Ankyloglossia (Tongue-tie)

What is Ankyloglossia?

Ankyloglossia (tongue-tie) is a medical condition that is present when a child is born and it prevents the tongue from having a range of motion.  The lingual frenulum, a thick band of tissue, keeps the tongue “tied” to the bottom of the mouth.

It can make it difficult for a child to swallow, speak, and even eat.  It can also cause problems with breast feeding.  Sometimes ankyloglossia does not cause problems and a simple procedure can correct it.

What are the Symptoms of Ankyloglossia?

A child who has ankyloglossia will have a hard time lifting the tongue as high as the upper teeth or even moving the tongue from one side of the mouth to another.  The child will likely be unable to stick the tongue out past the lower front teeth.

See a doctor

You should see a doctor if your baby has trouble breast feeding or if an older child has speech problems.

Ankyloglossia Causes

Doctors are not sure exactly why the lingual frenulum (the band of tissue underneath the tongue that connects it to the floor of the mouth) does not separate like it is supposed to before birth. In some cases they have found genetic factors that contribute to the frenulum staying connected, but there are many other cases where the cause cannot be determined.

Ankyloglossia is a common condition, with millions of children diagnosed every year. It occurs more often in boys than with girls and tends to run in families, but other risk factors are not known for the time being.

How is Ankyloglossia Treated?

Non-surgery treatment

There is a lot of controversy around treatments for ankyloglossia as some professionals like to take a wait and see approach while others like to correct the problem immediately.  Sometimes the lingual frenulum can loosen up as time passes but it can also cause problems over time.

Surgery treatment

Surgery may be recommended if the condition is causing significant problems.  A frenotomy is the simpler of the two options and can be done in a doctor’s office without anesthesia. Sterile scissors are used to snip the frenulum free in a quick procedure that has only minimal discomfort. There is minimal bleeding, if any.  A frenuloplasty is more complicated and is done under anesthesia. Self-absorbing sutures are then used to close the wound.  After a frenuloplasty surgery, tongue exercises may help to increase movement and reduce the possibility of scaring.

Ankyloglossia Prevention

This condition is nearly impossible to prevent. There is no way to know for sure the lingual frenulum has not separated from the floor of the mouth the way it is supposed to until after a child is born. Tongue-tie is generally not detected in children or adults unless it starts causing noticeable issues with eating or speaking.

The discussion of prevention in relation to Ankyloglossia is about ways to prevent the issues that can occur as a result of the condition.

Some of the issues that can occur as a result of tongue-tie are:

• Problems with weight gain in newborns and infants (due to being unable to latch during feeding)
• Problems for breastfeeding mothers with low milk supply and recurring breast inflammation (in limited cases)
• Speech impediments (due to interference with the ability to make some sounds)
• Gingivitis and tooth decay (due to limited range of motion and difficulty in sweeping food debris away from the teeth)

One way to prevent some of the issues that can occur because of tongue-tie is for parents with a family history of the issue to have doctors check for it once their baby is born. Because it may not be detectable until later, they should keep an eye on their child for possible symptoms as they grow.