Defined

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 Impact

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

Recurrent mastitis/thrush

Penetration/aspiration

Poor endurance

Increased respirations

Falls asleep nursing

Poor weight gain

GER

Combative behaviors

Extensive gas/hiccups

Lipstick-shaped nipples

Constant nursing

Lip blister

Anterior loss

Gagging

Poor milk supply

Extended feedings

Munching at breast

Overly strong suction

 

In bottle-fed infants:

Anterior loss

Gagging

Penetration/aspiration

Increased respiration

Clicking

Poor weight gain

Combative behaviors

Poor endurance

Lip blister

GER

Excessive gas/hiccups

Constant feeding

Falls asleep feeding

Extended feedings

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.
.

Function

Symptoms

Appearance 

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.

Different classifications

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:  

Lingual Frenuloplasty With Myofunctional Therapy 

Manual Therapy Prior to and After Frenectomy 

Functional

Evaluation

Find the best treatment specifically tailored to the client.

Myofunctional Therapy

Initiate neuromuscular reeducation to maximize the success of the therapy after surgical revision.

Release

We only refer to providers who have had additional education in lingual and labial releases. 

Post-post Therapy

Post operative myofunctional therapy provides individualized care for the client to optimize recovery and healing after surgery, as well as strength training and pattern retraining exercises for the tongue and orofacial muscles. 

Ankyloglossia affects 4.8% of the population, more often males than females (3:1 ratio).

PHONE 402-484-0326

FAX 402-484-0229

5760 S 86th Drive Suite 2
Lincoln, Nebraska 68526
USA

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