Tongue-tie, also known as ankyloglossia, is a congenital soft tissue attachment formed in utero that affects both function and mobility of the tongue and its associated muscles. Typically, this piece of tissue regresses during the growth and development process before birth, allowing the tongue free range of motion. With tongue-tie, the lingual frenulum remains attached to the bottom of the tongue and causes restriction for the normal function of swallowing, feeding, and elevation.

Tongue-tie is a very common condition that often is missed or undiagnosed. The tongue's posture in the oral cavity has a big impact on a child's developing airway health and their ability to establish consistent nasal breathing. Tongue ties can also impact the quality of sleep that a child experiences, and this can negatively affect their daytime behavior due to poor quality sleep.

Signs of tongue-tie in infants may include:

  • Difficulty breastfeeding, painful latch
  • Clicking or smacking noises while feeding
  • Difficulty transitioning to solid foods
  • Delayed speech development
  • Restless sleep, moving aroung in sleep often
  • Poor, slow weight gain
  • Difficulty lifting the tongue up or moving it from side to side
  • The tongue looks notched or heart-shaped when stuck out

Treatment of Tongue-Tie

The treatment of tongue-tie for infants is a simple surgical procedure called a frenectomy. A functional evaluation is performed to determine symptoms experienced and a structural assessment is followed to determine extent of functional restriction and anatomical positioning. A soft tissue CO2 laser is used for frenulum release and post operative stretching is recommended to ensure proper healing and prevention of reattachment. 

Frenectomy for tongue-tie in older children and adults is similar to that for infants, although it is usually involve placement of sutures. Myofunctional therapy is required pre and post operatively to ensure the most optimal long term result.