Tongue-Tie

Topic Overview

What is tongue-tie?

Tongue-tie (ankyloglossia) is a problem that occurs at birth. It happens when the tissue that attaches the tongue to the bottom of the mouth (lingual frenulum) is too short. This can limit the movement of the tongue.

See a picture of tongue-tie.

What causes tongue-tie?

The cause of tongue-tie isn't always known. It can run in families or may occur in babies who have other problems that affect the mouth or face, such as cleft palate.

What are the symptoms?

Many babies with tongue-tie don't have symptoms. The tissue either stretches as the child grows, or the child adapts to the tongue restriction. But some children with tongue-tie have:

• Trouble latching on to the mother's breast and sucking. This occurs because the tongue can't move milk from the milk glands of the breast to the nipple. Bottle-fed babies usually don't have feeding problems, because it is easy to get milk from the nipple of a bottle.
• Gaps or spaces between the front lower teeth.
• Speech problems, because the tip of the tongue cannot rise high enough to make some sounds clearly, such as t, d, z, s, th, n, and l.
• Personal or social problems related to the restricted tongue movement, such as problems cleaning food off the teeth with the tongue. A child with tongue-tie may be made fun of by peers.

How is tongue-tie diagnosed?

Your doctor will do a physical exam of your child's mouth and ask about his or her symptoms. In an older child or adult, the doctor may check the shape and movements of the tongue.

How is it treated?

Most children with tongue-tie don't need treatment. If your child has tongue-tie, you may choose to wait and see if his or her lingual frenulum stretches on its own.

While you wait and see, you can also:

• Talk to a lactation consultant if you are having breast-feeding problems.
• Consult a speech therapist if your child is having speech problems.

If your child's problems with breast-feeding are severe, medical treatment may be done. In children younger than 1, a procedure to clip the lingual frenulum (frenotomy) is usually all that is needed. In older children, if speech problems are very bad or are causing personal or social problems, surgery that clips the lingual frenulum and closes the wound with stitches (frenuloplasty) may be done.

Children who have either procedure will need to do tongue exercises to improve tongue movement. Children who have not had surgery may also be taught tongue exercises if they have mild problems with tongue-tie.

Frequently Asked Questions

Learning about tongue-tie:	What is tongue-tie? Who is affected? How can you deal with breast-feeding problems?
Getting treatment:	What is a frenotomy? What is frenuloplasty?

Other Places To Get Help

Organizations

American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS)
1650 Diagonal Road
Alexandria, VA  22314-2857
Phone:	(703) 836-4444
Web Address:	www.entnet.org
The American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) is the world's largest organization of physicians dedicated to the care of ear, nose, and throat (ENT) disorders. Its Web site includes information for the general public on ENT disorders.
KidsGrowth.com: Pediatric Health Care Alliance, P.A.
P.O. Box 1068
Oldsmar, FL  34677
Web Address:	www.kidsgrowth.com
The KidsGrowth website, created by pediatricians, has children's health resources for parents and teens. It offers a free newsletter and information about child development, behavioral issues, and illnesses. The TeenGrowth interactive website (www.teengrowth.com) offers a secure environment for teens to get valuable information on topics such as alcohol, drugs, emotions, health, family, friends, school, sex, and sports.
La Leche League International (LLLI)
P.O. Box 4079
Schaumburg, IL  60168-4079
Phone:	1-800-LA-LECHE (1-800-525-3243) (847) 519-7730
Fax:	(847) 969-0460
TDD:	(847) 592-7570
Web Address:	www.llli.org
La Leche League International (LLLI) offers information and encouragement—mainly through personal help—to all mothers who want to breast-feed their babies. It also offers support and information about breast-feeding babies with various disabilities, such as cleft lip or cleft palate. Call for information about a chapter in your area.

Related Information

• Bottle-Feeding
• Breast-Feeding
• Mouth Problems, Noninjury

References

Other Works Consulted

• Breward S (2006). Tongue tie and breastfeeding: Assessing and overcoming the difficulties. Community Practice, 79(9): 298–299.

• Hall DMB, Renfrew MJ (2005). Tongue tie. Archives of Disease in Childhood, 90(12): 1211–1215. [Erratum in Archives of Disease in Childhood, 91(9): 797.]

• Lalakea ML, Messner AH (2003). Ankyloglossia: Does it matter? Pediatric Clinics of North America, 50(2): 381–397.

Credits

By	Healthwise Staff
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Primary Medical Reviewer	Adam Husney, MD - Family Medicine
Specialist Medical Reviewer	Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
Last Revised	February 2, 2011

By:	Healthwise Staff	Last Revised: February 2, 2011
Medical Review:	Michael J. Sexton, MD - Pediatrics Adam Husney, MD - Family Medicine Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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