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What Is a Tongue-Tie?

The tissue connection between the bottom of the tongue and the floor of the mouth is called a frenum. If you lift your tongue and look in a mirror, you can see it. This piece of tissue can develop too short, too thick or too tight, and it can physically restrict the function and movement of the tongue. Being tongue-tied can lead to many different health consequences, including speech problems, mouth breathing, clenching or grinding, jaw or TMJ pain, headaches, neck and shoulder tension, snoring or sleep apnea, increased risk for cavities and gum disease, and slower orthodontic treatment or relapse after orthodontic treatment.

How Do We Evaluate for a Tongue-Tie?

First, a survey is done between the patient, or patient’s caregiver, and our dentists to determine if there are any symptoms that could be related to a tongue-tie. We interview the patient or caregiver and document the history of symptoms and any functional issues that may be known or even known but not identified. Next, our dentists will perform a thorough oral examination to physically look at the restriction and identify the degree of restriction. We can take photos of the restriction inside the mouth with a small camera to help visualize each patient’s unique anatomy.

What Are Some Signs That I or My Child Has a Tongue-Tie?

Signs and symptoms can vary by age and how restricted the tongue-tie is. Below is a short list of symptoms that may indicate a tongue-tie.

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Babies and Infants
(past or present issues)

  • Painful nursing
  • Shallow latch
  • Reflux and excessive gassiness
  • Milk dribbling out of the mouth when eating
  • Clicking noises or “chewing” while feeding

Children and Adults

  • Trouble with speech sounds, hard-to-understand speech or mumbling
  • Speech delay
  • Slow eater
  • Picky eater, especially about textures
  • Choking or gagging on food
  • Crooked or crowded teeth
  • Frequent headaches or neck and shoulder pain
  • Hyperactivity or trouble paying attention
  • Restless sleep (lots of movement during sleep)
  • Waking frequently throughout the night
  • Snoring or stopping breathing (apnea) during sleep
  • Grinding teeth during sleep
  • Waking frequently throughout the night
  • Mouth breathing or sleeping with mouth open

What Can Be Done To Correct a Tongue-Tie?

In most cases, tongue-ties are treated with a minor surgical procedure called a frenectomy that releases the tissue that is too short, tight or thick. The procedure is straightforward and relatively quick and can be done at Northline Dental with our dentists. There are very few risks associated with the procedure.

How Is the Procedure Done?

Our dentists and team are trained in the use of laser-assisted dental surgery procedures. First, the area is numbed for a more comfortable experience, then a dental laser is used to release extra tissue that is holding the tongue from being able to move freely. Immediately after the procedure, the patient is asked to move the tongue forward (stick their tongue out) and around to feel the difference and evaluate the new range of movement.

Is There Anything I Can Do To Make the Procedure More Successful?

Yes! Our dentists will explain the pre-procedure and post-procedure stretching exercises for you. We may also recommend an evaluation with a lactation consultant, speech and language therapist, myofunctional therapist, or chiropractor as needed on a case-by-case basis. The tongue is a muscle, just like any other in the body, so it makes sense that some physical therapy would be needed before and after to have as much success as possible.

What About Lip-Ties?

Lip-ties differ from tongue-ties in location and symptoms or side effects. The upper lip has a connection to the gums above the upper front teeth. In some people and even infants, this connection is too tight, short or thick. For infants, this can lead to struggling with latching during breastfeeding and even with bottle-feeding. For older children or adults, the area may be difficult or even painful to brush due to the tightness of the connection, and a gap may be noticeable between the front teeth as a result of the lip-tie. In some cases, after braces are completed, an orthodontist may recommend a lip-tie release to prevent the gap from coming back after the braces are removed. The procedure to release a lip-tie is very similar to a tongue-tie and often can be done at the same time as a tongue-tie release if indicated. Not every person with a tongue-tie has a lip-tie, and the opposite is true as well: Not every person with a lip-tie has a tongue-tie.

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