Tongue-Tie Unraveled: Navigating Its Impact on Health and Development

Introduction

In recent years, there’s been a noticeable increase in tongue-tie diagnoses, closely linked with the growing preference for breastfeeding. This surge in recognition has sparked renewed interest in evaluating how tongue-tie, medically known as ankyloglossia, affects both infants and mothers during breastfeeding. But the impact of this condition extends beyond nursing, influencing speech, feeding, breathing, sleep, and more.


What is Tongue-Tie?

Image taken from “Ankyloglossia as a risk factor for maxillary hypoplasia and soft palate elongation: A functional – morphological study” by A. J. Yoon et. al.

A tongue-tie occurs due to a restricted or short sublingual frenulum, the band of tissue under the tongue. This limitation can hinder tongue elevation, crucial for effective nursing. Babies with tongue-tie often demonstrate signs like arching their backs or a forward head posture, indicating discomfort and difficulty in achieving proper nursing positions.


Tongue-Tie and Myofunctional Disorders

When the sublingual frenulum is excessively tight, it can force the tongue into a low resting position in the mouth. This abnormal posture can lead to orofacial myofunctional disorders. Effective myofunctional therapy, which hinges on the tongue’s ability to access and comfortably rest on the palate, is crucial for treating these disorders.


Evolution of Tongue-Tie Treatments

Centuries ago, midwives would release tongue-ties using their fingernails. Today, we have safer and more effective methods. Dental or oral surgery specialists may recommend a lingual frenectomy or frenuloplasty, depending on the severity. These procedures, usually done under local anesthesia in-office, involve cutting the frenulum with scissors or laser, sometimes requiring sutures. In rare cases, general anesthesia is necessary.


The Role of Myofunctional Therapy

Myofunctional therapy is essential both before and after tongue-tie release. It prepares the tongue for surgery and aids in postoperative exercises and stretching. Unfortunately, many adults with tongue-tie remain undiagnosed until their child faces similar issues. Adult treatment can be more complex, addressing decades of compensatory behaviors.


Tongue-Tie in Adults

Many healthcare providers overlook tongue-tie in adults, especially if there are no evident speech issues. Yet, it can lead to neck tension, temporomandibular joint disorder (TMD), bruxism (grinding teeth), headaches, migraines, snoring, sleep disorders, digestive issues, aerophagia, and acid reflux. Adults often seek treatment for these symptoms without realizing the underlying cause could be tongue-tie.


Diverse Opinions and Treatment Approaches

Opinions on tongue-tie and its treatment vary widely among professionals. Without speech impediments, the condition is often disregarded. However, an altered lingual frenulum can significantly impact the normal function and development of the orofacial complex. Myofunctional therapy focuses on improving the tongue’s rest posture, strength, coordination, and involvement in essential functions like swallowing, chewing, and nasal breathing. Repetition is key, as per the principles of neuroplasticity and neuromotor rehabilitation, to make these improvements automatic. It’s advisable to engage in myofunctional exercises for 4-5 weeks before a tongue-tie release and continue them alongside special stretches post-procedure.


Conclusion

Tongue-tie is more than a breastfeeding issue. Its implications span various aspects of health and well-being. Understanding and addressing this condition requires a multi-faceted approach, combining surgical interventions with dedicated myofunctional therapy. As awareness grows, so does the opportunity for effective treatment and improved quality of life for both children and adults affected by tongue-tie.