Does it really exist?

Tongue tie, also called Ankyloglossia (or crooked or looped tongue) is a real medical condition and has its own typical problems and presentation. Symptoms can be mild or severe, and where no difficulties are caused no intervention is needed. Where problems exist, it can be diagnosed, assessed, and successfully treated. It is not well known - although the expression  'tongue tied' is generally used to mean 'unable to speak'.

Can anything be done?

Much can be done to counter the problems caused by a tongue tie which is causing significant difficulties. Since it is caused by a structural anomaly, the structural defect must be physically corrected before other treatments for presenting problems will have a chance to succeed. Early intervention is recommended to avoid the formation of incorrect habits of using the tongue in feeding and speech.

Does it hurt?

Release of the frenum by snipping causes little pain, some babies sleep through the procedure. Surgery in hospital with a general anaesthetic will cause soreness until healing takes place in a week to 10 days. Revision by laser causes very little pain in most cases.


How is it caused?

The frenum is a remnant of tissue that was part of the facial structure of the infant during early pregnancy. Usually it disappears or reduces to a very slight membrane which is elastic and does not limit the tongue in its movements or disrupt function. Similar webs of tissue can also occur joining the cheeks or lips to the gums and these - like a tongue tie - also can be released surgically. When the lingual frenum does cause problems it is because tightness, thickness or width of the frenum  affects the function of the tongue in various ways. There is a very strong tendency for tongue tie to run in families, and it is more common in boys.

Who should diagnose it?

Tongue tie may be diagnosed by family doctors, dentists, lactation consultants, ENT (ear, nose and throat) doctors, surgeons, or speech-language pathologists.


Is it too late for adults?

No. it is never too late. Adults with problems report the following improvements: ability to chew better, not biting their tongues or cheeks when chewing, a sense of space in the mouth, improvements with speech, not having to think before they speak, relief of tight, clicky jaws, tension headaches and migraine, improved oral and dental health, and ability to control a lower denture! However, the strong oromuscular habits acquired while the tongue tie was present will be harder to get rid of in older persons. Speech therapy after surgical revision is strongly recommended.  


How common is it?

Tongue tie is very common, but often not diagnosed even when it causes problems. Accurate figures of incidence are not available, but several American studies done show ranges of 4 per 1000, to 22 per 1000. An English randomized controlled trial done in 2002, found that in a 5-month period, where 1,866 live births were recorded, 201 (10%) had a tongue tie. 124 were boys and 77 were girls.

Agreement about the definition of a tongue tie will be needed before statistics will be generally accepted. Checking for the presence of a tongue tie should be part of every neonatal (newborn) examination, to avoid the possibility of infant feeding problems.  

Why do doctors and nurses sometimes say “we don’t do this operation any more”?

This operation became uncommon in the 1940's when breastfeeding became less popular. It is now better known and the release or revision of the frenum is performed by doctors, dentists and surgeons who are interested in the topic. In some parts of England, lactation consultants and midwives are being trained to diagnose tongue tie and perform snipping of the frenum when breastfeeding problems arise.