Questions and Answers about Tongue-Tie

What exactly is tongue-tie? Tongue-tie, referred to as ankyloglossia in the medical community, is a congenital condition affecting the lingual frenum (the fold of skin under the tongue). Ankyloglossia is characterized by a thick, tight and/or short lingual frenum that results in limited movement of the tongue.

What are the common signs of tongue-tie? One of the hallmark characteristics of tongue-tie is the heart-shaped or notched appearance of the front portion of the tongue. Ask your child to stick out his tongue. If your child has a significant tongue-tie, you will notice a dimple at the front midline of the tongue. This occurs because the restricted lingual frenum has essentially anchored the tongue to the floor of the mouth and pulls the tongue inward when tongue protrusion is attempted. In mild cases, the tongue tip is normal in appearance, but the lingual frenum is markedly short, tight and/or fibrous. In these cases, the most obvious characteristics are limited and/or atypical tongue movements. For example, a child with a mild tongue-tie may be able to stick out his tongue, but not lift his tongue.

From a more functional standpoint, children with ankyloglossia may also experience the following difficulties:

  • Problems with nursing

  • Feeding difficulties

  • Poor oral and/or dental hygiene

  • Drooling

  • Tongue thrust swallow pattern

  • Delayed and/or atypical speech development

  • Reduced speech intelligibility

  • Frustration

What should I do if I suspect my child has a tongue-tie? As a parent myself, I encourage other parents to err on the side of being cautious where a child’s health and development are concerned. If you suspect that your child has a tongue-tie, I would encourage you to speak to your child’s physician, and if necessary, seek a referral to a licensed and certified speech-language pathologist for a comprehensive speech-language evaluation.

If your child does indeed have ankyloglossia, the physician and/or speech-language pathologist will most likely refer you to an otorhinolaryngologist, commonly referred to as an ENT specialist, or perhaps even to a dentist or oral surgeon, for consultation as to whether your child would benefit from a simple outpatient procedure to release the lingual frenum. Following this surgery, speech-language therapy may be indicated.

Melodie Meadows is a speech-language pathologist with over twenty years of experience. She is licensed in the state of North Carolina and certified by the American Speech-Language Hearing Association.