Lip and Tongue Tie
What are Tongue-Ties and Lip-Ties?
A physical condition that limits the use of the tongue is called a tongue-tie. This restriction often causes a range of issues and affects around 20% of the population. A lip-tie, on the other hand, is a condition where the upper lip is restricted and cannot move normally. It can cause difficulty with nursing, make it harder to brush the top teeth, and can also lead to a gap in the teeth.
The tongue and lip are made up of a very complex group of muscles and are important for all oral functions. For this reason, having a tongue- or lip-tie can lead to nursing, feeding, dental, speech, sleep, or breathing problems. Problems can even persist into adulthood with a variety of medical problems.
A tongue restriction affects speech differently in everyone. Some children with a “to-the-tip tie” can articulate well but may struggle with increased effort when speaking. Other children, with a less visible or “posterior tie” may have a speech delay or difficulty producing the sounds for L, R, T, D, N, TH, SH, and Z.
Studies to measure the effects of tongue-tie on children’s speech and the effectiveness of the release procedure are being conducted. The following issues all saw a significant improvement after a tongue-tie release: frustration in communication, difficulty being understood, difficulty speaking fast, difficulty getting words out, trouble with speech sounds, speech delay, and mumbling or speaking softly. There is no guarantee that every child will have immediate results, but we often see this type of drastic improvement.
Children that are tongue-tied often have eating issues from infancy, such as trouble nursing or taking a bottle. When transitioning to solid foods, they may choke, gag, or have difficulty swallowing certain textures.
In childhood, these eating difficulties can persist and are evidenced by only eating small amounts of food, slow eating, packing food in the cheeks like a chipmunk, and pickiness with textures (soft, mushy foods and meats are typically the most difficult, but children can struggle with other foods as well). In our recent study, 84% of children with feeding issues saw improvement.
A tongue-tied child will often grind his or her teeth at night, snore, or experience other sleep-disordered breathing problems. Releasing a tongue-tie can help a child to sleep more soundly because the tongue will be able to rest on the palate, as it was designed to do, rather than falling back to narrow or block the child’s airway. Sleep-disordered breathing can cause frequent waking, restlessness, bed-wetting, failure to feel refreshed upon waking and accompanying difficulty focusing (which is sometimes misdiagnosed as ADD or ADHD).
Because multiple factors contribute to the problem, such as large tonsils and adenoids, a narrow palate and tongue-tie, often a child will be seen by multiple specialists to try to remedy the problem. In addition, children with tongue-ties often have a history of multiple ear infections and needing ear tubes. They may have had tonsils and adenoids removed. All of these can be complicated by the mouth-breathing that frequently occurs in tongue-tied individuals, due to the low resting posture of the tongue. We have found that when there is a tongue-tie, sleep often improves dramatically after a simple in-office procedure.
How the Procedure Works
After listening to your concerns and conducting a comprehensive assessment, we’ll help you get to the root cause of the issues your child is experiencing. If a tongue- or lip-tie is the culprit, we’ll go beyond a traditional snip or clip and release it completely the first time. We do not use sedation or general anesthesia for this quick procedure.
Using a state-of-the-art dental laser, we easily release ties in a short procedure (usually less than a minute or two), usually with minimal to no bleeding. Babies are able to go home with mom immediately following the procedure and nurse if needed. Kids also leave immediately after the procedure and typically get on with their day with limited restrictions! We’ll provide you with exercises to do at home to help get the best results. Then we’ll follow up one week after the procedure.
It’s important to understand that when your child has a tongue or lip tie released, improvement isn’t always instantaneous. It’s typically just the first step in treatment. Just like any other muscle in the body, the tongue is used to functioning in a certain way. When it’s restricted by a tongue-tie, the body adapts and other muscles have to help compensate. When a tongue-tie is released, your child will have no muscle memory of how to use the tongue effectively without the restriction, so your child’s brain will need some time to learn the new skill.
While many mothers notice an immediate improvement in their infants’ ability to nurse, it is also completely normal for this to take time, as well. There may even be a little regression in sucking for a day or two as your child learns how to use an unrestricted tongue.