Tongue-tie (ankyloglossia)

Overview

Tongue-tie (ankyloglossia) is a condition present at birth that restricts the tongue's range of motion.

With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth. Depending on how much the tissue restricts tongue movement, it may interfere with breastfeeding. Someone who has tongue-tie might have difficulty sticking out the tongue. Tongue-tie can also affect eating or speaking.

Sometimes tongue-tie may not cause problems. Some cases may require a simple surgical procedure for correction.

Symptoms

Signs and symptoms of tongue-tie include:

• Difficulty lifting the tongue to the upper teeth or moving the tongue from side to side.
• Trouble sticking out the tongue past the lower front teeth.
• A tongue that appears notched or heart shaped when stuck out.

When to see a doctor

See a doctor if:

• Your baby has signs of tongue-tie that cause problems, such as having trouble breastfeeding.
• A speech-language pathologist thinks your child's speech is affected by tongue-tie.
• Your older child complains of tongue problems that interfere with eating, speaking or reaching the back teeth.
• You're bothered by your own symptoms of tongue-tie.

Causes

Typically, the lingual frenulum separates before birth, allowing the tongue free range of motion. With tongue-tie, the lingual frenulum remains attached to the bottom of the tongue. Why this happens is largely unknown, although some cases of tongue-tie have been associated with certain genetic factors.

Risk factors

Although tongue-tie can affect anyone, it's more common in boys than girls. Tongue-tie sometimes runs in families.

Complications

Tongue-tie may affect a baby's oral development, as well as the way the child eats, speaks and swallows.

For example, tongue-tie can sometimes lead to:

• Breastfeeding problems. Breastfeeding requires a baby to keep the tongue over the lower gum while sucking. If unable to move the tongue or keep it in the right position, the baby might chew instead of suck on the nipple. This can cause significant nipple pain and interfere with a baby's ability to get breast milk. Ultimately, poor breastfeeding can lead to inadequate nutrition and failure to thrive.
• Speech difficulties. Tongue-tie can interfere with the ability to make certain sounds — such as "t," "d," "z," "s," "th," "n" and "l."
• Poor oral hygiene. For an older child or adult, tongue-tie can make it difficult to sweep food debris from the teeth. This can contribute to tooth decay and inflammation of the gums (gingivitis).
• Challenges with other oral activities. Tongue-tie can interfere with activities such as licking an ice cream cone, licking the lips, kissing or playing a wind instrument.