According to the International Affiliation of Tongue-Tie Professionals (IATP), tongue tie can be defined as,
“An embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal tongue movement.”
The negative impact of tongue-tie varies from person to person. Tongue tie can hold the base of the tongue down instead of allowing it to assume its normal resting position on the palate.
Results could include:
+ Dental crowding
+ Narrow palate
+ Tongue that can no longer fit into palate for appropriate rest posture, speech, and swallowing
+ As the muscles of the body relax during sleep, the tongue can fall backward and obstruct the airway.
+ Inappropriate feeding behaviors (gagging, packing, expelling, vomiting, swallowing whole, refusing)
+ Mouth breathing
+ Impacts on craniofacial development ("long face")
+ Increased cavities due an inability to effectively clear the food particles
+ Mumbling or speech errors
In breastfed infants:
Inability to latch/ unsustained latch/ shallow latch
Maternal nipple pain/trauma
Falls asleep nursing
Poor weight gain
Poor milk supply
Munching at breast
Overly strong suction
In bottle-fed infants:
Poor weight gain
Falls asleep feeding
Collapsing bottle nipple
At Link to Communication, LLC, a functional assessment is key to appropriate treatment.
It is not a linear process.
It is team-based.
Function is KEY.
Structure and function have a dynamic relationship.
Client must be symptomatic (not cosmetic or preventative).
Release decision is up to client/parent.
Looking at Function:
“Normal” Range of Motion
+ Lift the tongue to the palate with a wide open mouth .
+ Swing the tongue side to side.
+ Touch the maxillary molars with ease.
+ Lay the tongue on the roof of the mouth without excessive jaw movement or restriction.
+ Look at the other structures – palate, occlusion, etc.
+ Check for compensations - activation of neck muscles, jaw shifting, even eyebrows try to assist in supporting the tongue.
If the client's team recommends a lingual and/or labial release (tongue tie and/or lip tie release), the client will be referred to a trained provider. Myofunctional therapy must happen prior to and after the release for the best results. Research on the benefits of myofunctional therapy:
Ankyloglossia affects 4.8% of the population, more often males than females (3:1 ratio).