Tongue Tie

Tongue Tie, referred to as “Ankyloglossia” or ‘tethered tongue’ is a common but often overlooked condition. Other oral restrictions include ‘tethering’ of the cheeks and/or upper and lower lips. Collectively the ‘ties’ are now becoming better known as “Tethered Oral Tissues” or T.O.T.s, the acronym created by Dr. Kevin Boyd at the World Tongue Tie Summit Montreal 2014 (IATP).

A Tongue Tie, regardless of Grade, may restrict the ALL IMPORTANT normal tongue resting posture (entire tongue body ‘glued’ to the roof of the mouth/palate from behind the front teeth back to the soft palate) and tongue function. Most people are unaware that these tethers or T.O.T.s should dissolve and disappear at approximately 12 weeks in utero, well before the baby is born. Babies should be examined for T.O.T.s at birth, by a properly trained professional, a mandatory examination now carried out in Brazil and the state of New Jersey in the US. Unfortunately, many professionals have not been trained in this particular area and often, but inadvertently give the wrong diagnosis. Babies were routinely examined at birth for alterated/restricted tongues up to the 1940’s and when diagnosed, surgically corrected (often by the Mid-wife). This is unfortunately no longer the case, as today, T.O.T.s are given little attention and often ignored.

• Inadequate facial growth leading to an array of malocclusions (crooked teeth)
• Tongue may fall back into the throat area, thus impinge the airway and negatively impact breathing
• Sleep disorders often present due to airway size reduction when tongue impinges the airway
• Babies may experience breast feed difficulties. However, an upper lip tie is very often correlated with such feeding problems and needs to be treated for successful breast-feeding to be properly established)
• Breastfeeding may be frequently very painful and difficult for Mums
• Toddlers have difficulty chewing food and swallowing correctly leading to ‘gut’ issues
• Both children and adults may have speech problems
• Many more problems

A small baby needs to get it’s tongue under its mother’s nipple, and, by using a combination of muscles, is able to extract milk from the breast.

Research has shown that breastfeeding has profound health benefits for the growing infant. Further to this, it is now known that the “suckling” action of a breast feeding baby is very important in the positive, normal, development of the palate and face, thus not only enhancing the looks of the child but also improving the airways and therefore reducing the chances of becoming a mouth breather, with all the associated negative consequences.

The Bottle-fed child does not feed with the same muscle action. Bottle-feeding requires strong piston-like up and down movement of the jaws which has very negative effects on facial growth.

Bottle-fed babies will often have high narrow palates, and may also develop a tongue thrust which may cause an open bite, poor facial profile, and crooked teeth.

INFANTS, CHILDREN AND ADULTS WITH A TONGUE TIE AND OTHER TOTS CAN EXPERIENCE A VARIETY OF PROBLEMS SUCH AS:

• AIRWAY obstruction
• SLEEP disorders
• Malocclusions (crooked teeth as face does not develop normally)
• Dental Problems become apparent (Tongue unable to ‘sweep’ teeth clean efficiently)
• Difficulty breastfeeding, which can cause “Failure to Thrive” for baby, and sleepless nights, as well as sore nipples for Mum
• Difficulty chewing solid foods, or fussy slow eaters
• Speech problems, especially making sounds involving “T,D,N,L and S
• Inability to open mouth widely, this can affect speech which can have social embarrasment
• Difficulty eating, kissing, and social situations
• Clicking Jaws
• Pain in Jaws
• Migraine headaches
• Protrusion of lower jaw (due to underdevelopment of upper jaw)

SURGERY

• A simple snip of the Tongue Tie is best carried out soon after birth. This is often performed without anaesthetic
• Surgery Snip: In older child and adults this procedure can be carried out under Local or General Anaesthetic.
• Laser Surgery (Which we offer at O Connor Dental Health from approximately 6 years +)

WHAT HAPPENS AFTER SURGERY?

• In infant no further treatment is required other than Mum ensuring through special exercises that the tongue (and lips if necessary) is kept mobile for several weeks following revision
• In young child or Adult it is most important that stretching exercises are given to the patient in order to stretch the tongue (and lips if necessary). This is important in order to avoid scar tissue forming and tongue tie re-developing.
• In our Practice, this is part of our Myofunctional Therapy Program. We are the only Practice in the country currently addressing, modifying, and correcting bad oral habits using Myofunctional Therapy.