Let’s Break it Down: What is a tongue tie and how can it affect important functions like speaking, feeding, swallowing, breathing, and even sleeping?

What Is a Tongue Tie?

A tongue tie, medically known as ankyloglossia, occurs when the thin piece of tissue that connects the bottom of the tongue to the floor of the mouth (called the lingual frenulum) is too tight, short, and/or thick. This restricts the tongue’s movement.

Tongue ties can be present at birth and range from mild to severe. In some cases, the frenulum is easily visible and tethering the tongue in a noticeable way. In others, it might be less obvious but still impactful.

How Does a Tongue Tie Affect Function?

Because the tongue is involved in so many functions, a restriction in its movement can lead to issues across several areas:

Feeding (Especially in Infants)

• Breastfeeding challenges: Babies with a tongue tie may struggle to latch properly, leading to poor milk transfer, frequent feedings, gassiness, or weight gain issues.
• Bottle-feeding difficulties: Though bottle-feeding may be easier than nursing, a restricted tongue can still cause inefficient sucking and swallowing patterns.
• Maternal discomfort: Nursing mothers may experience pain, nipple damage, or clogged ducts due to poor latch.

Swallowing

Swallowing is a complex process that relies on coordinated tongue movement. A restricted tongue can interfere with this, sometimes leading to:

• Difficulty transitioning to solids
• Gagging or choking on food
• Food aversions or picky eating
• Maladaptive swallowing patterns (e.g., tongue thrust)

Speech

The tongue needs freedom to move in specific ways for clear articulation of sounds. Tongue ties can lead to:

• Speech delays
• Difficulty with certain sounds (like “t,” “d,” “l,” “r,” and “s” )
• Slurred or mumbling speech

Breathing and Sleeping

A restricted tongue can alter the resting posture of the tongue and mouth. The tongue should rest at the top of the mouth, and a restriction may cause fixed low tongue rest posture. In children and adults, this may lead to:

• Mouth breathing (instead of nasal breathing)
• Narrow palate and crowded teeth
• Airway issues that may contribute to sleep disordered breathing symptoms such as snoring, restless sleep, or daytime fatigue or trouble concentrating

What Can Be Done?

If a tongue tie is suspected, evaluation by a qualified professional—such as a pediatrician, pediatric dentist, ENT specialist, speech-language pathologist, or lactation consultant—is essential. Treatment options may include:

• Tongue-tie release (frenotomy or frenuloplasty): A procedure that involves cutting or releasing the frenulum to free up tongue movement.
• Therapies: Feeding therapy, Orofacial Myofunctional therapy, and/or speech therapy are recommended before and after a release to optimize function and healing.

The Bottom Line

A tongue tie can have a big impact on quality of life, especially during the critical early years of development. Whether you're a parent noticing feeding issues in your baby, a teacher observing speech delays, or an adult struggling with sleep or speech challenges, understanding the role of tongue ties can be an important step toward relief and better function.

Have questions or concerns about tongue ties? Don’t hesitate to reach out to a trusted healthcare provider who can guide you through the evaluation and treatment process.

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