December 08, 2014
The tongue is attached to the floor of the mouth with a thin band of tissue. When this frenulum is thicker and shorter than normal, it hampers the mobility of the tongue. This condition is known as tongue tie or sometimes as anchored tongue in layman’s language. The medical name for this condition is ankyloglossia.
There is no definite explanation for why tongue tie occurs in some people. It is presumed that there may be a genetic factor as it tends to run in some families. Besides this, it is more commonly observed in boys than in girls.
If the tongue tie is mild, then it may not create much problems for the patient. But in its more severe form it has considerable impact on the person’s health and wellbeing. The tongue plays an important role in speaking, eating and drinking as well as other oral functions.
Generally it is first noticed when there are feeding problems, as a baby with tongue-tie is unable to latch correctly while breastfeeding. The infant’s tongue should cover the lower gums while suckling which does not happen with tongue tie. Consequently this leads to pain for the mother and tiredness for the baby. This will lead to failure to thrive as the baby is unable to feed properly.
Usually, tongue tie has a limited effect on speech. Nevertheless, some children may exhibit speech problems later as these become noticeable only as the child learns to speak. The sounds that are likely to be affected are l, r, t, d, n, th, sh, and z.
An effect that becomes cause for concern at a later age is dental problems. As the tongue helps to clear food particles from the teeth, limited mobility may lead to poor oral hygiene. As a consequence, the person is more likely to suffer from tooth decay and gum disease. Besides, the lower front teeth may be pushed outwards.
Severe tongue tie can even limit other activities, such as, licking the lips, playing wind instruments, kissing or such simple things like licking an ice-cream or a lollipop.
Distinguishing symptoms for tongue tie
If it is mild it may go unnoticed in infants. However, there are some typical features that become obvious on close examination. These are:
- The tip of the tongue is likely to be shaped like a V (so called V-shaped tongue)
- The child is unable to stick out the tongue beyond the upper gums.
- The person is unable to touch the palate or the roof of the mouth with his tongue.
- It may be hard to move the tongue side to side.
Patients with tongue tie may have space between their lower front teeth.
In some cases, the frenulum may gradually separate on its own, thereby making intervention unnecessary. However, if it persists and is severe enough to cause health problems, then a minor surgery, frenotomy, is done to loosen the frenulum. In an infant, it simply involves a small cut in the frenulum. However, for severe cases more extensive surgery called frenuloplasty of the tongue may become necessary.