Tongue-tie, or what is commonly referred to in the medical community as ankyloglossia, is a partial or total fusion of the tongue to the floor of the mouth due to an abnormality of the lingual frenulum. It is present at birth. Being tongue-tied can cause restrictions in tongue movement, possibly resulting in difficulties performing simple actions using the tongue. If a tongue-tie is present a person may not be able to extend his or her tongue past the edge of the lower gums or teeth. Sometimes the tongue takes on the shape of a heart when one sticks out their tongue. As a result, a true tip is unable to be formed.
Many people live with a tongue-tie with little to no effect on their daily lives. However, there are several areas where a tongue-tie can impact a person. If a baby is born with a tongue-tie there may be difficulties associated with feeding, either on the breast or with a bottle. A baby may be unable to attain an adequate latch which in turn effects how he sucks and ultimately plays a role in how much milk he consumes. In severe cases the baby has difficulty gaining weight, not to mention the pain that can occur on the part of the mother due to an irregular latch and suck. Often times clipping the tongue-tie of the baby can result in instant remediation of this problem. If a tongue-tie is not clipped during infancy, a person may later have a hard time moving food around for chewing or clearing food out of the cheeks or other areas of the mouth. If proper dental care is not obtained bad breath or tooth decay can occur.
Another area possibly affected by a tongue-tie is the growth of teeth. If the frenulum is attached high on the gum line, it can pull the gums down from the central incisors. Cosmetics and the way a person interacts with others are areas which some people may experience problems. A child or even an adult may not appreciate the appearance her tongue takes on due to the tie. A person may notice difficulty licking an ice cream cone or even French kissing. In severe cases an individual may have a decreased ability to control his saliva, resulting in drooling.
Speech-sound production is the final area of tongue function that may be affected due to a tie. However, there is no empirical evidence to suggest that having a tongue-tie causes difficulty producing specific sounds made by the tip of the tongue. The following sounds can be made by training the individual to use alternate parts of his tongue: /t, d, n, s, z, l, r, th/. Only after a person has tried the different placement techniques for these sounds and then finds that the speech errors continue, can a tongue-tie be to blame.
To remedy a tongue-tie at birth a simple clip of the frenulum by a doctor is performed. If one decides to have a tie clipped later in life a frenulectomy can be completed under general anesthesia. The procedure lasts only a few minutes with typically little to no complications or side-effects. An ENT, plastic, oral, or general surgeon may perform a frenulectomy.
A majority of people live with a tongue-tie and never experience ill-effects. However, babies with a tie who display problems feeding in infancy can greatly benefit from clipping their tie. As many would believe, there is no true evidence to support the notion that the presence of a tongue-tie directly causes errors in speech sound production. If you suspect you or your child may have a tongue-tie that is causing a specific problem, seek the advice of your doctor or a speech-language-pathologist.
Ballard, J.L., Auer, C.E., & Khoury, J.C. (2002). Ankyloglossia: assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad. Pediatrics, 110(5). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed
Fernando, C. (1998). Tongue-Tie from confusion to clarity: A guide to the diagnosis and treatment of ankyloglossia (tongue-tie). Sydney, Australia: Tandem Publications.
Kotlow, L. (2013). The significance of tongue and lip ties and why you should consider correcting them. Retrieved from http://www.kiddsteeth.com/articles/ttfactsheet.pdf
Kummer, A. W. (2005). Ankyloglossia: To clip or not to clip? That’s the question. The ASHA Leader. Retrieved from: http://www.asha.org/publications/leader/2005