Diagnosis and treatment of a tongue-tie

A tongue-tie refers to a visually tight/restricted lingual frenum that is causing difficulties in performing certain actions that require the use of the tongue, such as breastfeeding.

What is a lingual frenum?

The lingual frenum refers to the fold of soft tissue located under the tongue, joining it to the base of the mouth. Everybody has a lingual frenum and they will all appear different to one another.

An example of a lingual frenum in a baby’s mouth, highlighted by the yellow circle. Shutterstock Images.
Tongue-tie Royal Dental Care
An example of a lingual frenum in a child’s mouth, highlighted by the yellow circle. Shutterstock images.

There are a number of frenum’s present in the mouth. For example, the labial frenum that can be seen when lifting the upper and lower lips. Frenums are present from birth.

What is a tongue-tie?

A tongue-tie refers to the restricted movement of the tongue causing functional limitations, accompanied by a visually restricted lingual frenum. Ankyloglossia is the medical term for a tongue-tie.

How is a tongue-tie diagnosed?

The diagnosis of a tongue-tie should not be made based only on the appearance of the lingual frenum. Difficulty in performing functions that require the use of the tongue and a visually tight/restricted lingual frenum must both be present for diagnosis. For example, tongue-ties have been shown to be associated with breastfeeding issues. Some people may experience issues with speech however research does not show tongue-ties routinely affect speech development or production.

If you suspect your child has a tongue-tie, the health professional to first seek advice from depends on what issue your child is experiencing. If you are experiencing breastfeeding problems, look to consult with an International Board Certified Lactation Consultant (IBCLC), midwife or maternal child health nurse that can provide a breastfeeding assessment and recommendations.

If you are concerned about your baby’s transition from soft to hard foods or their speech development, it is best to seek advice from a speech pathologist. The health professional will take a thorough case history, assess your child’s tongue function and whether the problem is impacted by your child’s tongue function in order to make a diagnosis.

How is a tongue-tie treated?

It is best to try non-surgical treatment methods before looking into surgical treatment for a tongue-tie. For example, if experiencing breastfeeding issues, non-surgical treatment methods can include advice on positioning, latch optimisation, feed frequency, supporting mothers to maintain milk supply, and the use of external tools such as nipple shields or supplementary nursing systems. If your child is still experiencing problems, surgery may be explored as an option.

The surgical treatment completed can be a frenectomy, frenotomy or frenuloplasty. These treatments are all based on cutting the lingual frenum to try and create a better range of motion for the tongue. All surgical procedures are associated with risks, including treatments for tongue-tie. The surgeon treating your child will advise you of the risks associated with the treatment before it is done.

Surgical treatment of a tongue-tie for adults is considered elective treatment. The decision to undergo treatment should be made between the adult patient and their dentist. Get in touch with our professionals and book a time now

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