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Tongue-Tie: What Is It and How Is It Treated?

Cat got your tongue? While a cat isn’t literally holding your tongue, you may have felt tongue-tied before—tripping or stumbling over your own words. But did you know that a tongue-tie is also a medical condition?

“A tongue-tie, also known as ankyloglossia, is a disorder where the normal band of tissue under the bottom of your tongue, called your frenulum, is too tight and limits the movement of your tongue,” said Jonathan Skirko, MD, a pediatric facial plastic surgeon and ear, nose and throat specialist at Banner – University Medical Center Tucson in Arizona.

For some people, a mild tongue-tie may not cause any issues and may even go unnoticed. For others, however, a tongue-tie will require intervention; a surgical procedure known as a frenectomy.

If you believe your baby or child has a tongue-tie, here’s what you should know and next steps for treatment.

Causes of tongue-tie

A tongue-tie occurs when the tongue and the lingual frenulum (the thin tissue connecting the tongue and the floor of the mouth) don’t form normally. Either the frenulum is too short and tight, or the frenulum is still attached to the tip of the tongue. While the cause is relatively unknown, your family history may play a role.

What to look for

Tongue-ties can range from mild to severe. Here are some signs and symptoms to look out for.

In newborns and babies, you may notice:

  • They have a V-shaped or heart-shaped indentation at the tip of their tongue.
  • They have difficulty latching during breastfeeding. They may make a noticeable clicking sound while they feed. For nursing moms, you may experience cracked, sore nipples or issues with milk supply.
  • They are unable to stick their tongue out past the upper gums.

In children, you may notice:

  • They have difficulty moving their tongue side to side to the corners of their mouth, sticking it out or using it to touch the roof of their mouth.
  • Their tongue looks flat or square instead of pointy when they stick it out.
  • They may have difficulty playing wind instruments.
  • They may have speech impairments. Your child may have trouble making certain sounds, such as t, d, z, l and th.
  • They may have difficulty swallowing normally.

Diagnosing a tongue-tie

In newborns it can be difficult to diagnose a tongue-tie, however, your doctor or a lactation consultant might find tongue-tie as the possible cause if your baby has difficulties “latching on” during breastfeeding.

“In older children, you may notice they have difficulty licking an ice cream cone or lollipop,” Dr. Skirko said. “If they do, you’ll want to have your child assessed by their primary care doctor or a pediatric otolaryngologist, or ENT, who is skilled in recognizing and treating this condition.”

Treating a tongue-tie

For mild cases, your child’s doctor may not recommend any treatment. In some children, symptoms may go away with time. For more severe cases, your child’s doctor may recommend a frenectomy. This is a simple procedure where the doctor clips the extra tissue underneath the tongue to allow the tongue a wider range of motion.

“A frenectomy is a pretty quick and effective procedure and there is little risk involved,” Dr. Skirko said. “However, we usually reserve this procedure for when the disorder is severe and causes problems like swallowing, speaking or eating.”

For babies, the procedure can be done in-office, and babies can breastfeed immediately after the procedure.

For children, the procedure is typically done under general or local anesthesia. “This is done mostly because it’s harder for older children to hold still,” Dr. Skirko said. After the frenectomy, your child may need to see a speech therapist to help them retrain their tongue muscles.

Next steps

Talk to your child’s primary care doctor, a breastfeeding specialist or a pediatric otolaryngologist if your child is having difficulty breastfeeding, swallowing or making sounds, so they can help guide you in diagnosis and treatment. To locate a Banner Health specialist near you, visit bannerhealth.com.

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