#ankyloglossia

When we say, “tongue tied,” most of us think of a situation when we are too excited to express ourselves verbally. Although not a medical illness, tongue tie is the name for a common condition that limits the development of the tongue.

Before we are born, a strong cord of tissue called the frenulum is positioned in the center of the mouth and guides the development of the oral cavity. As we grow and develop, it thins out and fades to a small thin piece of tissue that attaches the bottom of the tongue to. In some children, the frenulum is especially tight or fails to recede and may cause problems with tongue movement.

In infants, tongue tie can present with trouble sucking or poor weight gain. In breastfed infants, it can cause trouble with latching, or the mother may experience pain when the baby is nursing. Some mothers give up nursing because of tongue tie that is not recognized. In toddlers and older children, tongue tie can be a cause of trouble with speech articulation, especially consonant sounds. Signs that your child may have difficulty due to tongue tie include a V-shaped notch at the tip of the tongue, inability to stick the tongue out past the gums, or simply difficulty licking an ice cream cone or lollipop.

Frenuloplasty

A shortened frenulum restricts the range of motion of the tongue, therefore a frenulectomy may be recommended. A frenulectomy is a surgical procedure performed to clip the frenulum and release the tongue. In infants a frenulectomy can be performed as a simple office procedure with topical local anesthesia. Older infants and young children often require anesthetic gas for the procedure, but older cooperative children can also have the procedure safely with only local topical anesthesia. Although it is considered a safe and simple procedure, risks of a frenulectomy may include infection, scarring and excessive bleeding.

A baby who struggles to latch properly during feeding, or an adult who has always felt their speech was slightly harder to articulate than it should be, may both be dealing with the same underlying condition without ever realizing it. Tongue-tie, medically known as ankyloglossia, restricts the tongue's normal range of motion, and while it is most commonly discussed in the context of infant feeding, it can affect speech, oral function, and comfort well into adulthood if left unaddressed.

Dr. Raj Bhayani, an ENT and craniofacial surgeon at the New York Institute of Otolaryngology and Aesthetic Surgery in Brooklyn and Rego Park, evaluates tongue-tie in both infants and adults as part of a comprehensive ENT practice. This guide explains what tongue-tie actually is, how it presents differently in babies and adults, how it affects feeding and speech, the treatment options available, and what recovery looks like after a frenectomy.

What Tongue-Tie Is

Tongue-tie occurs when the thin band of tissue connecting the underside of the tongue to the floor of the mouth, known as the lingual frenulum, is unusually short, thick, or tight, restricting the tongue's normal range of motion. In a typical mouth, this band is flexible enough to allow the tongue to move freely for feeding, speech, and general oral function. When it is too restrictive, the tongue cannot reach its full range of motion, which can create a variety of downstream effects.

Tongue-tie exists on a spectrum, ranging from mild cases that cause no noticeable problems to more significant restriction that meaningfully limits tongue movement and function. This variability is part of why tongue-tie is sometimes identified immediately after birth and other times not recognized until much later, occasionally not until adulthood.

Signs in Babies and Adults

Tongue-tie presents differently depending on age, since the functional demands placed on the tongue change significantly from infancy through adulthood.

In babies, difficulty latching properly during breastfeeding or bottle feeding

In babies, clicking sounds during feeding or apparent frustration while attempting to feed

In babies, poor weight gain related to feeding difficulty

In older children and adults, difficulty pronouncing certain sounds, particularly those requiring the tongue tip to reach the roof of the mouth

In adults, difficulty with activities such as licking an ice cream cone or playing certain wind instruments

In adults, discomfort or restriction noticed specifically when attempting to stick the tongue out fully

Many adults with tongue-tie have simply adapted their speech and oral habits around the restriction over years, sometimes without ever realizing that a specific anatomical cause was involved.

How It Affects Feeding and Speech

The functional impact of tongue-tie depends heavily on its severity and the specific demands being placed on tongue movement at any given stage of life.

In infants, restricted tongue movement can prevent an effective latch, leading to inadequate milk transfer and, in some cases, maternal nipple pain during breastfeeding

Inefficient feeding patterns can contribute to prolonged feeding sessions and infant frustration

In older children, tongue-tie can specifically affect sounds such as "t," "d," "l," "s," and "th," which require precise tongue tip positioning

In adults, tongue-tie rarely causes major speech problems by that point, since most adults have developed compensatory speech patterns over years, but it can still cause functional limitations and occasional discomfort

Speech difficulties related to tongue-tie are usually most apparent during early speech development, which is why pediatric evaluation often focuses heavily on this specific concern.

