When we say that someone is tongue-tied, we often refer to a person who finds it difficult to say what they want due to embarrassment or shyness. However, it turns out that this popular figure of speech is rooted in a very real condition.

Tongue-tie is a malformation of the tongue common among infants. Left untreated, it can lead to a host of problems for children and adults. In this article, learn what tongue-tie is and why it should be taken seriously.

What is Tongue Tie?

Tongue-tie is an oral anomaly also known as ankyloglossia. According to the Mayo Clinic, tongue-tie involves the lingual frenulum, a short stretch of tissue that attaches the tongue to the floor of the mouth. The problem occurs when this tissue is too tight, too short, or attached too near the tip of the tongue.

Diagnosing Tongue-Tie

Raisingchildren.net classifies tongue-tie as a congenital condition, meaning that babies with tongue-tie are born with it. It will not develop after birth. While the exact causes are unknown, some theories suggest that genetic factors may contribute to its occurrence.

To diagnose tongue-tie, your doctor will physically examine your child’s mouth and ask for a detailed description of his or her symptoms. In children and adults, the doctor typically checks the movements and shape of the tongue.

These are top symptoms that doctors look for:

In infants

  • Difficulty latching
  • Sliding off the nipple
  • Irritability or refusal during feeds
  • Restlessness after feeding
  • Unusually long feeds
  • Chewing or gumming
  • Spilling and dribbling
  • Stridor (clicking noise during the latch)
  • Unable to use the bottle or hold the pacifier
  • Colic
  • Excessive gas
  • Reflux

In Older Children

  • Inability to poke tongue out past lips
  • Inability to touch the roof of the mouth with the tongue
  • Square- or flat-looking tongue
  • Heart-shaped or notched tongue tip
  • Gap in the lower jaw’s front teeth

Aside from these indicators, doctors will also observe developmental signs such as delayed speech, posture problems, food aversions, and tooth decay. Beyond the physical appearance of the tongue, tongue-tie involves a wide range of symptoms that requires a medical professional to confirm.

Types of Tongue-Tie

Contrary to popular belief, not all tongue-ties are the same. Ongoing research divides tongue-tie into four major classifications. These are based on where the tongue is attached to the bottom of a child’s mouth.

  • CLASS 1: The tie is located at the very tip of one’s tongue. The most well-known type, this is what most people think of when thinking of tongue-tie.
  • CLASS 2: The tie is found farther back going to the middle of the tongue.
  • CLASS 3: The tie is at the base of the tongue.
  • CLASS 4: Since the tie is located under the mucous membrane, it must be felt to be diagnosed. Class 4 is also called Posterior Tongue Ties (PTT), and it is often mistaken for another oral issue: the short tongue.

Who Is At Risk for Tongue-Tie?

Basically, anyone. Recent studies pegged the prevalence of tongue-tie somewhere between 4% to 10.7%. In a study published on the U.S. National Library of Medicine: National Institutes of Health, 171 out of 1, 102 newborns at the pediatric service in Hospital de Nens, Barcelona were observed to have tongue-tie. In addition, more boys were diagnosed with tongue-tie than girls. Tongue-tie can also run in families.

Is Tongue-Tie Dangerous?

Yes and no. By itself, tongue-tie is not life-threatening. However, unresolved tongue-tie can lead to many adverse consequences as a child grows older:

  • Speech difficulties: Children with tongue-tie have a hard time making sounds that depend heavily on tongue-mobility (e.g. “t”, “d”, “s”, “l”, “z”).
  • Poor oral hygiene: Tongue-tie makes it difficult to remove food debris from the moth and teeth. This means that no matter how much a child tries to observe good oral habits, they are vulnerable to gingivitis (gum disease) and tooth decay. Tongue-tie can also lead to an unsightly gap in the front lower teeth.
  • Limited activities: Children with tongue-tie may find it challenging to perform common activities like playing a wind instrument or licking an ice cream cone.
  • Emotional and psychological distress: Due to speech problems, bad oral hygiene, and other issues related to tongue-tie, children may become withdrawn and exhibit low self-esteem.
  • Sleep apnea: Another disturbing effect of untreated tongue-tie is the potential development of Obstructive Sleep Apnea (OSA) later in life.

Bottom Line

Who knew something so simple can cause so many problems for children? Tongue-ties have long been dismissed as an issue that children will just grow out of. Unfortunately, new information has revealed that this is far from the truth. Tongue-tie is a complex oral problem that, if unresolved, can lead to more physical and emotional problems later in life. Sources: