Ankyloglossia and Its Release: Correcting Tongue Tie

Ankyloglossia, more commonly known as “tongue tie,” is a relatively common abnormality of the corded tissue structure beneath the tongue. This band of oral mucosa is called the lingual frenum or c and derives its name from the Latin “little bridle of the tongue.” The translation of the name is particularly apt in cases of ankyloglossia. When a patient is tongue tied, the lingual frenum actually does serve as a restricting bridle, preventing the tongue from extending as far out as it should.

Complications of Ankyloglossia

Tongue tie is typically initially detected within days or weeks of birth as the child first learns to nurse or drink from a bottle. When a tongue tied baby breastfeeds, the mother may find that the latch is incredibly painful and that her child is reluctant to feed. The baby will become increasingly fussy due to lack of food and may fail to gain weight as is expected of a newborn. A lactation consultant may be able to determine if ankyloglossia is the reason for this difficulty by observing how mother and child nurse.

While some infants and young children are capable of adapting to speech and feeding with a shortened frenum, many cases require surgical intervention at an early age. If the frenum’s length or width is interfering with the child’s ability to breastfeed, nurse from a bottle or speak normally, a frenectomy may be recommended. This simple procedure may also be performed when the frenum is causing the patient pain or discomfort while eating, speaking or moving the tongue about in the mouth.

Correcting Tongue Tie

Though most infants’ frena recede naturally over the course of their first year, up to two percent of babies experience ankyloglossia that affects their ability to develop normally in the areas of speech and feeding. In severe cases, the extended frenum may even contribute to the formation of a visible gap between the two bottom teeth.

To correct ankyloglossia in babies, the simple frenectomy is performed with or without anesthesia, depending on the severity of the tongue tie itself, the parents’ preferences and the informed recommendation of the attending doctor. Because there are very few nerve endings in the lingual frenum, pain is minimal and most children recover from the rapid snip very quickly. In fact, in the majority of cases, a baby can begin breastfeeding immediately after the procedure is completed. The tongue is free from its excessive attachment to the floor of the mouth and is capable of forming a proper latch, allowing the child to receive sufficient sustenance and preventing maternal discomfort.

Ankyloglossia in Older Children and Adults

In some cases, tongue tie does not cause problems with feeding or with speech and is therefore left uncorrected in infancy. Some older children and adults, however, find that their elongated or thickened frenum causes them trouble later in life and wish to have the issue remedied. In these cases, a more comprehensive surgery can be performed. This procedure, called a frenuplasty, is performed in an oral surgeon‘s office under local or general anesthesia.

The method of frenum release in a frenuplasty is loosely similar to that of a frenectomy. After the frenum is cut and the tongue is freed, the surgical site is thoroughly cleaned and sutured. Following this procedure, the oral surgeon may suggest specific tongue exercises to reduce the risk of post-surgical scars as well as to improve the tongue’s range of motion. Full recovery can be expected in approximately four weeks.

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