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Tongue tie: Treatment, symptoms, advice and help

About tongue tie

Tongue tie, also called ankyloglossia, is a condition present from birth in which there is decreased mobility of the tongue tip as the underside of the tongue is tethered to the floor of the mouth. It varies in severity from mild cases characterized by mucous membrane bands to complete ankyloglossia whereby the tongue is tethered to the floor of the mouth.

Tongue tie: Incidence, age and sex

The incidence of tongue tie is thought to be 4 per 1000 of the population. Around 16 percent of babies who experience difficulty with breastfeeding, may have a tongue tie. It is more common in boys, than in girls.

Symptoms and signs of tongue tie: Diagnosis

Diagnosis of ankyloglossia may be difficult. For infants, passively elevating the tongue tip with a tongue depressor may reveal the problem. For older children, making the tongue move to its maximum range will demonstrate the tongue tip restriction. When they protrude their tongue, there will be a heart-shaped look at the front of the tongue and no tongue tip can be seen.

Causes and prevention of tongue tie

It is caused by a short, thick membrane (lingual frenulum ) connecting the underside of the tongue to the floor of the mouth. Genetic factors have been implicated .Tongue tie may often run in families. Tongue tie sometimes occurs together with other congenital conditions such as a cleft lip or palate. It may also occur together with conditions, such as severe hearing loss or cerebral palsy.

Tongue tie: Complications

Ankyloglossia may affect feeding, speech, and oral hygiene. It may also result in mandibular prognathism; the anterior portion of the mandible has exaggerated anterior thrusts. Later in life, it may cause mechanical limitations which may include cuts or discomfort underneath the tongue and difficulties with kissing, licking one’s lips, eating an ice cream cone, keeping one’s tongue clean and performing tongue tricks as well as social effects such as embarrassment and teasing.

Tongue tie: Treatment

If there is no feeding difficulty in the infant, this would best be a wait-and-see approach. The frenulum naturally recedes during the process of a child’s growth between six months and six years of age. Surgery may be considered for patients of any age when there is a history of speech, feeding, or mechanical/social difficulties. Surgery will be in the form of frenotomy (also called a frenectomy or frenulectomy) or frenuloplasty. This may be done by means of a laser.