Tongue and Lip Ties

Tissue that attaches the tongue to the floor of the mouth is called a lingual frenum. This band of tissue may be short, thick, wide and/or attached close to the tip of the tongue or inside the lower front teeth. The medical term for this atypical attachment is ‘ankyloglossia’, but it is more commonly known as ‘tongue tied’. Upper and lower lips and cheeks also have frenums that sometimes attach in areas that restrict full movement and development of the lips.

Not all tongue and lip ties are a problem, however if they affect the function of the lips and tongue they may need to be surgically released.

Infants may experience:
- Latch and sucking difficulty during breast or bottle feeding, tiring quickly during a feed and long sleeps in between feeds
- Reflux, vomiting
- Difficulty settling
- Difficulty gaining weight
- White coating on tongue which can be mistaken for thrush but is often milk residue
Mothers may experience varying levels of pain or discomfort during breastfeeding, and mastitis can indicate poor latching and sucking. Low milk supply or a supply drop after a few months is also a sign the infant is not drawing adequately from the breast.

Toddlers and older children:
- Children may avoid certain textures that are difficult for their tongue to control. This can include particularly chewy foods like meat or soft/mashy textures. This can be misinterpreted as a child being picky or fussy.
- Lots of facial muscle movement to swallow. Eg Lips pursed, blinking, head moving forward and chin wrinkling.
- Holding water/food in the mouth before swallowing or for long periods of time.
- Increased risk of sleep disorders like snoring if the tongue cannot elevate sufficiently to keep clear of the upper airway.
- Increased risk of middle ear infections if the tongue tie causes atypical swallowing. Swallowing helps clear the Eustachian tubes.
- Increased risk of developing a narrow jaw, crowded/crooked teeth and underdeveloped facial bones. Correct tongue and lip position and function ‘sculpt’ the oral and facial bones to create wide smiles and attractive profiles.
- Frenums that attach to the jaw bone close to teeth can cause gaps between the teeth, gum recession and rotation of the teeth.