Tongue-tie is one of the congenital structural problems and can cause various problems in infants, from sucking function to speech and dental health. This problem, which is called ‘ankyloglossia’ in medicine, is often present in babies congenitally. In order for the tongue to perform its functions, it must be able to move freely in the mouth. However, this is not possible in babies with tongue-tie, and there may be serious problems with the functions of the tongue. We will also convey the answers to questions such as what are the symptoms of tongue-tie and how is the treatment. First, let’s take a closer look at what a tongue-tie is.

What is a Tongue-Tie?

Tongue-tie, in its most basic form, is when the tongue-tie structure gains a different shape than it should be. An abnormality in this ligament called the Lingual Frenulum prevents the tongue from moving freely in the mouth. It restricts the tongue, and this can lead to various dysfunctions, especially the sucking dysfunction. This connection between the tongue and the palate is quite short in some people. In some people, it is longer and its length can cause more serious problems.

What Causes Tongue-Tie?

It is known that tongue-tie occurs in the embryological development process of babies before birth. We can say that the anterior part of the tongue develops at a rate of 2/3 within the scope of the embryological development process at 4 weeks of pregnancy. However, in this period, the tongue is not yet separated from the palate. In the following weeks of pregnancy, the tongue separates from the floor of the mouth and gains a free form in the mouth. It is only attached to the palate by a ligament called the frenulum. However, tongue-tie may occur due to a structural problem in this connective tissue or cell proliferation.

We can say that tongue-tie is more common in male babies, and its incidence in the society varies between 0.1% and 10%. In the researches, it was understood that there was no genetic abnormality. There are some findings that genetic factors may be the trigger in only some cleft palate syndromes.

What Are the Symptoms of Tongue-Tie?

In the case of tongue-tie, symptoms are most likely to occur during infant sucking. Normally, when babies suckle, their tongue covers the lower gums, which helps protect the nipple and ensure that it is firmly grasped. However, in the presence of tongue-tie, babies cannot fix their mouth to the nipple correctly. For this reason, it cannot suck effectively and often does not get enough milk during the feeding period. At the same time, babies often swallow air due to the inability to grasp the nipple tightly, and developmental delays can be seen due to malnutrition. We can briefly summarize what happens during breastfeeding when babies have tongue-tie:

  • Babies’ lips do not fully cover the nipple
  • Babies can chew rather than suck.
  • Babies who become restless just before breastfeeding may cry while breastfeeding.
  • Babies may act as if they are always hungry because they are not fully satiated.
  • Breastfeeding time is longer
  • They swallow more air while sucking and therefore have more gas problems

We can give the following examples of problems that expectant mothers may notice about breastfeeding times:

  • There may be pain in the nipple during and after breastfeeding
  • Nipple cracks may occur
  • Inflammation may occur in the breast tissue
  • Over time, the amount of milk coming from the breast decreases
  • In the case of tongue-tie in babies, the following symptoms can also be observed:
  • Both sides of the mouth cannot move freely
  • The tongue cannot reach the upper palate
  • The tongue cannot be extended beyond the length of the palate
  • When the tongue is pulled out, a V-shaped fraction is observed at the tip.

How Is Tongue-Ties Diagnosed?

With a simple physical examination, it is possible to diagnose tongue-tie in babies. It is extremely important to convey information about infant nutrition to the doctor at the stage of diagnosis. In childhood, they are asked to say some consonants. Having trouble pronouncing some consonants or syllables is also an effective factor in the diagnosis.

Tongue length in newborn babies is expected to be around 16 mm. If the tongue length is shorter than 11 mm, then there is a high probability of tongue-tie. A tongue length of less than 7 mm significantly increases the presence of tongue-tie. However, at this point, it should be determined whether there is a developmental delay in the baby and this possibility should be excluded.

How Is Tongue-Ties Treated?

We cannot say that treatment should be applied in every case of tongue-tie. Symptomatic patients need to be treated. However, if there is no problem with the functions of the tongue in newborn babies, the option of patient follow-up may be considered. If it is determined that some problems such as nutritional problems for the patient are caused by the tongue-tie, then a surgical intervention called frenotomy will be required.

When tongue-tie treatment options are evaluated, it is possible to state that the most frequently applied method is frenotomy. The area that is intervened with surgery is the tongue-tie tissue. This tissue does not cause excessive bleeding or excessive pain due to its structure. We can say that tongue-tie surgery is not a very challenging intervention due to its blood vessel and nerve structure. In surgery, the main purpose is to keep the tongue free in the mouth. Anesthesia is often not needed for the operation.

One of the most frequently asked questions by mothers is breastfeeding the baby after the operation. Of course, the baby can be breastfed after the operation. In fact, since a much more efficient breastfeeding process will be experienced compared to the past, the problem of feeding the babies will be eliminated.

If the tongue-tie problem is very serious, then the frenuloplasty method can be chosen. In this method, the cut frenulum is fixed to a different area by suture. However, anesthesia will also be needed when this method needs to be applied. We can also say that the processing time is longer when compared to other methods. When this method is preferred, language exercises and speech therapy are also needed after the operation.

The recovery process after the operation is also one of the frequently asked factors. How long the recovery will take varies depending on the age at which the operation was performed, the condition of the tissues or the method by which the tongue-tie was intervened. Therefore, we cannot talk about a clear time frame for the recovery period. However, we can also underline that a shorter recovery period is experienced than many in-mouth surgeries take.

Tongue-tie operation is an extremely safe surgical procedure. Although there is no problem with nutrition, if there is a high probability of problems with speech in the following years, it will be beneficial to perform the operation in the early period.

What is Laser Tongue-Tie Surgery?

The main goal is the same in laser tongue-tie surgery. The operation is performed by following an approach similar to frenotomy. However, a laser device is used instead of a scalpel to solve the tongue-tie problem. When the laser is used, the incision can be made much thinner, which ensures much less bleeding in the area. Also, it is possible to state that the healing in the tissue is completed in a much shorter time in the laser tongue-tie treatment. As an alternative to tongue-tie treatment with laser, the tongue-tie tissue can be intervened with electrocautery. You can write your questions about tongue-tie in the comment section.