum.

If bleeding occurs, it is likely that only one or two drops of blood. After the procedure, a baby can breastfeed immediately.

The complications of a frenotomy are rare but can include bleeding or infection, or damage to the tongue or salivary glands. Also it is possible to have scars or by the lingual frenulum to return to the base of the tongue.

Frenuloplasty

A more extensive procedure known as a frenuloplasty may be recommended if you are in need of a repair or the lingual frenulum is too thick for a frenotomy.

A frenuloplasty is usually done under general anesthesia, the surgical instruments. In an adult, the procedure can be done using a type of anesthesia to reduce pain and help to relax. After which the lingual frenulum is released, the wound is usually closed with sutures that are absorbed into his own as the tongue heals.

The possible complications of a frenuloplasty are like a frenotomy and are rare: hemorrhage or infection, or damage to the tongue or salivary glands. Healing is possible thanks to the more extensive nature of the procedure, as are the reactions to the anesthesia.

After a frenuloplasty, the language of the exercises may be recommended to improve the movement of the tongue and reduce the potential for scarring.

Preparing for your appointment

Here's some information to help you prepare for your appointment and know what to expect from your doctor.

What you can do

Prepare a list of questions in advance, such as:

  • How serious is the language of the tie?
  • It is a treatment that is necessary?
  • What are the treatment options?
  • Should I consider the possibility of surgical correction?
  • What is involved in the surgical correction? What are the risks?
  • Is anesthesia required?
  • Will surgical correction to improve my child's ability to get more milk while breastfeeding?
  • The procedure is performed in the office or in the hospital nursery?
  • Do I need to consult with an ear, nose, and throat doctor or other specialist?

What to expect from your doctor

The doctor will ask a series of questions. For example:

  • If your baby has tongue tie, are having problems with breastfeeding?
  • If your older child has a tongue tie, your child is having trouble making certain sounds or take care of their teeth?
  • If you have tongue tie, you are concerned about the activities that you are not able to do due to the limitation of movement of the tongue?

Prepare and anticipate questions will help you make the most of your time with the doctor.

Symptoms and treatment of Tongue tie (ankyloglossia)