ALL YOU NEED TO KNOW ABOUT TONGUE TIES 

July 1, 2019 /

Written by Caroline Meyer

A tongue tie (ankyloglossia) is not very common and is basically due to tissue on the underside of the baby’s tongue connecting it to the floor of the mouth restricting movement. This can cause a situation where baby cannot extend his tongue out of his mouth and may have difficulty swallowing, breastfeeding and making sounds. A tongue tie is easily corrected and not very serious if it is identified early. 

Signs and symptoms of tongue tie 

  • Difficulty with tongue movement 
  • Cannot stick tongue out  
  • Battles to latch or breastfeed 
  • Upper lip curls inwards 
  • Has lip blisters 
  • Tongue is two-toned 
  • Has dents in the tongue or tongue curls 
  • The frenulum under the tongue is popped 
  • Baby is chewing and not sucking on the breast or teat 
  • Baby attempts to drink for extended periods of time 
  • Baby is not thriving and gaining weight properly 
  • Your baby seems hungry all the time 
  • The tip of the tongue appears heart-shaped 
  • There is often a clicking noise when baby is feeding 

Reasons for tongue ties 

Before babies are born, the lingual frenulum (the thick tissue under the tongue) separates from the tongue before birth. This allows for tongue movement after birth. Sometimes this tissue does not detach and tongue movement remains restricted. There is a suspicion that this may be genetic, but the reasons are still unknown at this point. It is important that the condition is addressed early to avoid complications. 

Possible complications if untreated 

  • Speech problems: If untreated baby may be unable to make sounds such as “r”, “z”. “d”, “th”, “s” and sometimes even “l”. This can hamper speech development dramatically. 
  • Bad oral hygiene: Cleaning lower gums can be difficult with the tongue in the way. This can lead to gum disease and tooth decay. It can also cause a gap in the two front teeth in the lower jaw. 
  • Movement restriction: A tongue tie can result in the child not being able to eat properly, being unable to lick their own lips or a food item and even being unable to play wind instruments if they were inclined to.  

Treatments for a tongue tie 

In many cases treatment may not be needed. If the baby is feeding fine, the situation is left to resolve itself over time. If feeding is affected, your doctor may recommend surgical interventions to resolve the tongue tie. There are two different procedures that may be used depending on the tongue tie itself. A Frenotomy is when the lingual frenulum is cut to allow the tongue to move properly. It is usually done with local anaesthesia or without any anaesthesia as it is generally painless and quick. There are minimal nerve endings or blood vessels in the area, so there isn’t much bleeding either. If the frenulum is too thick or needs more that a small cut, a frenuloplasty is done under anaesthesia. There may be stiches involved and tongue exercises are usually recommended. 

Risks of treatment 

The lower part of the mouth can get infected.  There may be excessive bleeding. There may be damage to the salivary glands or the tongue. Explore all options and discuss fully with your doctor before your baby undergoes the procedures. Make sure you attend follow up consultations. Check if your baby will need to be under the care of an ENT after surgery. 

If you suspect your baby may have a tongue tie, have him examined by your doctor who can assess the type of treatment required. Fortunately, the risk of complication is slight in these procedures and baby goes on to be able to feed and speak normally afterwards.