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Tongue-tie (ankyloglossia)

Tongue-tie (ankyloglossia) is a condition that restricts the tongue's range of motion.

With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth. A person who has tongue-tie might have difficulty sticking out his or her tongue. Tongue-tie can also affect the way a child eats, speaks and swallows, as well as interfere with breast-feeding.

Sometimes the lingual frenulum loosens over time and tongue-tie resolves on its own. In other cases, tongue-tie persists without causing problems.

If necessary, tongue-tie can be treated with a simple surgical procedure called a frenotomy. If additional repair is needed or the lingual frenulum is too thick for frenotomy, a more extensive procedure known as frenuloplasty might be an option.

Symptoms Causes Risk factors Complications

Symptoms of tongue-tie include:

  • Difficulty lifting the tongue to the upper teeth or moving the tongue from side to side
  • Trouble sticking out the tongue past the lower front teeth
  • A tongue that appears notched or heart shaped when stuck out

When to see a doctor

If your baby is having trouble breast-feeding, talk to your baby's doctor or a lactation consultant.

Similarly, consult the doctor if your older child complains of problems with his or her tongue — such as trouble reaching the back teeth — or you're bothered by your own symptoms of tongue-tie.

Typically, the lingual frenulum separates before birth — allowing the tongue free range of motion. With tongue-tie, the lingual frenulum remains attached to the bottom of the tongue. Why this happens is largely unknown, although some cases of tongue-tie have been associated with certain genetic factors.

When tongue-tie is present, it's apparent at birth.

Although tongue-tie can affect anyone, it's more common in boys than girls. Tongue-tie sometimes runs in families.

Tongue-tie can affect a baby's oral development, as well as the way he or she eats, speaks and swallows.

For example, tongue-tie can lead to:

  • Breast-feeding problems. Breast-feeding requires a baby to keep his or her tongue over the lower gum while sucking. If a baby isn't able to move or keep his or her tongue in the right position, he or she might chew instead of suck on the nipple. This can cause potentially significant nipple pain and interfere with a baby's ability to receive breast milk. Ultimately, poor breast-feeding can lead to inadequate nutrition and failure to thrive.
  • Speech difficulties. Tongue-tie can interfere with the ability to make certain sounds — such as "t," "d," "z," "s," "th" and "l." It can be especially challenging to roll an "r."
  • Poor oral hygiene. For an older child or adult, tongue-tie can complicate oral hygiene — making it difficult to sweep food debris from the teeth. This can contribute to tooth decay and inflammation of the gums (gingivitis). Tongue-tie can also lead to the formation of a gap or space between the two bottom front teeth (lower central incisors).
  • Challenges with other oral activities. Tongue-tie can interfere with activities such as licking an ice cream cone, licking the lips, kissing or playing a wind instrument.
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