Tongue Tie (Ankyloglossia): Signs and Treatment Methods

Tongue tie can drastically impact a person’s tongue function and mobility, leading to issues with feeding, speech, and oral hygiene. While it is a relatively common condition, it often goes undiagnosed, leaving many affected individuals struggling with its consequences.

This article takes an in-depth look at...

  • what tongue-tie is,
  • how it is diagnosed, and
  • how it is treated.
Keep reading to find out everything you need to know about this condition.
Tongue Tie (Ankyloglossia)_ Signs and Treatment Methods

What Is Tongue Tie?

Tongue tie or Ankyloglossia is a condition that limits tongue function and mobility, causing a person to have difficulty speaking, eating, and even breathing. It happens when the lingual frenulum (the band of tissue that connects the underside of the tongue to the floor of the mouth) is too tight or short.

It is most commonly seen in newborns and infants, but it can also affect adults. The severity of the condition can range from mild to severe, with some individuals having more extreme cases that require surgical intervention.

Tongue-tie Symptoms

In newborns and infants, it is important to look out for symptoms of tongue tie for early diagnosis and treatment. One of the most common signs to look out for is difficulty breastfeeding. It can make it hard for the baby to latch onto the breast properly, leading to poor feeding, poor weight gain, frustration for both the baby and the mother, and in most cases, nipple pain for the mother.

Babies with tongue tie could display the following early signs:

    • Clicking or smacking sounds while breastfeeding,
    • Chewing or biting on the nipple,
    • Unusual movements while they are trying to suckle,
    • Falling asleep at the breast without getting enough milk,
    • Refusing to breastfeed altogether, and
    • Difficulty sucking liquids through a bottle or straw.

In older children and adults, tongue tie can cause speech problems. The tongue plays a crucial role in forming many sounds and words, so if it can’t move freely due to a short or tight frenulum, it can lead to a lisp, difficulty pronouncing certain sounds (such as “s” or “r”), or other speech impediments. It can also affect oral hygiene, as it could be difficult to clean the tongue and teeth properly, leading to a higher risk of tooth decay and gum disease.


The exact cause is not fully understood, but it is thought to be a combination of genetic and environmental factors. Some babies are born with a short lingual frenulum, while in others, the condition may develop over time due to abnormal tongue movement or other developmental issues.

Genetics and Heredity

Genetics plays a significant role in the development of this condition. Research has shown that many cases of tongue tie are hereditary and passed down from parents to their children. In some instances, an abnormal gene or mutation may be the cause. In others, a combination of genetic factors may contribute.

It is crucial for doctors to consider the patient’s family history to diagnose and treat this condition. Genetic testing may be recommended to identify any underlying gene mutations responsible. By studying the role of genetics and heredity, medical professionals can improve their understanding of this condition and develop more effective treatment options.

Other Potential Causes

Poor nutrition during pregnancy, maternal smoking, and certain medications can all increase the risk of a baby being born with tongue tie. Other factors like forceps delivery or a difficult birth may also contribute. Some research has also suggested that prolonged use of pacifiers and bottles can lead to tongue tie, although more research is needed in this area.

In some cases, the cause is unknown and doctors will refer to it as an idiopathic case.

If you notice the early signs stated above, seek medical advice from your healthcare provider, such as a pediatrician, dentist, or lactation consultant. Early diagnosis and treatment are key for ensuring healthy language development in young children. Untreated tongue tie could lead to speech problems later on in life.

How Is It Diagnosed

How Is It Diagnosed?

Diagnosis is typically done through a physical examination. The doctor will thoroughly examine the affected area and assess any restricted tongue movement. The doctor may also order an X-ray or ultrasound to confirm their diagnosis and ensure that all underlying issues are addressed. They may also use other tests, such as a swallow study or speech evaluation, to assess the extent of the condition and its impact on the child’s health and development.

Before making a diagnosis or pursuing treatment options, it’s important for parents to discuss any potential contributing factors and family history with their doctor.

Different Types of Tongue-Tie

There are different types of tongue tie, and they are classified based on the location and severity of the restriction caused by the lingual frenulum. Here are the three common types:

    • Anterior tongue-tie is the most common type, where the frenulum is attached too close to the tip of the tongue, resulting in a limited range of motion. It affects feeding, speech, and oral hygiene.
    • Posterior tongue-tie occurs when the frenulum extends too far back, closer to the throat. The restriction is often more severe and can cause difficulties with speech, swallowing, and even breathing.
    • Submucosal tongue-tieis less common and harder to detect as the frenulum is located beneath the surface of the tongue.

Remember that not all cases are the same, and the differences in type and severity determines the best course of action.

What Are The Treatment Options

What Are The Treatment Options?

Treatment for tongue tie typically focuses on restoring mobility and may include tongue exercises or in more severe cases, tongue-tie surgery. Sometimes, no treatment may be necessary, especially if the child is not experiencing any significant problems. If tongue tie is interfering with breastfeeding, speech, or oral hygiene, there are several treatment options available:

1. Frenotomy Procedure: Tongue-tie release is a simple surgical procedure where a doctor cuts the frenulum to release the tongue. The procedure is quick and relatively painless. It usually doesn’t require any stitches, but some infants may be fussy or have a sore tongue for a day or two after the procedure. These are usually resolved on their own. Frenotomy has been shown to be safe and effective for treating babies and infants with tongue tie.

2. Exercises and Stretches: For mild cases, exercises and stretches can help improve tongue mobility and function. A healthcare provider or speech therapist can teach you or your child simple exercises to do at home, such as moving the tongue side to side or up and down, or pressing the tongue against the roof of the mouth. These exercises can help strengthen the tongue muscles and increase range of motion over time.

3. Speech Therapy: For older children and adults, speech therapy may be recommended. A Speech-Language Pathologist (SLP) works with the individual to improve their pronunciation, clarity, and overall speech skills. They may use exercises, drills, and other techniques to help the individual learn to use their tongue more effectively and overcome any barriers caused by tongue tie.

4. Alternative Therapies: While there is limited scientific evidence to support alternative therapies for tongue tie, some individuals may choose to try them as a complement to other treatments. Chiropractic care, craniosacral therapy, and myofunctional therapy are among the alternative therapies that have been used for tongue tie.

It is important for parents of children with tongue-tie to work closely with their doctor so they can determine which method of treatment is best suited for their child’s individual needs.
If you are worried about your child’s struggles, get in touch with our team so we can help you determine the best plan of care.

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Lauren Templeton - Apheleia Speech Therapy
Lauren Templeton

Owner & Speech-Language Pathologist

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