Tongue Tie/Lip Tie

The estimated prevalence of tongue-tie (restricted lingual frenum) is estimated to be between 4% and 10% of the population. A tongue-tie can be a hidden reason behind nursing difficulties in babies, feeding problems in toddlers, speech issues in children, and even migraines or neck and jaw pain in adults.

The International Affiliation of Tongue-Tie Professionals (IATP) definition of tongue tie is, “an embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal tongue movement.” In layman terms this means it is a tight string of tissue under the tongue that can prevent the tongue from functioning properly. If the tongue appears tied, it is important to assess what function has been impacted. The lingual frenum can vary in length, thickness, position, and elasticity. Some ties are hidden underneath the outer mucosal layer and are not readily visible (Baxter, R. Tongue Tied, 2018, 1-4).

A tongue-tie will often promote a low tongue resting posture which can interfere with a child’s development of their upper jaw contributing to a narrowing of the roof of mouth and can also promote the lower jaw to be more protrusive (crossbite) due to the tongue living low in the mouth. The tongue is supposed to rest on the top of the mouth which promotes proper growth of the maxilla (upper jaw). A tongue tie can also make it difficult for the tongue to move separately from the lower jaw and can contribute to multiple speech sound errors. For example, the tongue tip may not be able to elevate up to the alveolar ridge to properly produce a /t/, /d/, /n/ or /l/ and instead compensates by using the mid portion of the tongue to elevate which leads to a distortion of these sounds. Elevating the back of the tongue to produce /k/ or /g/ or elevating the lateral posterior tongue borders for oral stability required to produce /s/, /z/, /ch/, /sh/, /j/ can also be impaired. These impairments often lead to compensations of the lip/jaw/facial muscles to over work due to inefficient tongue mobility. A tongue-tie also promotes an abnormal swallow pattern because the tongue cannot elevate completely up to the roof of the mouth or chewing may be difficult because the tongue cannot move freely in the oral cavity to manipulate the food particles. These children are often labeled as “picky eaters”. It is important to have your child evaluated by a speech-language pathologist that is trained in orofacial myology to conduct a functional assessment to determine if oral function is affected by a lingual frenum restriction.

Speech/orofacial myofunctional therapy is essential to the success of a lingual frenum release before and/or after the release to improve oral motor patterns and teach the child or adult how to correctly produce speech sounds without compensations and to incorporate proper orofacial myofunctional patterns to prevent reattachment of the released tissues. This clinic works closely with release providers to provide the best care for each patient.

We can help with your pre and post tongue tie treatments. Call us today for a functional assessment if a tongue or lip tie is suspected.