A tongue-tie is a type of tethered oral tissue (commonly referred to as a TOT) and is an anatomical variation under the tongue that occurs when the strip of connective tissue (lingual frenulum) connecting a baby’s tongue to the floor of their mouth is shorter or tighter than usual.  Other oral ties, or TOTs, include lip-ties and cheek or buccal ties.  In certain circumstances, this attachment may have an impact on the child's ability to function normally.

Signs of tongue-tie include:

  • Restriction of the tongue’s movement, making it harder to breastfeed
  • Difficulty lifting the tongue up or moving it from side to side
  • Difficulty swallowing certian types of foods for older chidren such as meat or mashed potatoes.
  • Difficulty staying asleep, very restless sleep and/or excessive movement in bed
  • The tongue looks notched or heart-shaped when stuck out

Treatment of Tongue-Tie

Releasing this tissue is a routine in-office procedure that results in minimal to no bleeding. Your child’s doctor examines the lingual frenulum and uses laser to snip the frenulum free. Stitches are usually not necessary. Since there are few nerve endings or blood vessels in the lingual frenulum, local anesthetic is often not necessary.

Frenotomy for tongue-tie in older children and adults is similar to that for infants, although it may involve stitches.  For older children, release of a tongue tie is often done in conjuction with myofunctional therapy.  Myofuctional therapy is like physical therapy for the tongue; much like physical therapy is required after some injuries or joint replacements to improve range of motion, myofunctional therapy may be required to help acclimate the tongue to its improved mobility. 

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