Treatment Options

Not every case of tongue-tie requires treatment, and the decision depends on the severity of the restriction and the specific functional problems it is causing.

Mild tongue-tie causing no functional problems may simply be monitored without intervention

A frenotomy, a simple snip of the frenulum, is often used for infants with significant feeding difficulty, sometimes performed with minimal or no anesthesia given how quick the procedure is

A frenectomy, a more complete removal of the restrictive tissue, is typically used for older children and adults, usually under local anesthesia

Speech therapy may be recommended alongside or following treatment for children with speech difficulties related to tongue-tie

The specific procedure recommended depends on the patient's age, the severity of the tongue-tie, and the specific functional problems being addressed.

Recovery After a Frenectomy

Recovery from a frenectomy is generally quick and well tolerated, particularly compared to many other minor surgical procedures.

Infants undergoing a frenotomy typically resume feeding within minutes to hours, often with immediate improvement in latch quality

Older children and adults typically experience mild discomfort for a few days following a frenectomy

Tongue stretching exercises are often recommended after the procedure to prevent the tissue from reattaching too tightly during healing

Full healing of the area generally occurs within one to two weeks

Most patients, regardless of age, notice functional improvement fairly quickly after treatment, whether that improvement shows up as easier feeding in an infant or a wider range of tongue motion in an older child or adult.

Choosing the Right ENT for Tongue-Tie Evaluation

👅 Did You Know? A condition called Tongue Tie (Ankyloglossia) is present at birth, where the tissue connecting the tongue to the floor of the mouth is shorter, thicker, or tighter than normal.

⚠️ This can lead to: ✔️ Jaw Growth Problems ✔️ Malocclusions ✔️ Chewing & Swallowing Issues ✔️ Incorrect Tongue Posture ✔️ Disturbed Sleep

Early diagnosis and treatment can prevent long-term complications. Don’t ignore the signs—your oral health matters!

🌐 Visit: www.dentalwiresdentalclinic.com 📞 Call: +91 98763 27841

In this informative video, Dr. Bhavesh Doshi, a renowned Pediatric Surgeon in Mumbai, sheds light on tongue tie, a common condition that affects children.

He explains how tongue tie can lead to delayed speech or slurring of speech due to the inability to protrude the tongue beyond a particular part of the mouth, and how this condition can be corrected through a simple surgical procedure using a Bipolar Cautery device.

Dr. Doshi emphasizes that the surgery should be performed at around 8 to 10 months of age when the child is learning to speak, and that older children may require speech therapy for complete correction of their speech.

With over a decade of experience in the field, Dr. Doshi's expertise in pediatric surgery and his passion for educating people about common childhood conditions make this video a must-watch for parents and caregivers.

For any queries or questions, book an appointment with Dr. Bhavesh Doshi:

📞 Call: +91 9820565205

📧 Email: [email protected]

🌐 Visit: https://dhanvantarihospitals.com/dr-b...

📍 Borivali West | Dahisar East | Kandivali West

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When we say, “tongue tied,” most of us think of a situation when we are too excited to express ourselves verbally. Although not a medical condition, tongue tie is the name for a fairly common condition that limits the movement of the tongue – medically referred to as ankyloglossia.

Before we are born, a strong cord of tissue called the frenulum is positioned in the center of the mouth and guides the development of the oral cavity. As we grow and develop, it thins and recedes to a small thin piece of tissue that attaches the bottom of the tongue to the floor of the mouth. In some children, the frenulum is especially tight or fails to recede and may cause difficulty with tongue movement. Ankyloglossia or tongue tie can cause eating or speaking difficulties in some children.

In infants, tongue tie can present with trouble sucking or poor weight gain. In breast-fed infants, it can cause trouble with latching, or the mother may experience pain when the baby is nursing. Some mothers give up nursing because of tongue tie that is not recognized. In toddlers and older children, tongue tie can be a cause of trouble with speech articulation, especially consonant sounds. Signs that your child may have difficulty due to tongue tie include a V-shaped notch at the tip of the tongue, inability to stick the tongue out past the gums, or simply difficulty licking an ice cream cone or lollipop.

Frenuloplasty

Because a shortened frenulum restricts the range of motion of the tongue, a frenulectomy may be recommended. A frenulectomy is a surgical procedure performed to clip the frenulum and release the tongue. In infants a frenulectomy can be performed as a simple office procedure with topical local anesthesia. Older infants and young children often require anesthetic gas for the procedure, but older cooperative children can also have the procedure safely with only local topical anesthesia. Although it is considered a safe and simple procedure, risks of a frenulectomy may include infection, scarring and excessive bleeding.