Tongue tie or Ankyloglossia, is a inherited oral anomaly characterised by a limited tongue movement due to a short or too thick lingual frenulum or band attaching the tongue to the lower jaw. The extent to which tongue tie causes clinical symptoms have long been a subject of controversy. Some practitioners believe that no ill effect will result however more practitioners are now thinking that limited movement may contribute to feeding, speech, development and mechanical problems.
The incidence of tongue tie in adolescents and adults, and their frequency, have traditionally been overlooked. Mechanical (non-speech-related) symptoms and social concerns due to impaired tongue mobility are common and may not become apparent until later in childhood. Tongue tie is not just about being able to suckle as a child. Ankyloglossia symptoms should be taken into account, and looked for in every assessment of jaw development and functional problems.
Tongue-ties can contribute to lowered tongue posture and have now been identified as a risk factor for obstructive sleep apnoea.
Also with the lower tongue position and the resulting lower jaw position, migraines, chronic headaches and neck tension has also been reported to improve when the tongue restriction is released.
We believe that the tongue is to live in the roof of the mouth if proper growth of the top jaw is to happen due to the 2000 times we swallow a day. With tongue tie we may also find more tongue thrust on swallowing and a open bite in the front teeth as a result. Alternatively the restricted tongue does not apply pressure on the spot on the roof of the mouth and stimulate proper forward and sideways growth of the upper jaw that is needed to fit all our teeth into the bone.
Normal tongue movements help to spread out the palate and widen the jaw, allowing for adequate room for teeth. When this spreading of the palate doesn’t happen the way it should it can lead to a lot of problems with a child’s teeth. We assess the mobility of the tongue and may prescribe tongue exercise in order to stretch the tongue tie but in some cases surgical intervention may be required in conjunction to tongue exercises. The exercises are important in the healing process after the surgery in order to limit the scarring and further limiting of the tongue movement after healing
What we look for to assess the tongue mobility:
- the tongue can’t poke out past the lips
- the tongue tip can’t touch the roof of the mouth and be sucked into the roof of the mouth entirely
- the tongue can’t be moved sideways to the corners of the mouth
- the tongue tip may look notched or heart-shaped