Cat Got Your Tongue? The Problems of Being Tongue and Lip Tied

There's so much to learn and share with you!  Today's post is about Tongue Ties.  It's  called ankyloglossia.  Also, we'll touch on Lip Ties as well.
I briefly mentioned  tongue ties in past posts, but today's post will go more in depth.  This may not be a problem for you but bet you know a mom who's had trouble breastfeeding or maybe a child that doesn't speak, or how about orthodontics that's relapsing?  Could that be because of a tied lip or tongue?  Possibly! Read on and then share this with others!  A wise woman once told me - "you don't know what you don't know."  It's time to learn.

Lift the lip and look! 

 First you need to know about frenums- a frenum is a band of tissue and muscle that attaches the lip to the jaw, or the tongue to the floor of the mouth.  There are seven frenums in your mouth, three on the upper jaw and then four on the lower. That band of tissue under your tongue is a frenum.  In normal development nobody even knows it's there.  However, sometimes this tissue is short, tight, thick or a combination of these variants.   That's when problems can start!  I  read a book by Alison Hazelbaker titled: Tongue-Tie.  She's written an entire book about this.  My goal is to give you the short version of why this matters so much, and what can be done to correct it.

What the heck does being tongue tied mean?  Being tongue tied is the result of the frenum under the tongue being thick/short/tight and attaching the tongue to the floor of the mouth or even right behind the front teeth such that the tongue can not function correctly.  This occurs in approximately 4% of the population and does run in families.  Some folks who are tongue tied learn to compensate for this short attachment  and feel this is not a problem worth addressing.  On the other hand, it can truly be a problem that absolutely should be corrected.  Tongue ties are not always obvious.  Besides occurring on the tip of the tongue, there can also be posterior tongue ties which are harder to diagnose.  If, after you review this post you have concerns about yourself or your baby, find a myofunctional therapist, lactation consultant or send me an email for a referral to someone who is knowledgeable about tongue ties and can help you resolve this issue.  More on that at the bottom of the post.

Dr. Kotlow has lots of great information  so click here! 

Newborns and Infants: Lift that lip and look! 

Calling all moms!! You need to read this!  Whether you choose to breastfeed your baby or elect to bottle fed, it's vital to lift the lip and look under your baby's tongue.  Your baby's health will benefit, and whether breastfeeding or bottle feeding, your baby will thank you!  Both tongue ties and lip ties affect baby's ability to nurse or bottle feed properly.
     Breastfeeding- tongue tied babies can not get their tongue in the proper position over the lower gum ridge to get a deep latch.  A deep latch is vital to remove all the breast milk.  Instead, they gum your nipples for milk.  Ouch!   So moms, if you have mastitis, sore nipples, painful nipples, damaged nipples, low milk flow, nipple compression syndrome, baby sleeps during nursing only to wake and still be hungry, or baby has failure to thrive, it's time to lift the lip and tongue.  With all those problems, who would want to nurse a baby?   Babies with problems latching may present with a "suck blister" on their upper lip.   It may well not be a problem with your milk production  but instead, a tongue or even a lip that is tied down tight!  Baby is trying hard to nurse but can't because his tongue or lips can not  move properly.   I applaud all moms that tough it out so their baby can have the benefit of breast milk.  Take a peek under the tongue, chat with your lactation consultant and find the cause.  Beautiful women that you are, you are made to feed your baby!  And breastfeeding should not be painful.  If it is, look and fix!  There's a fabulous blog that goes into much more detail about infant tongue and lip ties- so if this is your problem, click here and here to read Heather's blog post  for more great information.  No need for me to repeat what she has already done beautifully!  Again, if someone tells you it's not a problem but you know something's not right, keep looking and searching.  Lip ties and tongue ties definitely do interfere with baby's ability to eat!   Keep reading for other problems as baby grows.


     Bottle feeding- Okay you say, I'll just bottle feed...  Unfortunately, the problems baby encountered with the breast nipple did not disappear by switching to the bottle.  The tongue tie inhibits movement for ALL type of feeding.  Bottle feeding also needs  proper tongue placement and mobility.  Because of this lack of  tongue mobility, baby can't control the milk flow, especially if the teat hole is too large.  Instead, the baby may well push the bottle out so he can breathe.  Remember, breathing trumps all.  Baby is in a suck-swallow-breathe cycle and needs to protect his airway if the tongue can't move the way it should.   Signs baby is having problems: swallows too much air, arm/leg cycling, hands and foot clench, dribbling, fussing during feeding, slow feeder, colic, and reflux.

