Cat Got Your Tongue? The Problems of Being Tongue and Lip Tied

Barbara Tritz
· April 21, 2015 ·

8 minutes

There’s so much to learn and share with you!  Today’s post is about Tongue Ties.  Ankyloglossia, if you’re fancy.  Also, we’ll touch on Lip Ties as well.
I briefly mentioned tongue ties in past posts, but today’s post will go more in-depth.  This may not be a problem for you, but bet you know a mom who’s had trouble breastfeeding or maybe a child that doesn’t speak clearly, or how about orthodontics that’s relapsing?  Could that be because of a tied lip or tongue?  Possibly! Read on and then share this with others!  A wise woman once told me – “you don’t know what you don’t know.”  It’s time to learn.

Lift the lip and look! 

Lift the lip and look!

First, you need to know about frenums (also called frenulums!)- a frenum is a band of tissue and muscle that attaches the lip to the jaw, or the tongue to the floor of the mouth.  There are seven frenums in your mouth, three on the upper jaw and then four on the lower. That band of tissue under your tongue is a frenum.  In normal development, nobody even knows it’s there.  However, sometimes this tissue is short, tight, thick, or a combination of these variants.  That’s when problems can start!  I  read a book by Alison Hazelbaker titled, Tongue-Tie.  She’s written an entire book about this!  My goal is to give you the short version of why this matters so much, and what can be done to correct it.

What the heck does being tongue-tied mean?  Being tongue-tied is the result of the frenum under the tongue being thick/short/tight and anchoring the tongue to the floor of the mouth, or even right behind the front teeth such that the tongue can not function correctly.  This occurs in approximately 410% [2021 update: of the population and does run in families.  Some folks who are tongue-tied learn to compensate for this short attachment and feel this is not a problem worth addressing.  On the other hand, it can truly be a problem that absolutely should be corrected.  Tongue ties are not always obvious.  Besides occurring on the tip of the tongue, there can also be posterior tongue ties which are harder to diagnose.  If, after you review this post you have concerns about yourself or your baby, find a myofunctional therapist, lactation consultant or send me an email for a referral to someone who is knowledgeable about tongue ties and can help you resolve this issue.  More on that at the bottom of the post.

 
Dr. Kotlow has lots of great information so click here! 

Newborns and Infants: Lift that lip and look! 

Calling all moms!! You need to read this!  Whether you breastfeed your baby or bottle feed, it’s vital to lift the lip and look under your baby’s tongue.  Your baby’s health will benefit, and, whether breastfeeding or bottle feeding, your baby will thank you!  Both tongue ties and lip ties affect baby’s ability to feed properly.

Breastfeeding– tongue-tied babies can not get their tongue in the proper position over the lower gum ridge to get a deep latch.  A deep latch is vital to remove all the breast milk.  Instead, they gum your nipples for milk.  Ouch!  So moms, if you have mastitis, sore nipples, painful nipples, damaged nipples, low milk flow, nipple compression syndrome, baby sleeps during nursing only to wake and still be hungry, or baby has failure to thrive, it’s time to lift the lip and tongue.  With all those problems, who would want to nurse a baby?  Babies with problems latching may present with a “suck blister” on their upper lip.   It may well not be a problem with your milk production but instead, a tongue, lip, or even cheek that is tied down tight!  Baby is trying hard to nurse but can’t because their mouth cannot move properly.  I applaud all moms that tough it out so their baby can have the benefit of breast milk.  Take a peek under the tongue, chat with your tie-savvy lactation consultant and find the cause.  Beautiful women that you are, you are made to feed your baby!  And breastfeeding should not be painful.  If it is, look and fix!  There’s a fabulous blog that goes into much more detail about infant tongue and lip ties- so if this is your problem, click here and here to read Heather’s blog post for more great information.  No need for me to repeat what she has already done beautifully!  Again, if someone tells you it’s not a problem but you know something’s not right, keep looking and searching.  Lip ties and tongue ties definitely do interfere with baby’s ability to eat!  Keep reading for other problems as baby grows.

[Editor’s note (2021): As I review this for updates, I’m hit with all the symptoms that my son and I had before his tongue and lip tie diagnosis.  When he was a newborn, we had a hard time getting diagnosed. Yes, even the daughter of the Queen of Dental Hygiene! You can read about my experience in a special post here: Untied for the Win. If you need help getting diagnosed, please please reach out and we’ll help you find the right professional.]

