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Ear Nose And Throat

Tongue tie

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Definition

Tongue tie is a condition in which the bottom of the tongue is attached to the floor of the mouth.

This restricts your ability to freely move the tip of the tongue.

Alternative Names

Ankyloglossia

Causes, incidence, and risk factors

The exact cause of tongue tie is not known.  Your genes may play a role.  It tends to run in some families.

The tongue is stuck to the bottom of the mouth by a band of tissue called the lingual frenulum.

Symptoms

In a newborn or infant, the symptoms of tongue tie are similar to the symptoms in any child who is having problems with breast feeding, including:

  • Acting irritable or fussy, even after feeding
  • Difficulty creating or maintaining suction. The infant may become tired in 1 or 2 minutes, or fall asleep before eating enough.
  • Poor weight gain or weight loss
  • Problems latching onto the nipple. The infant may just chew on the nipple instead.

The breast-feeding mother may have problems with breast pain, plugged milk ducts, or painful breasts, and may feel frustrated.

Signs and tests

Most experts do not recommend that health care providers examine newborns for tongue tie unless there are breast-feeding problems.

Most health care providers only consider tongue tie when:

  • The mother and baby have had problems establishing breast-feeding
  • The mother has received at least 2 to 3 days of support from a breast-feeding (lactation) specialist

Treatment

Most breast-feeding problems can be easily managed with a variety of strategies.

If you run into any problems, talk to a lactation consultant (a person who specializes in breast feeding).

Surgery is seldom necessary, but if it is needed, it involves cutting the tissue under the tongue. This surgery is called a frenulotomy.

Most often, this procedure is done in the doctor's office. Infection or bleeding afterwards are possible, but rare.

Surgery for more severe cases is done in a hospital operating room. A surgical reconstruction procedure called a z-plasty closure may be needed to prevent scar tissue from forming.

Complications

On rare occasions, tongue tie has been associated with tooth, swallowing, or speech problems.

References

Hall DM, Renfrew MJ. Tongue tie. Arch Dis Child. 2005;90:1211-1215. Review. Erratum in: Arch Dis Child. 2006;91:797.

Tinanoff N. Common lesions of the oral soft tissues. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 307.

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