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Health and Wellness: What you need to know about tongue-tie

By Sarah Hilton, RN - Stage Marketing | Nov 13, 2021
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Young child with a tongue-tie.

Got a tongue? Then you may be interested to learn about tongue-tie, a condition that affects nearly five percent of newborns, according to Children’s Hospital of Philadelphia. It’s very likely that someone you know has had tongue-tie — and since experts differ on how best to treat this condition, they may still have it! Could tongue-tie be the mystery root cause of your friend’s sleep apnea?

Keep reading to learn what tongue-tie is, the complications it may cause and treatment options. By understanding this condition, you may be able to help yourself or someone in your life eat, breathe and live better.

Defining tongue-tie

Tongue-tie, or ankyloglossia, is a condition that restricts the motion of the tongue. It occurs when the lingual frenulum — a fold of tissue that helps anchor and stabilize the tongue — is too thick, tight or short.

“When the tongue is restricted or tied, normal swallowing, feeding and speech are negatively impacted,” said Chris Farrugia, DDS, a practicing dentist at the Dreamwell Center in Destin, Florida, who specializes in treating children and adults with sleep breathing disorders often associated with disorders of the tongue. “If you look under the tongue, it often looks just like the name implies: The tongue appears to be tied to the bottom of the mouth. People who have tongue-tie often have difficulty sticking out their tongue or opening their mouth widely. This reduced mobility has a significant negative effect on the important functions of the tongue.”

The potential complications

Tongue-tie is a condition present at birth, and complications can be apparent right away. In infants, you may notice sleep deprivation, difficulty with breastfeeding and failure to gain weight appropriately. In the mother, there may be pain with breastfeeding, low milk supply and mastitis, i.e., blocked ducts or nipple thrush.

But what if the tongue-tie is not treated and persists into childhood or beyond? In a child with tongue-tie, you may notice the persistence of dribbling, an inability to chew age-appropriate foods, delayed speech development, dental problems and more.

Adults with tongue-tie face symptoms that are “very much the result of old habits of compensation for inadequate tongue mobility,” according to http://tonguetie.net. “The areas of difficulty spread to include social and domestic situations, self-esteem, the work environment, and dental health. … The consequences of unrepaired tongue tie do not reduce with time — instead, more difficulties are experienced as time passes.”

Adults with tongue-tie may face the following:

  • The inability to speak clearly when talking fast, loudly or softly
  • Jaw pain and/or migraine
  • Protrusion of the lower jaw
  • Dental problems, including inflamed gums and the need for fillings and extractions

Tongue-tie can also cause obstructive sleep apnea (OSA), a serious sleep disorder that causes you to stop breathing multiple times throughout the night, according to Dr. Farrugia.

“People with tongue-tie are often perpetual mouth-breathers. In turn, this can cause the tonsils to enlarge and obstruct the airway,” he said. “Their tongue may not be able to rest at the roof of the mouth, which can interfere with the full development of the palate and cause it to be abnormally arched, high or smaller than normal. This leaves less room for the nasal passages above and the tongue below, thus becoming a contributing factor to OSA.”

Treatment options

Tongue-ties range from mild to severe, and experts don’t always agree on the best approach to treatment. Some physicians or lactation consultants recommend intervening right away, while others take a wait-and-see approach. The lingual frenulum can loosen over time, and lactation consultants can often help babies with tongue-tie learn to breastfeed successfully.

The treatment most often recommended is a frenotomy, a simple procedure used to release the lingual frenulum by cutting it with sterile scissors or a laser. The procedure can be done in a doctor’s office and causes very little (if any) bleeding. Babies can typically breastfeed immediately after the procedure.

The follow-up is more involved: Parents or caregivers will need to stretch the tissue that’s been cut every day for about a month. This stretching helps encourage the tissue to regrow more loosely than it was originally so that the baby can continue to swallow and feed effectively.

“Complications of a frenotomy are rare — but could include bleeding or infection, or damage to the tongue or salivary glands,” according to http://mayoclinic.org. “It’s also possible to have scarring or for the frenulum to reattach to the base of the tongue.”

Besides a frenotomy, tongue-ties can be managed by working with a lactation consultant or doing one or more therapy programs: craniosacral, physical occupational or oral motor therapy. One of these options may be just what is needed, especially in milder cases.

Tongue-tie is a common condition, and the complications can be serious, but there are simple treatment options and therapies to help. If you think you or someone you care for has a tongue-tie, reach out to your doctor or dentist for a better experience eating, breathing and sleeping.

Sarah Hilton, RN, has 20 years of healthcare experience and serves as Stage Marketing’s director of advisory services.

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