Tongue-tie

The lingual frenum is a string of tissue connecting the underside of the tongue to the floor of the mouth. Tongue-tie (ankyloglossia) is a condition where tongue movement is limited by a short or tight lingual frenum, which may in turn affect functions such as feeding or speaking.

Causes of tongue-tie

There are two main causes of tongue-tie; either the frenum is too short and tight, or it did not move back down the tongue during development and is still attached to the tongue tip.

Many adults and children will not have problems despite having a short, tight lingual frenum.

Signs of tongue-tie

The signs of tongue-tie can include:

• The tongue can’t poke out past the lips.
• The tongue tip can’t touch the roof of the mouth.
• The tongue can’t be moved sideways to the corners of the mouth.
• The tongue tip may look flat or square instead of pointy when extended.
• The tongue tip may look notched or heart-shaped.
• The front teeth in the lower jaw may have a gap between them.

Signs that a baby could be tongue-tied include:

• The mother has sore nipples during and after breastfeeding.
• The mother has flattened-looking nipples after breastfeeding.
• The mother has a white compression mark on the nipple after breastfeeding.
• The baby has low weight gain or does not feed well.

The mother may notice that the baby:

• comes on and off the breast
• gets tired quickly during feeds
• makes a clicking sound when sucking.

Tongue-tie and baby feeding problems

Breastfeeding issues can be associated with tongue-tie but the condition can be hard to diagnose in newborns and many of the symptoms of a tongue-tie also occur with other feeding issues. Therefore, it is important to see your doctor, a maternal and child health nurse, or a lactation consultant if you are having trouble breastfeeding.

It is important to remember that most breastfeeding problems are not caused by tongue-tie and can be overcome with the right support.

Tongue-tie and speech problems

A small number of children may develop speech problems because of tongue-tie. Tongue-tie in toddlers seems to be less common than in babies, which suggests that a short frenum can resolve itself as the child grows.

In persistent cases of tongue-tie, the child may have certain speech problems. They may have difficulties creating sounds that need the tongue or tongue tip to:

• touch the roof of the mouth – such as the t, d, n, l, s and z sounds
• arch off the floor of the mouth – such as the ‘r’ sound.

Treatment for tongue-tie

Tongue-tie can resolve in early childhood if the frenum loosens by itself, allowing the tongue to move freely for eating and speech.

Seek support from a qualified lactation consultant or other appropriately qualified health professional to address baby feeding issues.

Surgical treatment may be considered if tongue-tie has been diagnosed by a trained health professional and other methods have not been successful. Surgical treatment often means snipping the frenum with surgical scissors or laser. The medical term for this procedure is frenectomy.

Where to get help

• Your GP (doctor)
• Paediatrician
• Your maternal and child health nurse
• Your lactation consultant
• Your speech pathologist
• Your oral health professional (dentist)
• Dental Health Services Victoria
• Emergency dental care is available to all Victorians through the through the Royal Dental Hospital Melbourne and community dental clinics, for eligible people. For more information about public dental services Tel. (03) 9341 1000, or 1800 833 039 outside Melbourne metro
• Australian Dental Association ‘Find a Dentist’ search function or Tel. (03) 8825 4600