Tongue tie results when the band of tissue that connects the base of the tongue to the floor of the mouth is too short and tight leading to restricted movement of the tongue. It is a congenital anomaly also known as ankyloglossia. About 4.2% to 10.7% of babies are born with tongue tie. It is more common in boys than girls and can be hereditary.

The severity of tongue tie varies from mild forms which involves the attachment of the tongue to the floor of the mouth by a thin membrane to the severe form which involves attachment up to the top of the tongue by a thick membrane.

Signs and symptoms

  • Difficulty in elevating the tongue; this is due to the attachment to the floor of the mouth. The child also finds it difficult to protrude the tongue, lick an ice cream cone, stick out his tongue and play a wind instrument.
  • Difficulty with breast feeding; infants with tongue tie tend to cause their mother nipple pain. They also find it difficult to latch on to the breast and sustain breastfeeding. This might lead to inadequate weight gain and fussiness of the baby.
  • Speech impairment; people with tongue tie usually have problems with the following sounds:‘t’, ‘d’, ‘z,’, ‘s’, ‘th’ and ’r’. They also mispronounce ‘Ls as ‘Ws’’. However, some people with mild tongue tie don’t have problems with their speech. It also doesn’t cause a delay in speech and language development.
  • Notched or heart-shaped tongue when they stick it out

Treatment

Surgery; this involves the process of cutting the frenulum to release the tongue. It can be done at any age. Patients complain of post-operative pain after the procedure.

A viable alternative to surgery for children with ankyloglossia is to take a wait-and-see approach. It has been reported that the frenulum naturally recedes during the process of a child’s growth between six months and six years of age thus relieving the symptoms of tongue tie.