All of us have a piece of tissue under our tongue called a frenulum that holds the tongue to the floor of the mouth. Very early in our development in the womb, the tongue separates from the floor of the mouth, and the frenulum that remains varies in size and tightness from person to person. If the frenulum is restricting proper motion of the tongue and other oral dynamics, we call this a tongue tie, or “ankyloglossia.” There are other frenum in the mouth that may be tight as well, called lip tie and buccal tie.
Many people only think about tongue tie in terms of breastfeeding. If the baby is experiencing breastfeeding problems, many professionals will identify a tongue tie. The issue of tongue tie may come up again if the child has difficulty with speech. Depending on the tie, there may be certain movements the tongue physically cannot make until the child has a revision. The third common area around which tongue tie can be discovered is food handling and choking. When someone is experiencing issues with food handling, it may be because his chew and swallow patterns are compromised and the compensations he has developed are not effective.
But what about other effects from tongue tie?
Ideally, the tongue should rest on the roof of the mouth. In a newborn, the tongue compresses the breast or bottle onto this spot, which decompresses the vomer bone above the hard palate. This vomer decompression allows the other bones of the head to move freely and thus, the newborn head can make a smooth transition from squished newborn head, to beautiful round infant head. If the tongue doesn’t have proper elevation, this decompression is compromised, even if the infant is still able to extract milk.
When the tongue rests on the roof of the mouth, structures in the deep brain responsible for making hormones and other chemicals are gently stimulated by the undulation of the tongue upon the palate. These chemicals include everything from tooth remineralization compounds to feel-good endorphins that keep people feeling well and happy. For this reason, people generally feel more well-being when their tongue is resting on the roof of the mouth.
Perhaps most importantly, resting the tongue on the roof of the mouth and having a proper swallow pattern expands the palate to it’s proper size. Think of seaweed in the ocean: it never grows straight up and down, it bends to the current. In this way, the teeth and palate form in direct response to the swallow pattern and the position of the tongue. If a person has developed a compensatory swallow pattern to accommodate restricted frenum, her lips and tongue will constantly be pushing her teeth backward into her mouth. Thus, her palate becomes high and narrow, the teeth crowd and the amount of space left for the tongue becomes diminished.
The tongue, with nowhere else to go, moves back into the airway. Sometimes the tongue restricts the airway before any teeth have even come in, caused by the position the tongue must take as a result of the tie. The long-term effects of a restricted airway are so plentiful it would boggle the mind to list them. Considering that every function of the body depends on oxygen, it is easy to see that airway restriction can become a huge problem over time, affecting all areas of life. Even the bacteria living in our gut depend of proper oxygenation to help us digest our food and make vitamins for us.
So, what should you do if you are not sure if tongue tie is affecting you? Find a professional who is educated on the matter who can help you identify if you or your child has proper oral dynamics. Dentists specializing in tongue tie are equipped to diagnose and treat the problem. It is important to work with a Craniosacral therapist to retrain the muscles and fascia, improve the latch in breastfeeding babies, and to release restrictions in the tissue built up from compensatory patterns. Finally, you may need to work with a myofunctional therapist to retrain the swallow pattern and rebalance the muscles.
There is a new awareness about the effects of tongue tie, and not all professionals are educated about it. Just because your child extracts milk well, or because it doesn’t visually appear that you are dealing with a tongue tie, doesn’t mean you or your child isn’t being affected. I have personally seen people who appear to have an obvious tongue tie who function well, and conversely I have seen others who don’t appear at first glance to be affected, and yet who have benefitted dramatically from revision and therapy. If you think this problem is affecting you, it is not too late to get relief if you find the right professionals to guide you. If you are in the position of caring for a young person, addressing this issue may be one of the best things you can do for his long-term health and happiness.