Infant & Adult Tongue Tie

What is Tongue Tie?

Tongue tie, also known as ankyloglossia, is a condition that affects the mobility and proper function of the tongue. Imagine if your tongue was connected to the bottom of your mouth with a tight string. Well, that’s what happens in tongue tie. There’s a piece of tissue called the frenulum that holds your tongue down. In infants and adults with tongue tie, this tissue is too short or tight, which restricts the movement of the tongue.

This can cause problems when speaking, eating, or even sticking out your tongue. It may make it difficult to pronounce certain sounds or words properly. With tongue tie infants, it can also lead to problems with breastfeeding in babies.

What is Lip-Tie?

The piece of tissue behind your upper lip is called the frenulum. When these membranes are too thick or too stiff, they can keep the upper lip from moving freely, known as lip-tie. Lip-tie has not been studied as much as tongue-tie, but treatments for lip-ties and tongue-ties are very similar. Lip-tie occurs when the frenum connecting the upper or lower tip is too short or too tight. The frenums that connect the upper and lower lips to the gums are called labial frenulums. When they are tight or short, they can cause difficulty moving the lips, speaking and eating.

What is a Buccal Tie?

The least commonly known type of tethering is the buccal tie, lateral frenum, or buccal frenum. The term “buccal ties” is most commonly used by feeding specialists and lactation consultants and are restrictions or taut fibers that are abnormally attached from the gums to the inside of the cheeks. Some doctors will release these ties as well during frenectomy.

Symptoms of tongue tie

Symptoms in adults

  • Snoring and sleep apnea,
  • Chronic fatigue and mouth breathing,
  • Dark circles under the eyes,
  • Clenching and facial tension,
  • Neck Tension and headaches,
  • Reflux and IBS (Irritable Bowel Syndrome).
  • Difficulty sticking out the tongue past the lips or touching the roof of the mouth.
  • Trouble moving the tongue from side to side or in a circular motion.
    Difficulty lifting the tongue to touch the upper teeth or clean the back of the mouth.
  • Challenges with certain speech sounds, such as “t,” “d,” “l,” and “r.”
  • Problems with breastfeeding, such as difficulty latching onto the nipple or poor milk transfer.
  • Inability to fully extend the tongue beyond the lower front teeth.
    Speech that sounds muffled or unclear.
  • Difficulty swallowing certain foods, particularly those that require extensive tongue movement.
  • Dental issues like a gap between the bottom front teeth, caused by the constant pressure of the tongue pushing against them.
  • Persistent mouth breathing due to limited tongue mobility can lead to dry mouth and other oral health problems.

Symptoms in infants

  • Breaks latch seal, clicking or smacking sounds, gassy, reflux, vomiting, colic.
  • Shallow latch, not able to latch or unsustained latch (sliding off nipple), clamping.
  • Chewing or gumming while latching.
  • Unsatisfied nursing episodes fight latching.
  • Prolonged feeding episodes.
  • Unable to hold the pacifier.
  • Failure to thrive, poor weight gain.
  • Signs of congestion, mouth breathing, abnormal breathing, and sleep apnea.
  • Falls asleep on the breast

What May a Mother Experience with a Tongue-Tied Infant During Nursing?

  • Cracked, blistered, bruised nipples
  • Bleeding nipples
  • Blanched or creased nipples after feeding (flattened)
  • Severe pain upon latching infant
  • Plugged ducts and mastitis
  • Engorged or unemptied breasts
  • Nipple thrush
  • Infected nipples
  • Exhaustion or even depression
  • Premature weaning

How Can I Check My Infant for Tongue-Tie?

Run your finger under the tongue to identify a “guitar string”, which may indicate that the tongue attachment is problematic.

If there is a smooth, uninterrupted pass under the tongue, the infant likely will be able to have a successful latch.  If there is a significant interference during the sweep under the tongue, seek evaluation of the tongue-tie.

Causes of Tongue Tie

  • Genetic factors: Tongue tie can run in families, meaning it may be inherited from parents or other relatives.
  • Developmental issues: Problems during pregnancy, such as improper growth or development of the frenulum, can lead to tongue tie.
  • Congenital condition: Some individuals are born with tongue tie, and it is present at birth.
  • Abnormal tissue formation: The frenulum may not properly separate or elongate during fetal development, resulting in tongue tie.
  • Trauma or scarring: Injuries or surgical procedures involving the tongue or mouth can cause the formation of scar tissue, leading to tongue tie.
  • Syndromes or medical conditions: Certain genetic syndromes or medical conditions, such as Ehlers-Danlos syndrome or Down syndrome, can increase the likelihood of tongue tie.
  • Environmental factors: Although less common, exposure to certain environmental factors during pregnancy may contribute to the development of tongue ties.

Treatment

The Hobson Institute is one of the few clinics providing pre and post-frenectomy care as well as lingual and labial frenectomy procedures.  We use frenectomy as a helpful solution for people who have tongue tie and lip tie issues. 

Additional Information On Tongue Tie and Lip Tie