Bottle feeding– Okay you say, I’ll just bottle feed…  Unfortunately, the problems baby encountered with the breast nipple did not disappear by switching to the bottle.  The tongue tie inhibits movement for ALL types of feeding.  Bottle feeding also needs proper tongue placement and mobility.  Because of this lack of tongue mobility, baby can’t control the milk flow, especially if the bottle’s flow is too fast (look for slow or “newborn” nipples!).  Instead, the baby may well push the bottle out so he can breathe.  Remember, breathing trumps all.  Baby is in a suck-swallow-breathe cycle and needs to protect his airway if the tongue can’t move the way it should.  Signs baby is having problems: swallows too much air (gassy), arm/leg cycling, hands and foot clench, dribbling, fussing during feeding, slow feeder, colic, and reflux.

This video on YouTube is worth watching- https://www.youtube.com/watch?v=lrD9cemJNyw
It shows you how hard a baby with a posterior tongue tie works to use a bottle.  Note how she spits out the teat to breathe and then continues eating.

Babies and Children

Here’s a list of possible problems for tongue-tied or lip tied children as they grow:
  •  Inability to chew age-appropriate solid foods
  •  Inability to swallow causes solid food to be pushed back out
  •  Gagging, choking, and vomiting
  •  Slow, picky eater or
  •  Fast sloppy eater
  •  Persisting food fads/Only wants to eat… (soft foods)
  •  Digestive issues
  •  Delayed speech development
  •  Deterioration of speech
  •  Behavior problems
  •  Persistent dribbling
  •  Tongue thrust
  •  Crooked teeth/ spaces between teeth
  •  Swallowing air while eating
  •  Dental problems start appearing
  •  Strong incorrect habits of compensation acquired
  •  Loss of confidence because they feel and sound different

Adults

The problems from childhood start compounding.   Adults have been compensating for this inadequate tongue mobility and now the results show themselves in all their painful glory. And what a nice list this is not!
 
    • Crooked teeth
    • Narrow arches/high palate
    • Relapsed orthodontic treatment
    • Bone loss
    • Tooth decay
    • Gum infections
    • Recession
    • Digestive issue
    • Mobile teeth
    • Inability to open wide
    • Slow eating
    • Always watching speech
    • Clicky jaws,
    • Pain in jaws
    • Migraines/tension headaches
    • Inability to speak clearly when talking fast/loud/soft
    • Inability to French kiss
    • Obstructive sleep apnea
    • Mouth breathing and a propensity to allergies
    • Restricted dental arch development
    • Inability to keep lower denture in place
    • Long face syndrome
That tongue tie caused this bone loss
Note the webbing below the front teeth
 

The tongue was meant to be free.

It is supposed to help with suck, swallow, chew, and talk.   It helps shape the dental arches into a nice curve. If untethered, it should rest on the roof of the mouth, behind the bumps (rugae) which are behind the upper front teeth. This ensures proper jaw development.  The tongue’s other job is to assist in proper and thorough mastication (chewing) of food.  It assists in moving food from side to side in the mouth. The tongue then collects the food into a mass called a bolus.  If tied, it cannot move sideways and collect the food.  Children will often reject food they find difficult to chew.  Textures are difficult as well.  Swallowing food occurs within a vacuum, the tongue goes to the roof of the mouth, creates a seal, and forces the bolus backward down the throat. Tongue-tied people push their tongues forward instead, straining to swallow.

I spoke with a young lady this week who did not realize she was tongue-tied.  No one had ever told her!  She acknowledged she was a very slow eater and never knew why.  Something so simple to correct has such a long reach throughout our lives.

 

So, what to do about it?

Healthy tongue attachment is vital to a healthy airway and a healthy life

Healthy tongue attachment is vital to a healthy airway and a healthy life

Untie that tongue or lip, without a doubt!  This procedure is called either a frenectomy or a frenotomy.   Infants should be treated as soon as possible, and at that age, it is a very simple procedure.  A cut of the frenum is a simple procedure done with a topical anesthetic – takes five minutes and baby can start nursing right away.  In children and adults, it’s a little more involved.  A dental laser can make short work of this procedure. A laser in the hands of a skilled dentist may not even require any numbing.  How uncomfortable is a frenectomy?  Everything I have read says healing is quick and minimally uncomfortable.  Lips or tongue must be stretched throughout the day and an over-the-counter pain medication should be enough to do the job of pain/discomfort management.  It is a minor surgical procedure so I would expect some discomfort.  That said, I have not had a tongue frenectomy done. What I have had done was a lip tie release at age 11.  That is probably the reason I am a dental hygienist today!  I had a large space between my upper front teeth due to the large frenum that kept my teeth apart.  And, while a cool party trick to squirt water out between my teeth, I am always glad I had that procedure done.  Most lip ties come with a free tongue-tie, though, so if you’re diagnosed with a lip tie, check the tongue, too!

Muscles should be retrained and exercised to prevent reattachment of the frenum. A myofunctional therapist can help you relearn proper muscle movement and swallowing patterns. Do your exercises!  Babies with releases done should also be evaluated to see if an OT or a PT can help them loosen up any residual tension.

