Tongue Tie, Lip Tie and Treatment

What is Tongue Tie?

Ankyloglossia, also known as tongue tie or adhesive tongue, is a congenital anomaly of unknown cause in which the tongue is attached to the floor of the mouth with a short and thick band, which can cause restriction of tongue movements. It can be seen alone or in combination with some syndromes (Ehler Danlos Syndrome, Epidermolysis Bullosa). It is more common in males than females.

There may be serious cases where the tongue is completely adhered to the floor of the mouth, or there may be cases where it is completely asymptomatic and does not cause any distress or limitation. Tongue tie (ankyloglossia) can sometimes regress with age.

Tongue tie, which can cause sucking and feeding problems in newborns because the tongue cannot be moved, can cause speech disorders, gap between the lower front teeth, gingival recession behind the lower front teeth and periodontal problems at an older age.

In cases where the tongue tie is short or thick, there is usually restricted movement of the tongue and the tip of the tongue takes the shape of a “heart” or “v” when the tongue is protruding. In more advanced cases, the tongue may not be able to lift up towards the palate, it may not be able to come out and the person may not be able to lick their lips.

What methods are used for diagnosis?

There are many methods used to make a diagnosis. During the examination, the limitation of tongue movement is taken into consideration, speech is evaluated and some letters are checked. The letters that are most difficult to say are usually the letters “s” and “r”. In addition, the teeth and surrounding tissues are checked to see if there is a gap between the lower front teeth and if there is gingival recession. In newborns, the baby’s mouth and tongue structure are examined.

The biggest factor in the treatment of tongue tie is speech disorders and in the vast majority of cases, speech improves after treatment. With the exercises recommended before and after treatment, recovery is comfortable. The treatment of the tongue tie is surgical cutting of the ligament or removal of the tissue with a laser.

All or part of the ligament can be surgically removed or the tongue can be freed. Frenectomy is the removal of the entire ligament.

In laser treatment, the tissue can be removed painlessly and bleeding-free with only topical anesthesia without the need for anesthesia and there is no need for stitches after the procedure.

Laser treatment is more comfortable than traditional methods, with less pain during and after treatment and fewer complications of feeding and speech. Recovery is also faster than with traditional methods.

Should the tongue tie be removed?

The American Pediatric Association recommends that the tongue tie should be removed as soon as possible after it is noticed to be short, thick or adherent. In this way, structural changes in the tongue, feeding and swallowing problems, teeth and gum problems, and speech problems can be prevented before they occur or become serious. There is no need to wait for any age for tongue tie removal.

The lip tie (lip frenulum), like the tongue tie, is present in everyone and is the soft tissue attachment of the lip to the gum. These connections, which can sometimes be in the form of a thick band, can cause gaps between the upper front teeth, gum recession and periodontal problems. A thick and band-shaped lip tie is usually genetic.

The treatment is surgical cutting of the ligament or removal of the tissue with a laser, as in the treatment of the tongue tie. Laser is frequently preferred today due to its advantages such as comfortable, painless, bleeding-free and quick healing. For the removal of the lip frenulum, the upper canines are usually expected to erupt. If the gap between the upper front teeth has not closed despite the eruption of the canines, then the removal of the ligament is definitively decided.

Uzm. Dt. Cansu Uzun Önalan