When you are tongue-tied, it can mean slipping up your words. When a newborn is tongue-tied, it is a medical condition that may need to be addressed sooner than later.
Tongue-tied, or ankyloglossia, is congenital anomaly where the piece of tissue connecting the tongue to the floor of the mouth (lingual frenulum) is short or thickened, which restricts movement of the tongue.
Dr. Nicole Giles, pediatrician at Marshfield Clinic Health System, said typically, ankyloglossia is first suspected when a newborn has difficulty breastfeeding or is visualized on routine examination. The infant will have a hard time latching or mom may experience nipple pain.
Signs of ankyloglossia
Along with breastfeeding problems, ankyloglossia can cause difficulty lifting the tongue to the upper teeth, inability to protrude the tongue beyond the lower gums, impaired side-to-side tongue movement, or a heart-shaped appearance of the tongue.
Additionally, it can cause articulation disorder or orthodontic problems like separation of incisors or an open bite, in older children.
“It is generally an isolated finding but can be associated with other craniofacial abnormalities,” Giles said. “There is a wide variation in opinion regarding how clinically significant it is and how it should be managed. It generally tends to be slightly more prominent among boys.”
Treatment options for ankyloglossia
If breastfeeding is your concern, Giles says treatment can start with an initial consultation with a lactation consultant.
If pain or inadequate milk transfer continues, the next step is referral to a surgical specialist, like oral surgery or ear, nose and throat, who will evaluate if frenotomy is necessary. Frenotomy is a simple clipping of the piece of tissue (frenulum).
“This procedure is often performed in newborns and generally, infants are able to breastfeed immediately upon completion of the procedure,” Giles said.
Impact in children and adults
If a frenotomy isn’t performed as an infant, it can have physical impact on someone as they age.
Ankyloglossia can result in speech or articulation problems as a toddler, or restricted tongue movement in older children. Giles said it also can lead to orthodontic issues including malocclusion, separation of incisors and mechanical problems with occasional psychological stress.
If you have concerns about you or your child being tongue-tied, ask for a referral from your pediatrician or primary care provider to a speech pathologist for speech concerns or an orthodontist for any bite concerns.