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understanding tongue tie
Dr Chris Darby

Dr Chris Darby

Understanding Tongue Tie

Tongue tie is a largely misunderstood health issue. It can cause many unrecognised major health consequences, ranging from problems with suckling, breastfeeding and chewing, through to speech impediments and even issues with facial growth and development affecting breathing and promoting snoring and obstructive sleep apnoea. A recent study in Brazil found that tongue tie occurs in 15% to 18% of children. In Brazil it is now illegal for an infant to leave hospital not having been checked for tongue tie. It is well known that tongue tie causes many health issues with long term health problems through discouraging breastfeeding. Brazil has recognised the significant impact lower breastfeeding rates has on overall health of their population.

What is a Tongue Tie?

Tongue tie refers to restriction of the tongue to normal range of movement. This is due to  an extended piece of “skin” attaching under the tongue. If this tissue is too long, and attached too high up on the under surface of the tongue, the tongue will be anchored to the lower jaw. As a result, the tongue cannot reach the upper jaw. This means that the tongue will be unable to press the nipple against the roof of the mouth when breastfeeding, and move the food around the mouth correctly when chewing food. A tongue tie patient often swallows or gulps oversized pieces of food. This makes gasping and choking more common and digestion poor. This creates issues with feeding, swallowing, speech and breathing.

If left undiagnosed and untreated, the problems multiply with age. Poor growth and development usually result because the tongue is needed for more and more behaviours and actions as we age.

Infants

The inability to breastfeed normally due to a restricted tongue with tongue tie has implications for both mother and child. As it is the correct suckling of the baby that causes supply of the milk in the mother, tongue tie can reduce milk supply and lead to the early termination of breastfeeding, affecting baby’s normal facial growth and development as well as the bond between mother and child. Poor attachment of baby can cause nipples cracking and mastitis. Tongue tie can make introducing solids more difficult due to the child having difficulty moving the food around their mouth.

Children

Difficulties don’t end in infancy. Children with tongue tie may have trouble eating age appropriate foods, gagging, choking and vomiting when they try and eat solid foods. This can create fussy eaters and even cause problems with dental hygiene and gut and digestion issues. This is usually the age where speech problems develop and the ability to speak can also be delayed. Poor breathing and swallowing is the cause of poor growth and development of the jaws resulting in crowded teeth and small jaws. Tongue tie plays a significant role here. The undergrowth of the jaws leads to crowded teeth. If not treated at a young age, the patient will likely need to see a traditional Orthodontist. Approximately 78% of teenagers will end up with 4 to 8 permanent teeth extracted.

Adults

Decreased tongue mobility caused by an unreleased tongue tie  leaves adults with many difficulties. Anxious patients should always be checked for tongue tie, as should patients that snore, or suffer from sleep apnoea. Speech impediments can cause a lack of self-esteem due to problems with speech and eating, as well as pain and clicking in the jaws and even the development of migraines.

The Impact on Oral Hygiene and Dental Health

Limited tongue mobility affects oral health in many ways. Poor mobility of the tongue, causing messy eating habits means food remains on the teeth and lips, increasing the chance of cavities. It can also be challenging to keep saliva in the mouth, so dribbling extends into adolescence. Speech patterns are also affected by the need to account for excess saliva in the mouth.

The pressure of the tongue on the front teeth creates malocclusions which require orthodontic intervention. It also leads to the development of an open mouth posture and poor facial growth. This is due to a restricted and undergrown upper and lower jaws.

Treating Tongue Tie

In the past, tongue tie was easily treated at birth or shortly after. The usual procedure was to clamp the middle of the excess tongue tissue (Frena) and cut the tie with a pair of scissors. If the baby was crying, they were placed on the breast, and the entire procedure was over in a few seconds.

As children get older, general anaesthetic was required to release the tongue tie, which increases the risk of complications.

Laser Tongue Tie Release

Thanks to laser technology, general anaesthetics are no longer required. The entire procedure to remove a tie takes 5-minutes, and it only requires a local anaesthetic at most.

After the procedure, it is essential that two steps are followed:

  • Post-operation exercises are performed twice a day for at least two weeks to prevent re-attachment of the excess tissue and scaring. These exercises are taught pre-operatively by our Myofunctional Therapist, and followed up after the tongue tie for optimum success.
  • Review the success of the operation annually until adulthood with studies showing that in 30% of cases have significant reattachment of the frena.

The first step is especially important as there is a significant chance of reattachment of the excess tissue affecting the range of  motion of the tongue even using laser removal.

Pain is to be expected following the procedure. Painkillers should be taken 4 times a day (6 hourly) for about 4 days. After this, there will be some discomfort for 10 days. Hot salt mouthwashes should be used to prevent infection, and soft foods are best. It’s best if you do the post-operation exercises for a couple of weeks before the procedure. This way, you will get used to doing them, forming a habit.

Laser Tongue Tie release is such a simple, effective and pain-free solution. No child or adult should be left to suffer from a tongue tie. It really is unnecessary, and the implications are severe. Is there anything more important than being able to eat, communicate and BREATHE optimally? Tongue tie release prevents these problems and their impacts on physical and mental health.

Holistic Dentistry

As a holistic dental practice, Lifetime Holistic Dental wants to deliver total health. That’s why we want patients to come and see us and have their tongue tie assessed and if necessary tongue tie released. A free tongue will allow you to eat, breathe and talk normally. It will allow the jaws to grow and develop normally, hopefully avoiding braces and orthodontic extractions. That’s what total health is all about.

If you would like more information or to book an appointment, please contact us.

 

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