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Tongue-tie (ankyloglossia)

Medically reviewed by Drugs.com. Last updated on May 5, 2023.

Overview

Tongue-tie (ankyloglossia) is a condition present at birth that restricts the tongue's range of motion.

With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth, so it may interfere with breast-feeding. Someone who has tongue-tie might have difficulty sticking out his or her tongue. Tongue-tie can also affect the way a child eats, speaks and swallows.

Sometimes tongue-tie may not cause problems. Some cases may require a simple surgical procedure for correction.

Tongue-tie

Tongue-tie (ankyloglossia) is a condition in which an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth. If necessary, tongue-tie can be treated with a surgical cut to release the frenulum (frenotomy). If additional repair is needed or the lingual frenulum is too thick for a frenotomy, a more extensive procedure known as a frenuloplasty might be an option.

Symptoms

Signs and symptoms of tongue-tie include:

When to see a doctor

See a doctor if:

Causes

Typically, the lingual frenulum separates before birth, allowing the tongue free range of motion. With tongue-tie, the lingual frenulum remains attached to the bottom of the tongue. Why this happens is largely unknown, although some cases of tongue-tie have been associated with certain genetic factors.

Risk factors

Although tongue-tie can affect anyone, it's more common in boys than girls. Tongue-tie sometimes runs in families.

Complications

Tongue-tie can affect a baby's oral development, as well as the way he or she eats, speaks and swallows.

For example, tongue-tie can lead to:

Diagnosis

Tongue-tie is typically diagnosed during a physical exam. For infants, the doctor might use a screening tool to score various aspects of the tongue's appearance and ability to move.

Treatment

Treatment for tongue-tie is controversial. Some doctors and lactation consultants recommend correcting it right away — even before a newborn is discharged from the hospital. Others prefer to take a wait-and-see approach.

The lingual frenulum may loosen over time, resolving tongue-tie. In other cases, tongue-tie persists without causing problems. In some cases, consultation with a lactation consultant can assist with breast-feeding, and speech therapy with a speech-language pathologist may help improve speech sounds.

Surgical treatment of tongue-tie may be needed for infants, children or adults if tongue-tie causes problems. Surgical procedures include a frenotomy or frenuloplasty.

Frenotomy

A simple surgical procedure called a frenotomy can be done with or without anesthesia in the hospital nursery or doctor's office.

The doctor examines the lingual frenulum and then uses sterile scissors to snip the frenulum free. The procedure is quick and discomfort is minimal since there are few nerve endings or blood vessels in the lingual frenulum.

If any bleeding occurs, it's likely to be only a drop or two of blood. After the procedure, a baby can breast-feed immediately.

Complications of a frenotomy are rare — but could include bleeding or infection, or damage to the tongue or salivary glands. It's also possible to have scarring or for the frenulum to reattach to the base of the tongue.

Frenuloplasty

A more extensive procedure known as a frenuloplasty might be recommended if additional repair is needed or the lingual frenulum is too thick for a frenotomy.

A frenuloplasty is done under general anesthesia with surgical tools. After the frenulum is released, the wound is usually closed with sutures that absorb on their own as the tongue heals.

Possible complications of a frenuloplasty are similar to a frenotomy and are rare — bleeding or infection, or damage to the tongue or salivary glands. Scarring is possible due to the more extensive nature of the procedure, as are reactions to anesthesia.

After a frenuloplasty, tongue exercises might be recommended to enhance tongue movement and reduce the potential for scarring.

Preparing for an appointment

The following information will help you prepare for your appointment, and understand what to expect from your doctor.

What you can do

Prepare a list of questions ahead of time, such as:

What to expect from your doctor

The doctor is likely to ask you a number of questions. For example:

Preparing and anticipating questions will help you make the most of your time with the doctor.

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