Tongue-Tie or Ankyloglossia

Someone may say you are tongue-tied if you are having difficulty expressing yourself verbally. However, the origin of this saying comes from an actual congenital (present from birth) disorder known as ankyloglossia. In this condition, the frenulum—the piece of tissue that connects the tongue to the floor of the mouth—is too short.

Girl sticking tongue out

Eri Takahashi / Getty Images


Ankyloglossia occurs in approximately 3% to 5% of the population. There is relatively little known about the causes associated with this congenital disorder. There also does not seem to be any strong evidence of congenital syndromes associated with ankyloglossia. Twice as many men are born tongue-tied as women.


It can be difficult to diagnose ankyloglossia in a newborn. Often, newborns will not have any symptoms and not need an intervention. In severe cases, you will see a "V" or heart-shaped notch at the tip of the tongue. One of the hallmark symptoms of an infant being tongue-tied is difficulty in "latching on" to breastfeed. You may also notice that, if you are able to breastfeed your baby, your nipples will remain sore longer than expected.

When diagnosing ankyloglossia, your physician will look at the structures and function of the tongue. The frenulum will often be shorter, thicker, and feel tight when touched in those with this condition. When older, tongue movement can be evaluated. Sometimes your child may not be able to touch the tip of their tongue to the roof of their mouth. Other tongue movements that may be difficult include:

  • Moving the tongue from side to side
  • Licking an ice cream cone or lollipop
  • Sticking their tongue out

Other symptoms that may accompany being tongue-tied include:

  • Poor weight gain (due to breastfeeding difficulties)
  • Speech difficulties (a speech impediment)
  • Difficulty swallowing or eating
  • Dental problems


Treatment for being tongue-tied is not always necessary. When the disorder is severe enough to cause problems related to swallowing, speaking, or eating, treatment is necessary. Ankyloglossia is treated with a surgery called a frenulotomy. This surgery releases the tension in the frenulum to allow the tongue a wider range of motion. Other surgical procedures your child's doctor may discuss include frenulectomy and frenuloplasty. 

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By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.