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What is ankyloglossia?

Ankyloglossia is also known as tongue-tie. It is a condition where your child's tongue does not move as freely as it should. The tongue is connected to the floor of the mouth by a thin piece of tissue called the frenulum. With ankyloglossia, your child's frenulum may be shorter, thicker, or tighter than it should be. Ankyloglossia can range from mild to severe depending on how much it decreases movement of the tongue.

What increases the risk of ankyloglossia?

Ankyloglossia is a congenital condition, which means that your child was born with it. It may run in families and is more common in boys than in girls. Mothers with history of cocaine abuse have a higher risk of having a child with ankyloglossia. It is also seen in children with certain genetic problems.

How is ankyloglossia diagnosed?

Your child's healthcare provider will examine him. For infants, your child's healthcare provider will ask if he has problems with feeding. Your healthcare provider may watch your baby during breastfeeding or bottle feeding. If your child is older, your child's healthcare provider will ask him to stick out his tongue and lift it upwards. He will check the softness and length of his frenulum. Tell your child's healthcare provider if other family members have had the same condition.

How is ankyloglossia treated?

Mild ankyloglossia in babies may not be treated unless there are feeding problems. The inside of his mouth will change in size and shape during the first 4 to 5 years of life. When his teeth start to come in, his tongue grows and will narrow at the tip. Over time, his frenulum may grow, stretch, and even come loose on its own. When ankyloglossia is severe, your child may need any of the following treatments:

  • Frenulotomy: This surgery is done if the condition causes speech problems. The thinnest portion of your child's frenulum is cut to release the tongue tip. Local anesthesia may be used to control pain during surgery.
  • Frenuloplasty: This surgery is also called a frenectomy. It is done if the frenulum is thick and has many blood vessels. Your child may be given local or general anesthesia to control pain during surgery. The frenulum is cut and removed. The wound is then closed with stitches.

What are the risks of ankyloglossia?

  • Feeding: Babies may have problems with latching on to their mother's breast during breastfeeding or with bottle feeding. They may not get enough milk because of the condition. Breastfed babies may suck even harder and this may cause breast pain in mothers. Older children may have problems with swallowing chewed food or clearing food from the mouth.
  • Oral and dental: Food may get trapped inside your child's mouth. This can cause a bad smell and start tooth decay. Some teeth may not form well and he may have spaces between his teeth.
  • Speech: Ankyloglossia will not prevent or delay your child's ability to talk. This condition may only cause problems in how your child can say or pronounce some words. Words with the tongue sounds may be hard for him to say, such as the T, D, L, TH, and ST sounds.
  • Social: Your child may have problems doing what other children can easily do. These may include licking an ice cream cone or sticking his tongue out completely. He may also have problems playing wind instruments such as the flute.

When do I call my child's healthcare provider?

Call your child's healthcare provider if:

  • Your baby has problems with latching on to your breast during breastfeeding.
  • Your baby is not satisfied after feedings or you are having severe nipple pain when breastfeeding.
  • You are concerned about whether your baby is getting enough breast milk or formula during feedings.
  • You find breastfeeding painful.
  • Your child has problems swallowing food.
  • Your child has problems saying some words or speaking.
  • You have more questions about your child's condition or care.

When should I seek immediate care for my child?

Seek immediate care if:

  • Your child refuses to feed at all.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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