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. This means that the frenulum, the piece of tissue that connects the tongue to the floor of the mouth, is too short.

Ankyloglossia occurs in approximately 3 to 5% of the population. There is relatively little known as to causes associated with this congenital disorder, however, there does appear to be twice as many males born tongue-tied than females. There also does not seem to be any strong evidence of congenital syndromes associated with ankyloglossia.

It can be difficult to diagnose ankyloglossia in a newborn. Often times 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 that can help in identifying your child as being tongue-tied can be difficulty in "latching on" to breastfeed. You may also notice that if you are able to breastfeed your baby, that your nipples will remain sorer 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. 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 includes:

• Moving the tongue from side to side
• Licking an ice cream cone or sucker
• 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. Treatment for ankyloglossia should be reserved for cases when the disorder is severe enough to cause problems related to swallowing, speaking, or eating. When these types of problems occur, treatment is necessary. The way ankyloglossia is treated involves a surgery called a frenulotomy. This surgery releases the tension of the frenulum to allow the tongue a wider range of motion. Other surgical procedures that your child's doctor may discuss include a frenulectomy and frenuloplasty.