Tongue-Tie: Why It Matters!

Tongue-Tie: Why It Matters!

January 17, 2024

The tongue, a critical muscle in shaping facial and jaw development from birth, has more functions than one might realize. It plays a vital role in breathing, swallowing, and speaking. Occasionally, however, the tongue encounters a restriction due to a tight band of tissue connecting it to the floor of the mouth, known as tongue-tie or ankyloglossia. This limitation can pose challenges for individuals of all ages.

In this blog post, the focus is on shedding light on tongue-tie — what it is, how it can be diagnosed and treated, and exploring preventative and management strategies.

What Is Tongue-Tie?

Ankyloglossia, commonly known as a tongue tie, occurs when the underside of the tongue attaches abnormally to the floor of the mouth, restricting tongue mobility.

Ankyloglossia affects approximately 4.8% of newborns, with a prevalence of 4.2-10.7% in the overall population, but this figure does not account for posterior tongue ties which are also responsible for symptoms including pain and nipple damage for the mother.

The recent increase in diagnoses is attributed to factors like a heightened focus on breastfeeding benefits, increased awareness, and a surge in medical practitioners treating ankyloglossia.

Severity is often classified based on a tongue range of motion ratio (TRMR), ranging from Grade 1 (> 80%
motion) to Grade 4 (< 25% motion). There are also the Kotlow and Coryllos systems making communication among providers challenging at times due to opposite grading.

Conditions Related to Tongue-Tie

Restrictive lingual frenulum is linked to obstructive sleep apnea, particularly in children and adults. Infants with tongue ties may experience difficulties in breastfeeding, growth and development issues, as well as potential cognitive and behavioral disturbances. Tongue mobility decreases have also been associated with the narrowing of the maxillary arch, elongation of the soft palate, and altered swallowing patterns, contributing to issues like mouth-breathing and sleep-disordered breathing.

Children with short lingual frenula may experience abnormal breathing, airway collapsibility during sleep, adenotonsillar hypertrophy, and a high and narrow palatal vault. Mouth-breathing, associated with tongue ties, leads to enlarged tonsils due to increased upper airway resistance, causing inflammation and contributing to nasal obstruction and sleep-disordered breathing.

How Are Tongue-Ties Treated?

Frenectomy, or the release of tongue ties, is commonly performed using laser or scissors. Furthermore, the skill of the provider is even more important than the choice of instrument, however, the CO2 laser is preferred by most providers. The procedure is generally safe, with potential benefits in improving breastfeeding outcomes. Postoperative care and rehabilitation, often involving myofunctional therapy, are crucial for long-term success. Frenectomy can also show improvement in tongue protrusion, elevation, and articulation problems in children.

How Can Oral Myofunctional Therapy Help?

Orofacial myofunctional therapy (OMT) plays a vital role in the comprehensive treatment of tongue ties. It is a non-invasive behavioral modification program focusing on neuromuscular re-education for proper oral rest posture, efficient chewing, normalized swallowing, improved sleep quality, nasal breathing, and reduction of orofacial tension and pain. OMT contributes to addressing symptoms such as an anterior open bite, tongue thrust habits, mouth breathing, thumb sucking, dental eruption disturbances, and malocclusions.

The tongue, as a vital muscle, significantly influences craniofacial growth and development. Tongue ties are a common occurrence with potential negative consequences on jaw development, breastfeeding, and overall oral health. A comprehensive approach involving tongue tie resection, orthodontic/orthopedic treatments, and orofacial myofunctional therapy is essential for ensuring long-term stability and a foundation of health across all age groups. If you’d like more information regarding tongue-tie treatment near Cadillac, MI, feel free to reach out to Brite White Dental for more information.

Click to listen highlighted text!