What is Tongue tie?

What is all this talk about tethered oral tissues (TOT’s)? A tongue tie (ankyloglossia) or a lip tie is when the string of tissue (frenum or frenulum) under your tongue or above your upper front teeth is tight and restricts normal movement and proper function.

Sadly, I received close to ZERO education in dental school or pediatric residency on TOT’s. I always thought...”if you can stick your tongue out, you’re good.” Wrong!

Some signs of TOT’s:⁣⁣ Pain or difficulty with nursing, picky eating or grazing⁣⁣, speech issues, open mouth/mouth breathing/low tongue posture⁣⁣, crowded teeth or narrow palate⁣⁣, inability to touch back sides of upper molars with tongue⁣⁣, blanching of gingiva when lifting the upper lip or an excessive space after permanent have erupted⁣⁣, heavy plaque and food accumulation under upper lip⁣⁣, and other issues.

Possible effects of untreated TOT’s: (it’s not all about breast feeding!!): Nursing issues, failure to thrive, improper jaw and palate growth, speech issues, increased cavity risk, improper swallowing patterns, open mouth posture and/or mouth breathing, sleep disordered breathing/sleep apnea, neck/back pain, headaches, TMJ issues, airway and sleep concerns, orthodontic relapse, and more!⁣⁣

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It is always best to see an IBCLC, an ENT, an airway-focused dentist or another properly trained provider to be screened for TOT’s. It often takes a team to get the proper diagnosis, treatments, and therapies for ideal outcomes.

Fun fact: releasing a tongue tie can be dated back to the 1600’s and even⁣⁣

the Bible! “His ears were opened, his tongue was released.” Mark 7:35 (ESV). Midwives would keep one fingernail sharp so they could address a tongue tie immediately after birth. King Louis XIII was said to have had the procedure done in 1610!⁣⁣

Excellent books to read if you want to more about TOT’s are “Tongue-Tied” by Dr. Richard Baxter and “SOS 4 TOTs” by Dr. Larry Kotlow, both leaders in the field. @breathe_institute is working endlessly to get new research out, too, so stay tuned!