Tongue-tie, also known as tethered oral tissues or ankyloglossia, refers to reduced tongue mobility resulting from a tight or a restricted lingual frenum. The lingual frenum exists underneath the tongue. Its purpose is to connect the tongue to the floor of the mouth. It has a string-like appearance and is made from collagen cells.
We all have lingual frenums, however, abnormalities exist when the length and flexibility of the lingual frenum negatively impacts how far and easily the tongue can move within the mouth. A tongue restriction or tie would be comparable to walking freely (person who isn’t tongue-tied) versus walking with your shoelaces tied together (person who is tongue-tied).
Tongue-tie is a congenital condition that occurs during gestational development. As an infant develops the lingual frenum thins and recedes, however, in the case of tongue-tie, this process is disrupted resulting in the lingual restriction.
Children or adolescents who demonstrate tongue-tie often have trouble with speech and feeding tasks. Speech difficulties arise due to difficulty lifting the tongue tip up to the roof of the mouth, elevating the sides of the tongue to control airflow, creating lingual tension, retracting and elevating the posterior portion of the tongue. When lingual movement and tongue control (tension or cupping of the tongue) are inhibited, the following speech sounds can be distorted: t, d, n, l, s, z, sh, ch, dz, and r. Additionally, children may demonstrate frequent distortions during conversational speech due to difficulty moving and controlling their tongue movement.
Feeding difficulties can also occur due to difficulty moving the tongue tip side to side between molar surfaces, lifting the tongue tip, elevating the sides of the tongue or tongue cupping, suctioning the tongue to the hard palate, and using the tongue tip to clear out debris after eating. As a result, an infant may exhibit difficulty nursing, resulting in a clicking noise, poor suction, shallow/painful latch, milk leaking out the sides of the mouth, popping on and off the breast, falling asleep prematurely, reflux, poor weight gain, poor breast drainage, low milk supply, and nipple pain. An older child may demonstrate picky eating, messy eating, frequent cavities, slow or fast eating, a tongue thrust swallow, and reflux.
If you are concerned that your child may have a tongue-tie, reach out to a speech therapist who specializes in orofacial myofunctional therapy. Orofacial myofunctional therapy refers to a therapist who is knowledgeable about optimal development of oral structures and how to promote adequate lingual rest posture, feeding, and speech skills. It is important that any professional completing an assessment of tongue-tie looks at lingual range of motion in a functional context to determine if your child’s speech or feeding skills are being negatively impacted.
The team at Kid Connections Therapy specializes in this kind of assessment and collaborates with local dentists and orthodontists to complete a frenectomy procedure to release tethered oral tissues. Call Kid Connections Therapy at 410-274-0041 for more information.