Why Are Tongue Ties Important?

If you have young kids, you probably have heard about tongue and lip ties. I discussed it in my last Pollywog blog about oral ties in babies and children.

Maybe you are wondering why we hear about them much more than we did 20 years ago. Depending on who you talk to, you will likely get a whole bunch of opinions about them and whether or not a tie needs to be treated. It could be that more and more people are learning about them and the possible health issues that can arise from having one. There are more courses for healthcare providers, and more research is being done on oral ties and potential health effects.

Even with more people learning about them, many medical and dental providers might not know the impact of tongue-ties beyond proper speech and eating. Most healthcare providers get little to no formal training on assessing or treating oral ties. But these days, there is more and more evidence that as we get older, a tongue-tie can increase the risk of poor health over a person’s life.

So, what is a tongue-tie? If you look in your mouth, you will see the piece of tissue that connects the underside of the tongue to the floor of the mouth. This tissue is called a frenum or frenulum. When that tissue is unusually short, thick, or tight, it tethers the tongue to the floor of the mouth and restricts the tongue’s movement. To determine if you or your child has a tongue tie, visit a trained healthcare professional like a myofunctional therapist or airway-focused medical or dental provider for a formal assessment. Myofunctional therapy is an exercise training program for the muscles around the face, mouth, and tongue. Airway dentistry is a new field focused on the mouth’s structure and how that impacts a person’s breathing.

So why is this important? A tongue tie keeps the tongue from moving correctly so that the tongue cannot rise to the palate (roof of the mouth) and put pressure on the upper jaw. Having a tethered tongue increases the risk of having:

• Small jaws and palates (roof of the mouth)
• Crossbites and crowded teeth
• Mouth breathing, bedwetting, sleep, and behavior issues
• Difficulty drinking and eating, picky eating
• Tooth decay, gum disease, and TMJ pain.

When the tongue does not sit on the roof of the mouth, the palette is more likely to be high and narrow. The palate is the bottom of the nasal cavity, so this can make your nose space smaller and more difficult to use your nose to breathe. A tongue-tie can also contribute to posture issues and increase the possibility of chronic pain, especially in the back, neck, head, and the TMJ or joints of the jaw.

Traditional orthodontists can straighten teeth to make them look better, but if they do not look at WHY there is a need for braces, putting braces on for most people will not take care of the root cause. This means that many people, both kids and adults, need not just braces to straighten their teeth but also to expand their jaws to make room for the teeth and to make more room in the nose for breathing.

What is the treatment for a tongue tie? The best thing is to get an evaluation from a healthcare provider who is experienced and trained in assessing tongue ties. They will help determine the best treatment options and connect you with the providers you or your child may need to see.

If the tongue tie needs to be released, that is called a frenotomy or frenuloplasty. The doctor snips the frenulum with a laser or scissors. This simple, quick procedure is often done without anesthesia in young babies because the area has few nerve endings or blood vessels. It’s safe to do this in an outpatient office setting.

After a tongue-tie release, parents or caregivers have to physically stretch the tissue that’s been cut or lasered every day for at least 3 to 4 weeks afterward. This prevents the tissue from regrowing too tightly during the healing process and prevents scar tissue from forming.

If a release is not recommended, some other ways to manage tongue ties include craniosacral therapy, breastfeeding support, speech, and myofunctional therapy.

Myofunctional therapy is done on people aged four and older. It starts before a tongue tie release to help build the muscles needed for proper tongue movement and continues afterward to help retrain the tongue to move correctly.

To learn more about Tongue Tie, please check out:

• Healthline: Tongue-Tie: What It Is and How It’s Treated
• Tongue Tie – Nemours Kids Health
• A Parent’s Guide to Tongue Ties – Children’s Airway First Foundation

Some Oregon Health Care providers* who offer myofunctional therapy or tongue tie treatment

• • NW Myofunctional Therapy
  • Alphabet Soup Feeding & Speech Therapy
  • Myo2-breathe
  • Myofunctional Therapy Solutions
  • Breathe Works
  • Dr. Ghaheri, a board-certified ear, nose, and throat specialist with

*These links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or approval by Pollywog or the Early Learning Hub of any of the products, services, or opinions of the corporation or organization, or individual.