How Tongue-Tie (Ankyloglossia) Affects Breathing, Speech & Oral Development
The medical name of tongue-tie is ankyloglossia and can be present in people of all age groups. In this condition, the tongue movement is affected because of the thick, short, or tight lingual frenulum. The lingual frenulum is a tissue that makes a connection between the tongue and the floor of the mouth. This condition can lead to various other issues, like speech development, feeding, breathing, growth, and oral health.
Tongue-ties can be correlated with the following:
Mouth breathing
Speech delays
Sleep issues
Orthodontic problems
Posture-related issues
Early recognition of tongue-tie and proper management can lead to long-term health outcomes.
In this blog, we will discuss the effects of tongue-tie symptoms and treatment options.
What Is Tongue-Tie (Ankyloglossia)?
Tongue-tie occurs when a tissue called the lingual frenulum is restricted and does not let the front and/or back of the tongue move properly. The condition can be mild or severe and can occur in individuals of any age group.
Types of Tongue-Tie
Tongue-tie is of different types and is mentioned below:
Anterior Tongue-Tie – Visible, tight frenulum near the tip of the tongue
“Posterior Tongue-Tie” or Mid-Tongue Restriction – Hidden under mucosal tissue, harder to diagnose
Complete Tongue-Tie – Severe restriction affecting all tongue movement
Partial Tongue-Tie – Limited but noticeable restriction
How Tongue-Tie Affects Breathing?
Tongue-tie affects breathing in different ways, which are discussed below:
Impaired Nasal Breathing: The tongue maintains an open airway, and it is a crucial task. The following issues occur when the tongue is not able to rest properly against the roof of the mouth:
The airway may become narrow (more common when reclined)
Mouth breathing happens
Mouth breathing is linked to: dry mouth, snoring, sleep-disorered breathing
Oxygen intake can be compromised
Sleep quality is reduced
Sleep-Disordered Breathing & Sleep Apnea: The tongue may fall backward during sleep, and this can lead to partially blocking the airway. If the airway is blocked, the following conditions occur:
Snoring
Restless sleep
Sleep apnea (in children and adults)
Daytime fatigue
Clenching & Grinding (Bruxism)
Prolonged Bed Wetting (in children)
Recurrent Nightmares and/or Night Terrors
Poor Oral Posture: The airway and facial growth develop properly with proper tongue posture.
Tongue-ties may prevent the following:
Tongue resting on the palate
Proper jaw development and proper bite
Optimal airway size
The issue can lead to narrow dental arches and then also cause problems in breathing in adult years.
How Tongue-Tie Affects Speech Development?
Tongue-tie affects speech development in different ways, which are discussed below:
Difficulty in Tongue Movement and Elevation: The tongue has to be moved in various directions for speech. Tongue-ties can cause problems in clearly speaking the following letters: L, R, T, D S, Th, K, G. (problems with K and G sounds are more related to a “posterior tongue tie”)
Speech Delays in Children
Mumbling or General Lack of Clarity (in kids and adults)
Facial fatigue from speaking (more common in adults)
Tongue-ties may affect oral and facial development.
Common problems that may be related to a tongue tie:
Problem in Jaw Growth: The tongue helps in the development of jaw growth when it rests properly in the palate. Proper tongue posture consistently provides gentle pressure to the palate which tells the palate how wide, how tall, and how long to grow. Improper tongue posture due to a tongue tie may contribute to the following concerns:
Narrow upper jaw
Teeth crowding
Open bite, overbite, and other bite problems may occur
Dental Problems: Tongue-ties may contribute to various dental issues mentioned below:
Severe tongue-tie may cause gum recession on the lower front teeth and makes the teeth sensitive to hot, cold, and sweet
Tongue-ties can make it difficult to clean food off of the teeth and in turn contribute to more plaque build up
Tongue-ties can make it difficult to keep the mouth closed at night. When the mouth opens for a prolonged period of time the mouth becomes dry. Dry mouth is strongly correlated with increased cavities (dental decay).
Difficulty in Feeding and Swallowing: Infants with tongue ties may experience problems with latching, swallowing air, colic, and sometimes even poor weight gain. Children and adults may face problems in chewing harder/chewier foods, frequent choking or gagging on food, and only prefer softer or easier to eat foods. These signs can be related to swallowing dysfunction (which may caused by a tongue tie).
Changes in Facial Development: Tongue-ties may also cause problems in facial development by not allowing the tongue to properly rest in the palate.
The face becomes long and narrow
The chin is recessed
Cheekbone are underdeveloped (flattened midface)
Facial assymetry
Symptoms of Tongue-Tie
Tongue-ties can contribute or be correlated to many symptoms:
Symptoms in Infants: Infants often face problems with breastfeeding, and a clicking sound may be heard during feeding. Weight gain in infants may be slow. Other symptoms of tongue-tie in infants include reflux, gassiness, and colic.
Symptoms in Children: delayed speech, snoring, mouth breathing, orthodontic issues, and bruxism (teeth grinding).
Symptoms in Adults: jaw tension, speech fatigue, chronic tension in the neck and shoulders, problems in sleeping, and bruxism (clenching and grinding).
How is a Tongue-Tie Diagnosed?
Tongue-tie diagnosis includes the following:
Speech evaluation
Tongue mobility assessment
Swallowing assessment
Physical examination
The specialists who diagnose tongue-tie issues include
Pediatricians
Dentists
ENT Specialists
Lactation Consultants
Speech-Language Pathologists
Tongue-Tie Treatment
There are various ways of treating tongue-tie, and some of them are discussed here in detail:
Frenotomy or Frenectomy: The tight frenulum is released through a minor surgical process. It is a quick procedure performed with scissors or a laser. It is a quick process, and patients feel very little discomfort.
Myofunctional Therapy: Myofunctional therapy includes exercises to train the posture of the tongue and oral muscles. The therapy is performed before and after release. Myofunctional therapy aims to correct the swallowing patterns and improve breathing.
Speech Therapy: Speech therapy is performed to improve articulation and communication skills.
Conclusion
A tongue-tie is a condition in which patients experience difficulty in moving their tongue properly due to a tight lingual frenulum. Tongue-ties can lead to various problems in infants, children, and adults. Infants may face problems with breastfeeding. Children may face problems in speech, snoring, mouth breathing, and orofacial development. Adults may face sleeping problems, neck and shoulder tension, chronic mouth breathing, jaw issues, and more. Tongue-ties can be treated through a minor procedure, and patients have to go through myofunctional and/or speech therapies to ensure proper postoperative healing and improve breathing and swallowing patterns, and communication skills.
Frequently Asked Questions
1. What is the difference between tongue-tie and lip-tie?
Tongue-tie is a problem where the tongue has a limited range of motion. Lip-tie is a problem where the lips may have limited range of motion.
2. How can I know that my baby is suffering from tongue-tie?
If your baby struggles with latching, or is colicky during or after nursing that may be a sign of a tongue tie. Any abnormalities with nursing should be evaluated by a lactation specialist.
3. What are anterior and posterior tongue-tie issues?
Anterior tongue-tie is a condition in which the restrictive frenulum can be easily seen in front of the tongue. Posterior tongue-tie is a condition in which it is difficult to see the restrictive frenulum, as it is at the mid/back of the tongue (hidden under the mucosa).
4. What are the causes of tongue-tie?
Doctors are not aware of the exact reasons for tongue-ties. They can be passed down genetically. The frenulum may form in different ways in the womb, and if not released in infancy, will be present in adults.
5. How soon do patients recover?
The initial discomfort resolves within 3-7 days, but the full healing time can take up to 6 weeks.
