Tongue-tie (ankyloglossia) is
a problem that is present at birth. It happens when the tissue that attaches the tongue to the bottom of
the mouth (lingual frenulum) is too short. This can limit the movement of the tongue.
See a picture of tongue-tie.
The cause of tongue-tie isn't always known. It can run in families or may occur in babies who have other problems that affect the mouth or face, such as cleft palate.
Many babies with tongue-tie
don't have symptoms. The tissue either stretches as the child grows, or the child adapts to the tongue restriction. But some children with tongue-tie
Your doctor will do a physical exam of your child's mouth and ask about his or her symptoms. In an older child or adult, the doctor may check the shape
and movements of the tongue.
If your baby is younger than 1 year of age and has problems with feeding, the doctor may do a medical procedure (frenotomy) to clip the lingual frenulum. If your baby has tongue-tie and is feeding okay, you may choose to wait and see if his
or her lingual frenulum stretches on its own.
While you wait and see, you can also:
If tongue-tie causes speech problems or personal or social problems as your child grows, the doctor may do a frenuloplasty. In this surgery, the doctor clips the lingual frenulum and closes the wound with stitches. The doctor may also teach your child how to do tongue exercises to improve tongue movement.
Some children don't need treatment because they adapt to the way their tongue is or the problem gets better as they grow.
Learning about tongue-tie:
The American Academy of Otolaryngology—Head and Neck
Surgery (AAO-HNS) is the world's largest organization of physicians dedicated
to the care of ear, nose, and throat (ENT) disorders. Its Web site includes
information for the general public on ENT disorders.
The KidsGrowth website, created by pediatricians, has
children's health resources for parents and teens. It offers a free newsletter
and information about child development, behavioral issues, and illnesses. The
TeenGrowth interactive website (www.teengrowth.com) offers a secure
environment for teens to get valuable information on topics such as alcohol,
drugs, emotions, health, family, friends, school, sex, and sports.
La Leche League International (LLLI) offers information and
encouragement—mainly through personal help—to all mothers who want to
breast-feed their babies. It also offers support and information about
breast-feeding babies with various disabilities, such as cleft lip or cleft
palate. Call for information about a chapter in your area.
Other Works Consulted
Breward S (2006). Tongue tie and breastfeeding: Assessing and overcoming the difficulties. Community Practice, 79(9): 298–299.
Hall DMB, Renfrew MJ (2005). Tongue tie.
Archives of Disease in Childhood, 90(12): 1211–1215.
[Erratum in Archives of Disease in Childhood, 91(9):
Reamy BV, et al. (2010). Common tongue conditions in primary care. American Family Physician, 81(5): 627–634.
Yoon PJ, et al. (2011). Tongue-tie (ankyloglossia) section of Ear, nose, and throat. In WW Jay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., p. 485. New York: McGraw-Hill.
May 11, 2012
John Pope, MD - Pediatrics
& Chuck Norlin, MD - Pediatrics
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