Tongue Tie: What you should know?

Lynn Martelli
Lynn Martelli

Ankyloglossia, commonly known as tongue-tie, is a congenital condition that affects some children and causes difficulties with speech and eating. The frenulum of the tongue, which is a thin tissue connecting the underside of the tongue to the floor of the mouth, can be too short and tight in some children. This restricts the normal movement of the tongue. This can make it challenging for the child to stick their tongue out, move it from side to side, or touch their upper teeth with their tongue. Consulting a children’s ENT specialist is strongly recommended and the ENT Clinic in Singapore is one award winning practice that specializes in performing procedures to help with tongue-tie in kids.

What are the classes of tongue tie?

Tongue-tie is a condition that varies from child to child and is categorized based on the level of tongue movement. There are four classes of tongue-tie, with class 1 being the mildest and class 4 being the most severe. Only a small number of babies are born with this condition, and it occurs more frequently in boys than in girls.

How is a tongue tie caused?

Tongue-tie is a condition that arises due to abnormal formation of the tongue and frenulum, although the exact cause is still unknown to doctors. It is believed that family history may contribute to the occurrence of tongue-tie, as it can be hereditary.

What are the symptoms of tongue tie in children?

It is possible for a child with tongue-tie to not experience any difficulties, as many children do not. However, some children may encounter specific issues, such as difficulty with breastfeeding, struggling to produce certain sounds, having a gap between their front bottom teeth, and difficulties maintaining good oral health, which can lead to tooth decay. It is important for parents to observe any symptoms or concerns related to tongue-tie and seek medical attention if necessary. Treatment options, such as a simple surgical procedure known as a frenotomy, can help address the challenges associated with tongue-tie and improve a child’s quality of life. Tongue-tie can present challenges beyond difficulty with breastfeeding in infants. It can also impact a child’s ability to perform various activities, such as licking an ice cream cone, playing a wind instrument or leading to social problems in some children.

While most babies with tongue-tie don’t have breastfeeding problems, it may cause difficulty in some babies in latching. Untreated tongue-tie can result in insufficient weight gain in babies. Although tongue-tie rarely affects speech development, children may experience difficulties in producing specific sounds like t, d, z, s, th, n, and l.

In some instances, tongue-tie may be associated with other conditions, such as cleft lip or palate, which can cause additional symptoms. Therefore, parents should remain vigilant for signs of tongue-tie in their children and contact an ENT doctor if necessary. Addressing tongue-tie through treatment options, such as frenotomy, can improve a child’s ability to perform various activities and improve their quality of life.

How is tongue tie diagnosed in children?

The diagnosis of tongue-tie involves a thorough examination of a child’s tongue and its movements by an otolaryngologist , who will also take into account the child’s health history. Typically, tongue-tie is identified when a doctor is looking for possible causes of breastfeeding problems in infants.

How is tongue tie treated?

If a child doesn’t show any symptoms or if their symptoms are mild, the physician may not recommend any treatment for tongue-tie. In some cases, symptoms can go away over time as the frenulum, the piece of tissue that connects the tongue to the floor of the mouth, naturally moves backward between the ages of 6 months and 6 years. This is especially true for mild tongue-tie. However, for children with class 3 or class 4 tongue-tie, symptoms are less likely to resolve on their own, and treatment may be necessary.

For infants who are having difficulty breastfeeding, a doctor  may recommend working with a breastfeeding specialist. If this doesn’t help, a surgical procedure may be necessary. A speech specialist may also be necessary to test the child’s speech and recommend speech therapy or surgery.

Frenotomy is a simple and effective surgical procedure that can often be done as an outpatient procedure. During this procedure, the ENT doctor makes a small cut in the frenulum, allowing the tongue to move normally. However, some children may need a more complex procedure such as frenectomy or frenuloplasty. Frenectomy involves completely removing the frenulum, while frenuloplasty uses different methods to release the tongue-tie. These procedures may be necessary if  the child’s frenulum is very thick.

After a frenotomy or another surgical procedure, it may be necessary for the child to see a speech therapist to retrain the tongue muscles and improve speech. It is important for parents to work closely with a paediatric ENT specialist to determine the best treatment plan for their child’s tongue-tie, taking into account the severity of symptoms and other individual factors.

What should you do before an appointment?

Before your child’s medical appointment, it is important to understand the reason for the visit and what you hope to achieve from it. It’s a good idea to prepare a list of questions you want to ask during the visit.

It is important to understand why a new medicine or treatment is being prescribed, and what possible side effects may occur. Ask your physician if there are alternative ways to treat your child’s condition. Additionally, it is essential to understand why a test or procedure is being recommended and what the potential results could mean.

Key takeaways:

  • Tongue-tie is a condition that restricts the movement of the tongue and is present at birth.
  • This occurs when the frenulum underneath the tongue is too short and tight. The symptoms of tongue-tie can vary in each child, and some children may not experience any symptoms at all.
  • Tongue-tie can cause breastfeeding difficulties and difficulty producing certain sounds in speech.
  • Surgery is not always necessary, and treatment may not be required for mild cases or cases with no symptoms.
  • If the tongue-tie condition is more severe and causes significant symptoms, surgery may be recommended.
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