What Exactly is a Tongue-Tie?

The definition of a tongue-tie (ankyloglossia) is not always clearly understood. Parents often come to my office with their infant, child, or teenager concerned because their physician, dentist, or therapist looked in their child's mouth and noted they had a "tongue-tie." This can sometimes be completely surprising to the parent. These referrals sometimes result in the treatment of an undiagnosed tongue-tie. However, after evaluating the patient, I sometimes tell the parent that their child is perfectly fine and that they have no need to worry. Why is that?

The Merriam-Webster definition for ankyloglossia is "limited normal movement of the tongue chiefly due to an abnormally shortened frenulum". To put it simply, a tongue-tie is when the lingual frenum (which is normal anatomy) is attached in such a way that it is preventing the tongue from utilizing it's full range of motion. Subsequently, this limited range of motion can prevent infants from breast/bottle feeding correctly, delay the development of speech or eating in children, or prevent proper tongue posture while sleeping which leads to mouth breathing or snoring at night.

Going back to my previous question, a well intentioned physician, dentist or therapist who does not understand the definition of a tongue-tie (ankyloglossia) will notice the patient's lingual frenum (again this is normal anatomy) and assume the patient has a tongue-tie. If not careful, these patient may have a surgical procedure completed without any justification for the procedure. Unfortunately, this happens all too often.

In my opinion, a tongue-tie release should address a specific concern. Something that I tell parents all the time is that, just because a restriction is present, it doesn't mean a surgical release is the best treatment option at this time. I have seen countless times, infants/children with minor tongue restrictions that develop their abilities to eat, sleep and speak with or without the help of non surgical interventions like working with a therapist. Each case should be evaluated by a well trained therapist (lactation, speech, myofuntional...etc) to determine if developmental delays in speech, eating or sleeping can be improved with non-surgical interventions.

Dr. Rodenberg is a Board-Certified Pediatric Dentist who practices in the Louisville, Kentucky area and is the founder of the Kentucky Tongue-Tie Center.