What is tongue-tie?
Tongue-tie, or ankyloglossia, is a congenital condition in which the lingual frenulum (the band of tissue that holds the underside of the tongue to the bottom of the mouth) is abnormally short and thick, which prevents the tongue from moving freely. While some babies do not seem to be bothered by it, in others it can cause them to struggle when they are breastfeeding, which is often when the condition is noticed. Tongue-tie is thought to affect 4-11% of newborns and is more common in boys than girls.
Symptoms of tongue-tie
The key symptom is the short, thick membrane that holds the tongue to the back of the mouth, which can cause the tongue to be heart-shaped when it is pulled out. This, in turn, can cause several signs that may alert the baby’s parents or doctors to the problem:
- Difficulty moving or sticking out the tongue
- Difficulty latching on to the nipple or staying attached when breastfeeding
- Being underweight or not gaining weight as fast as expected
- Being hungry all the time
- A clicking sound when the baby feeds
If the baby has tongue-tie, this can also affect the mother’s breasts. For example, you may suffer from sore or cracked nipples or mastitis (inflammation of the breasts), and milk production may be less than it should be. In older children and adults, the tongue may impede speech and may cause difficulty eating certain foods.
Tongue splitting is quick, simple and causes little or no pain or discomfort.
What are the causes of tongue-tie?
It is unknown why the lingual frenulum does not separate before birth in tongue-tie cases, but it is thought that genetic factors may be involved, as it appears to be hereditary.
Treatments for tongue-tie
The standard treatment is tongue splitting; a surgical procedure that involves cutting the lingual frenulum. Tongue splitting is quick, simple and causes little or no pain or discomfort. In very young infants, there are very few nerve endings where the lingual frenulum is located, and some have been known to sleep through the procedure without anesthesia, although others cry. In older babies with teeth, general anesthesia is needed to render them unconscious. The procedure is performed by specially trained doctors, nurses or midwives. Some doctors use sterile scissors, while others use laser technology to cut the membrane.
Babies who have had tongue-tie appear to breastfeed much more easily after the procedure. The tongue tie may not be treated at all if the baby does not seem to be bothered by it and is able to feed. Tightness in the lingual frenulum may resolve on its own, over time. However, if it is still causing problems such as a speech impediment in older children and adults, tongue splitting can still be performed, but may require stitches.
What type of specialist treats the tongue?
Pediatric surgeons can perform tongue splitting.