This video on Youtube is worth watching- https://www.youtube.com/watch?v=lrD9cemJNyw
It shows you how hard a baby with a posterior tongue tie works to use a bottle.  Note how she spits out the teat to breathe and then continues eating.

Babies and Children

Here's a list of possible problems for tongue tied or lip tied children as they grow:

•  Inability to chew age appropriate solid foods
•  Inability to swallow causes solid food to be pushed back out
•  Gagging, choking and vomiting
•  Slow. picky eater or
•  Fast sloppy eater
•  Persisting food fads (Soft foods)
•  Digestive issues
•  Delayed speech development
•  Deterioration of speech
•  Behaviour problems
•  Persistent dribbling
•  Tongue thrust 
•  Crooked teeth/ spaces between teeth
•  Swallowing air while eating 
•  Dental problems start appearing 
•  Strong incorrect habits of compensation acquired
•  Loss of confidence because they feel and sound different

Adults

The problems from childhood start compounding.   Adults have been compensating for this inadequate tongue mobility and now the results show themselves in all their painful glory. And what a nice list this is not! 

• Crooked teeth
• Narrow arches/high palate
• Relapsed orthodontic treatment 
• Bone loss
• Tooth decay
• Gum infections
• Recession
• Digestive issue
• Mobile teeth
• Inability to open wide
• Slow eating 
• Always watching speech
• Clicky jaws,
• Pain in jaws
• Migraines/tension headaches
• Inability to speech clearly when talking fast/loud/soft
• Inability to french kiss
• Obstructive sleep apnea
• Mouth breathing and a propensity to allergies
• Restricted dental arch development
• Long face syndrome 



That tongue tie caused this bone loss

• Inability to keep lower denture in place

Note the webbing below the front teeth 

The tongue was meant to be free. It is suppose to help with suck, swallow, chew, and talk.   It helps shape the dental arches into a nice curve. If untethered, it should rest on the roof of the mouth, behind the bumps (rugae) which are behind the upper front teeth. This ensures  proper jaw development.  The tongue's other job is to assist in proper and thorough  mastication (chewing) of food.  It assists in moving food from side to side in the mouth. The tongue then collects the food into a mass called a bolus.  If tied it can not move sideways and collect the food.  Children will often reject food they find difficult to chew.  Textures are difficult as well.  Swallowing food occurs within a vacuum, the tongue goes to the roof of the mouth, creates a seal and forces the bolus backward down the throat. Tongue tied people push their tongues forward instead, straining to swallow.

I spoke with a young lady this week who did not realize she was tongue tied.  No one had ever told her!  She acknowledged she was a very slow eater and never knew why.  Something so simple to correct has such a long reach throughout our lives.  

So, what to do about it?  

Healthy tongue attachment is vital to a healthy airway and a healthy life

Untie that tongue or lip, without a doubt!  This procedure is called either a frenectomy or a frenotomy.   Infants should be treated as soon as possible, and at that age it is a very simple procedure.  A cut of the frenum is a simple procedure done with a topical anesthetic - takes five minutes and baby can start nursing right a way.  In children and adults, it's a little more involved.  A dental laser can make short work of this procedure. A laser in the hands of a skilled dentist may not even require any numbing.  How uncomfortable is a frenectomy?  Everything I have read says healing is quick and minimally uncomfortable.  Lips or tongue must be stretched throughout the day and an over the counter pain medication should be enough to do the job of pain /discomfort management.  It is a minor surgical procedure so I would expect some discomfort.  That said, I have not had a tongue frenectomy done. What I have had done was a lip tie release at age 11.  That is probably the reason I am a dental hygienist today!  I had a large space between my upper front teeth due to the large frenum that kept my teeth apart.  And, while a cool party trick to squirt water out between my teeth, I am always glad I had that procedure done.

Muscles should be retrained and exercised to prevent reattachment of the frenum.  A myofunctional therapist can help you relearn proper muscle movement and swallowing patterns.
What caught my eye in all my reading is that many in the medical profession do not think it is a problem and some even refuse to treat it!  There are  folks who think this tissue will stretch over time.  Not!   If  after you read this and want your frenum clipped but your doc says no, find another doc, get a second or even third opinion.  You know when something is not right!  If you need proof, read Hazelbaker's book.

All my references can be reviewed by clicking on the highlighted words. 

 In addition check out: Tongue Tie and Lip Tie

                                      Dr. Lawrence Kotlow

                                      Mouth Matters
                                      Feed the Baby LLC

There is so much more information out there.  If you have any questions, concerns, or want more information, it's all at your finger tips.  Do not suffer in silence!  Tongue and lip ties really do matter to your and/or your baby's health and well being.

I look forward to hearing from you!

Keep Smiling!
Barbara