By Dr Clayton Mentoor, Innohealth Clinic
Tongue tied is a phrase often used to describe stumbling over words, but did you know that it is also a medical condition known as ankyloglossia that can cause challenges with speech, breastfeeding and oral hygiene?
What is tongue tie?
Tongue tie, or ankyloglossia, is a condition present at birth where the band of tissue (lingual frenulum) that connects the underside of the tongue to the floor of the mouth is shorter, thicker, or tighter than usual. This can restrict the tongue’s movement, leading to potential issues with breastfeeding, speech, and oral hygiene.
Tongue tie is noted upon physical examination by a medical professional and can also be noted by a lactation specialist. Upon diagnosis a referral can be made to a specialist.
Challenges caused by tongue tie
In infants:
- Difficulty latching during breastfeeding
- Prolonged feeding times
- Poor weight gain
- Irritability with feeds breast or bottle
- Clicking sound while feeding
- Mother experiencing nipple pain or damage
In children:
- Difficulty with certain speech sounds
- Problems with licking, kissing, or blowing
- Difficulty moving the tongue to clean the teeth
- Issues with oral hygiene due to limited tongue movement
There is also potentially an emotional impact on parents, however parents should also be aware that tongue tie is not their fault, and that it can be treated/managed.
Management and treatment
Observation: mild cases may not require any intervention and can be monitored to see if they resolve on their own or if the child adapts.
Breastfeeding support: lactation consultants can help mothers with positioning and techniques to improve breastfeeding in infants with tongue tie.
Speech therapy: for children with speech difficulties, speech therapy can help improve articulation and speech clarity.
Frenulectomy: this is a minor surgical procedure where the lingual frenulum is cut to release the tongue. It is often done in infants and can be performed in a doctor’s office with little or no anaesthesia. The procedure is quick, and healing usually occurs rapidly with minimal discomfort.
Frenuloplasty: a more extensive surgical procedure, often used for older children or adults. It involves the release of the frenulum followed by suturing the wound. This procedure may require general anaesthesia and has a longer recovery period.
After a frenulectomy or frenuloplasty, specific exercises and stretches may be recommended to prevent reattachment of the tissue and to promote proper tongue movement. Pain management may be necessary, especially in older children and adults.
While complications are rare, they can include bleeding, infection, and scarring. There may also be a risk of reattachment of the frenulum, requiring further intervention.
If you suspect a tongue tie in an infant or child it is essential to consult with a healthcare provider, such as a paediatrician, lactation consultant, or dentist, to discuss symptoms and potential treatment options. Management of tongue ties involves a multidisciplinary approach to address the specific needs of the individual, whether it is breastfeeding support, speech therapy, or surgical intervention.
