Ankyloglossia (Tongue-Tie)

Ankyloglossia, also known as tongue-tie, is a congenital oral condition that can cause difficulty with breastfeeding, speech articulation, and mechanical tasks such as licking the lips. The term tongue-tie comes from an unusually short membrane (the frenulum) attaching the tongue to the floor of the mouth. The tongue will often have a heart-shaped appearance when the child tries to stick it out. Many children with ankyloglossia will not have symptoms (no breastfeeding, speech or mechanical problems), and the family may notice that over time the tongue is able to protrude farther as the lingual frenulum stretches.

Ankyloglossia can cause breastfeeding problems, specifically difficulty with latching on to the breast or prolonged nipple pain in the mother. If ankyloglossia is found in an infant, the frenulum can easily be clipped in a clinic office. This procedure is called a frenotomy or frenuloplasty. In an older child, a frenuloplasty is a minor procedure that may require general anesthesia.

Ankyloglossia can also lead to speech articulation or mechanical issues. Tongue-tie will not affect a child’s ability to learn speech and will not cause speech delay, but it may cause issues with articulation, or the way the words are pronounced. The mechanical issues most frequently noted with tongue-tie are difficulty licking the lips, keeping the teeth clean, licking an ice cream cone, French kissing or playing a wind instrument. Some children have problems with cuts under the tongue when the lingual frenulum gets caught between the lower central incisor teeth. In others, the frenulum may get in the way of wearing a lower retainer for the teeth. In addition, some children report social issues such as embarrassment or teasing because they cannot stick out their tongue. Surgical correction is a minor procedure that can be performed at any age.