What caught my eye in all my reading is that many in the medical profession do not think it is a problem and some even refuse to treat it!  There are folks who think this tissue will stretch over time.  Not!   If, after you read this and want your frenum clipped but your doc says no, find another doc, get a second or even third opinion.  You know when something is not right!  If you need proof, read Hazelbaker’s book.

 
 
All my references can be reviewed by clicking on the highlighted words.
 In addition, check out:

There is so much more information out there.  If you have any questions, concerns, or want more information, it’s all at your fingertips.  Do not suffer in silence!  Tongue and lip ties really do matter to your and/or your baby’s health and well-being.

I look forward to hearing from you!

Keep Smiling!
Barbara

 
 
 
 
This article was updated in February 2021
 
 

 

Hello, I'm Barbara Tritz

Unveiling the Stories Behind Dental Hygiene

Loving science, especially biology, from an early age, Barbara is a registered dental hygienist, certified biological hygienist, and orofacial myofunctional therapist. In 2019, she received the Hu-Friedy/ADHA Master Clinician Award from the American Dental Hygienist Association.

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5 Comments

  1. Disha Chandrikapure

    Real good information and very simple to understand for a non-medical person like me. I was looking all over for a dentist to find the best dental clinic to fix my teeth. Now with this information, i know how the procedure is and go ahead with my treatment.

    Reply
  2. Barbara Tritz

    Disha,
    Thank you for your kind comment. So glad this was helpful and informative. Are you tongue tied? Let me know how that goes. Be sure to do the exercises after the procedure or the tongue can reattach even shorter! There are myofunctional therapist that can Facetime with you to teach you the exercises if you can not find one where you are. Best wishes,
    Barbara

    Reply
  3. Anonymous

    It is amazing. I am an adult woman who has been in ortho as teen, treated later for chronic pain for years, much later identified as a severe tmj patient (after several years seeking help for pain), and then treated for tmj for years with extremely debt inducing and ultimately non-helpful useless splints for years. Never, never, until this year, did someone even once check my tongue. I have a very significanttongue tie, which is likely a large part of the reason I needed braces in the first place as a child. Even a speech pathologist I saw in the early nineties after my ortho noticed a slight relapse after my braces came off from a slight tongue thrust, never checked me for tongue tie, which was likely the cause of the reverse tongue swallow (that and the extraction of many of my teeth for braces which significantly reduced the amount of space my tongue had). I was a baby who did not breast feed successfully, and my mother stopped trying after two weeks because she got severe mastitis. Now I know it was likely because of my tongue tie which prevented me from nursing properly and draining her breasts adequately. Noone ever checked my tongue. Through all of this, ever. Howthankful am I that someone finally did at 38 years old. So thankful! Because maybe now I will get the help I need and get out of this long standing unbeknownst oxygen deficiency from reduced airway, leading me to be unwell in many ways for many years, not to mention I may now be able to get out of chrinc facial, jaw and neck pain, and all of the body wide structural imbalances and compensations from all of these years of dysfunctional jaw and cranial structure from these issues related in large part to my tongue tie. Thank you for bringing light to tongue tie. I hope as many people as possible learn to check for it, now I know better to help my child while shes small to prevent these developmental issues! Thanks

    Reply
  4. Barbara Tritz

    Hello,
    Thank you for your kind comments. My heart breaks for you and all you have had to endure. The tongue is a mighty muscle and when it's tethered, it can't function properly! It does block the airway and then an entire cascade of events occurs. So very glad you found someone to help you. Be sure to do your tongue stretching exercises after the frenectomy. There are airway centered dentists- not everyone is looking at that, they just don't "know" to look… I can get you names if you'd like to contact me off line – barbaratritz@gmail.com. I did do a blogpost on mouth breathing, so hope that is helpful. A myofunctional therapist can help your jaw issue with exercises to help re-educate your TMJ muscles. My favorite book for TMJ is Cynthia Peterson's: The TMJ Healing Plan. Excellent information, I do hope that you get the help you need. Something as simple as lifting the tongue and clipping that little band of tissue could have saved you a lifetime of pain and suffering! In Brazil it is law that they check the baby's frenum! Please let me know how you are progressing!
    Be well soon,
    Barbara

    Reply
  5. Nalazoo

    If you or your little one has a tongue tie, the is considered a mid-line defect and is associated with the MTHFR gene. This can cause metabolic syndrome as a result of genetic variants in the methylation pathway. I recommend getting your genetics done through 23andme and then processing through one of the genetic decoders, my preference is StrateGene. Take this to a functional medicine doctor or a naturopath who can test you appropriately for macronutrient and micronutrient imbalances, as well as, hormone levels and more. If these are left unchecked they result in a huge list of chronic health issues.

    Reply

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