Understanding Oral Dysfunction of the Face and Mouth (aka Tongue Tie) and its Implications

What is Tongue Tie (Ankyloglossia)?

Tongue tie, medically known as ankyloglossia, is a congenital condition where the lingual frenulum—the tissue connecting the tongue to the floor of the mouth—is too short or tight. This restriction limits tongue movement and can affect numerous oral functions throughout life, from infant feeding to adult speech and breathing.

Early identification and appropriate intervention can prevent a lifetime of challenges related to this condition. Research shows that approximately 4-11% of newborns have some degree of tongue tie, with varying levels of severity and impact.

Why Early Assessment Matters

When left untreated, tongue tie doesn’t simply resolve itself. The restricted tongue movement can lead to cascading effects on:

  • Infant nutrition and weight gain
  • Speech development
  • Jaw growth and dental alignment
  • Breathing patterns
  • Swallowing mechanics
  • Overall quality of life

Our practice specialises in comprehensive assessment and evidence-based treatments tailored to each patient’s specific needs.

Recognising the Signs: Age-Specific Symptoms

In Infants

  • Feeding Difficulties
    • Poor latch during breastfeeding
    • Inability to sustain a latch
    • Extended nursing sessions
    • Clicking sounds while feeding
    • Milk leakage during nursing
    • Falling asleep at the breast before satiation
    • Colic and excessive gassiness
    • Reflux symptoms
    • Poor weight gain despite frequent feeding
  • Visible Signs
    • Heart-shaped or notched tongue tip when extended
    • Inability to move tongue sideways or extend beyond lips
    • Flat or square tongue tip instead of pointed
    • Restricted upper lip movement (in cases of lip tie)
    • Gap between front teeth
  • Maternal Symptoms
    • Pain during breastfeeding
    • Decreased milk supply
    • Nipple damage or mastitis
    • Early weaning due to difficulties

In Children

  • Eating Challenges
    • Difficulty chewing age-appropriate foods
    • Gagging, choking, or vomiting during meals
    • Persistent food selectivity or “picky eating”
    • Messy eating habits
  • Speech Issues
    • Delayed speech development
    • Difficulty with specific sounds (T, D, L, R, S, Z)
    • Unclear speech, especially when speaking quickly
    • Frustration when trying to communicate
  • Other Manifestations
    • Persistent drooling
    • Dental problems (cavities, misalignment)
    • Behavioral issues related to frustration
    • Decreased self-confidence
    • Mouth breathing and snoring
    • Difficulties with oral hygiene

In Adolescents and Adults

  • Functional Limitations
    • Restricted mouth opening
    • Jaw pain or clicking (TMJ issues)
    • Migraines and tension headaches
    • Neck and shoulder pain related to compensatory postures
  • Social and Professional Impact
    • Self-consciousness about speech or appearance
    • Need to constantly monitor speech in professional settings
    • Difficulty with clear articulation when tired or after minimal alcohol
    • Impacts on relationships and social interactions
    • Challenges with activities like playing wind instruments
  • Ongoing Health Concerns
    • Gum inflammation and dental issues
    • Sleep-disordered breathing
    • Forward head posture and associated pain
    • Difficulty wearing or retaining dentures (in elderly patients)

Understanding the Causes

While the exact cause of tongue tie remains incompletely understood, research suggests genetic factors play a significant role. During embryonic development, the tissue that anchors the tongue normally recedes. In cases of tongue tie, this natural recession is incomplete.

Recent studies have identified several genetic markers associated with tongue tie, explaining why the condition often runs in families. Environmental factors may also contribute to its expression and severity.

Our Assessment Process

Our specialised assessment for tongue tie includes:

  1. Comprehensive History: We gather detailed information about feeding, speech, dental history, and any functional challenges.
  2. Physical Examination: Using specialised tools, we evaluate the structure and function of the frenulum, tongue mobility, and impact on surrounding structures.
  3. Functional Assessment: We observe how the restriction affects feeding, speaking, or breathing depending on age.
  4. Collaborative Approach: When needed, we consult with lactation specialists, speech pathologists, and other healthcare providers to ensure comprehensive care.

Treatment Options: A Personalised Approach

Treatment recommendations are based on the severity of restriction and its functional impact:

Frenectomy Procedures

  • Laser Frenectomy: Using advanced dental laser technology, this minimally invasive procedure precisely releases the restricted tissue with minimal bleeding and faster healing. Most infants can feed immediately afterward.
  • Scissor Frenectomy: A traditional approach using surgical scissors, sometimes preferred in specific clinical situations.
  • Frenuloplasty: For thicker or more complex restrictions, this surgical procedure involves releasing and reconstructing the frenulum tissue, followed by suturing. Generally recommended for older children and adults.

Supportive Therapies

  • Pre-Procedure Exercises: Specific techniques to prepare the oral tissues and maximise post-procedure success.
  • Post-Procedure Stretching: Essential exercises that prevent reattachment and promote optimal healing and function.
  • Myofunctional Therapy: Specialised exercises to retrain oral muscles and establish proper function after release.
  • Lactation Support: Expert guidance to optimise breastfeeding before and after treatment.
  • Speech Therapy: Targeted intervention for speech sound production and articulation.

Comprehensive Management

  • Orthodontic Collaboration: We work closely with orthodontists to address jaw development and dental alignment issues.
  • Sleep Medicine Integration: For patients with breathing-related symptoms, we coordinate with sleep specialists.
  • Long-term Follow-up: Regular monitoring ensures sustained improvement and addresses any emerging concerns.

The Connection Between Tongue Tie and Overall Health

Research increasingly demonstrates connections between tongue tie and:

  • Dental Development: Improper tongue positioning can lead to narrow palates, crowded teeth, and increased risk of decay.
  • Breathing Patterns: Restricted tongues may contribute to mouth breathing, which affects facial development and sleep quality.
  • Sleep Quality: Tongue restriction may contribute to sleep-disordered breathing and sleep apnea in both children and adults.
  • Posture and Pain: Compensatory head and neck positioning can lead to chronic pain patterns and postural issues.

Frequently Asked Questions

Infants typically experience minimal discomfort during laser frenectomy, often feeding immediately after. Older children and adults may experience mild discomfort managed with over-the-counter pain relievers. The laser approach minimises pain and promotes faster healing.

Initial healing occurs within 1-2 weeks. Complete functional improvement may take several weeks to months, especially if supportive therapies are needed.

Coverage varies by provider. Our office staff will help determine your benefits and provide necessary documentation for claims.

If you’ve noticed any symptoms mentioned above, a professional assessment is recommended. Not all ties require treatment—we base recommendations on functional impact, not just appearance.

When symptoms are present, earlier intervention typically yields better outcomes. However, successful treatment is possible at any age.

Call Us Today

Don’t let tongue tie restrict your or your child’s potential. Our specialised team offers comprehensive assessment and treatment options for patients of all ages.

To learn more about tongue tie treatment options or to schedule an assessment for frenectomy, contact our office in Mackay or Moranbah today!