Tongue Tie: Impacts on Speech, Dentition, Feeding, and More

Unlock the mysteries of tongue tie with our comprehensive, helpful guide tailored specifically for caregivers of children facing this challenge. We will define this condition, review identification, discuss the impacts, outline laser surgeries, and provide more reading material about tongue tie.

Tongue Tie Defined

Tongue tie, formally known as, ankyloglossia, restricts the tongue’s range of movement, making it challenging to reach the top palate or sides of the mouth. This movement is not only important for producing speech sounds, but also for manipulating foods to the sides of the mouth for chewing and clearing mouth pockets of leftover foods.  The tongue is connected to the bottom of the mouth by a band of tissues called lingual frenulum.  Tongue tie occurs when this collection of tissues is unusually short, thick, or tight. Children are born with tongue ties with some needing laser surgery to release the restriction.

How is Tongue Tie Identified?

Most often, a tongue tie is first identified by lactation consultants when nursing mothers have difficulty feeding their infants.  Otherwise, your child’s speech pathologist may refer you to specialists for suspected tongue tie.  Some behaviors observed in a child with tongue tie include:

• Inability to point tongue straight out of the mouth
• Difficulty lifting the tongue up inside the mouth and reaching the palate
• Reduced ability to move the tongue from side to side
• Small indentation at the tongue tip that makes the tongue look like a heart when the person sticks his tongue out
• Unable to stick the tongue out past the lower teeth
• Trouble with moving the tongue up when licking ice cream or lollipops

Speaking from personal experience, I have referred five clients over the last eight years to a local periodontist for suspected tongue tie.  Two of those clients needed a tongue tie release surgery and soon after demonstrated immediate, notable improvements in both speech sound productions and feeding.

What Else can a Tongue Tie Impact?

In addition to a tongue tie, some clients also have lip ties.  Beyond having implications on speech production, tongue and lip ties can also impact the following:

• tooth decay
• pain while brushing teeth
• dental issues such as teeth crowding
• food and texture aversions
• chewing and swallowing difficulties
• TMJ
• facial tension
• chronic sinus/ congestion issues
• ear infections
• migraines

Why are Laser Surgeries a Better Option than Clipping Tongue Ties?

Laser procedures completely disintegrate the restricted lingual frenulum with no reattachment of the muscles observed with children undergoing this procedure.  According to a local periodontist, Dr. Robert Pick, who pioneered the using a carbon dioxide Laser Frenectomy technique with his team at Northwestern in 1983,

“The laser is fabulous for tongue tie release because there is no bleeding during and/or after the procedure, no suturing needed, minimal to absent swelling and scarring, almost no chance for recurrence and a decreased to complete absence of pain post-surgically! In addition to use of the laser surgical time is dramatically reduced.”

Observations during Tongue Tie Release

Dr Pick has been using his innovative laser procedure with pediatrics for over 30 years at his office.  I called the office as soon as I finished exploring his website. A month later, I found myself observing a tongue tie release in Dr. Pick’s office.

The frenectomy, lasting 30 minutes, ensured numbing, keeping the patient informed and calm. Dr. Pick’s jovial manner and skilled surgery left a lasting impact. Within seconds of the laser surgery, the patient exclaimed, “I can finally stick my tongue out of my mouth!”  The muscle vanished before my eyes and the tongue found freedom. Five minutes later, the procedure was complete, and the patient was heading out the door to a lunch date with mom.

Recommendations and Resources

For tongue tie surgery, seek a specialized surgeon. Dr. Pick’s expertise ensures successful releases. According to Dr Pick, he has not had to perform a second release on any patient that he has seen over the last few decades; however, he does refer post-operative patients to their speech pathologists and/or myofunctional therapists to teach the tongue new placements at rest and during speech productions.  Below are some links and resources that you may find helpful in identifying red flags and performing post-operative exercises.

List of Published Articles Concerning Tongue and Lip Tie

Tongue Tie Babies