To be “tongue-tied” may usually mean to be too shy or embarrassed to speak, but it also has a second meaning. Tongue tie, also known as ankyloglossia, is a dental condition most often discovered in newborns. While communicating with words is not generally expected of newborns, this condition can cause significant problems in eating and later acquisition of language for the children who have it.
What is tongue tie?
Tongue tie is a condition that a baby is born with. For these newborns, the membrane that attaches the tongue in the mouth is longer and attaches at different areas (instead of simply at the base of the tongue).
There are four classes of tongue tie:
- Class 1: This type indicates that the lingual frenulum is attached to the very tip of the tongue. When people refer to a baby tongue tie, a Class 1 tongue tie is most often what they mean.
- Class 2: The tie is located further behind the tip of the tongue.
- Class 3: Located closer to the base of the tongue, this type may not cause any difficulty in infancy at all. Because of this, it may not even be identified.
- Class 4: This type occurs underneath the mucous membrane and must be felt to be diagnosed. This can make the tongue appear shorter and result in a misdiagnosis.
What does it mean when a baby is tongue tied?
When a baby is born with a tongue tie, it may not be immediately apparent. Indeed, in the case of a Class 3 tie, the baby may not exhibit any problematic symptoms.
For some, problems may arise immediately and include the following.
Difficulty latching on
While many new moms experience some difficulty in the beginning stages of breastfeeding, a tongue tied baby may not be able to properly latch on.
Nursing is dependent on the baby creating a seal and suction on the mother’s breast. This may not be possible with a tongue tie.
Excessive gas
Even if the baby can latch on enough to feed, they may be taking in excessive air if the seal is not complete. This can cause excess gas. Babies with colic should be checked for tongue tie.
Failure to thrive
Failure to thrive is a medical diagnosis that means the baby is not getting enough nutrition for their health, but tongue tie can be at the root.
While a diagnosis of failure to thrive is an extreme, babies with this condition may have poor weight gain because they are filling up with air and not milk.
Poor milk supply
A mother’s milk supply is dependent on the amount of nursing a baby does. If the baby is not emptying each breast at feeding time, a mother’s body will slow down milk production.
This is a vicious cycle that can lead to a diagnosis of failure to thrive.
Cracked, bleeding, or sore nipples
This symptom may affect the mom but may help diagnose a deeper issue. Some soreness is normal, but chronic cracking, bleeding, and pain is not.
It’s important to note that breastfeeding, although a natural option, is not necessarily easy to learn for mother and child. There is an adjustment period. The above signs make nursing difficult even after mother and child establish a rhythm. Further, formula supplementation may not work because the tongue tie makes nursing from a bottle challenging as well.
Tongue tied babies may grow into toddlers and children with speech difficulties, too. The tongue is an important component of language development. If it is not able to move freely in the mouth, speech may be delayed or accompanied by an impediment.
What does a tongue tie look like in an infant?
With the exception of Class 4, all classes of baby tongue tie can be seen. You can look at your own tongue first. There is a thin membrane that connects the tongue to the floor of the mouth. In standard development, this membrane is visible and present but reaches less than halfway towards the tip of the tongue.
For tongue tie, this membrane may reach all the way to the tip of the tongue. A Class 4 must be felt. This occurs underneath the membrane and is not visible.
What are tongue tie treatment options?
The best tongue tie treatment is one that is minimally invasive and as gentle as possible. It is important to first decide if it needs to be treated. In some cases, what is technically a tongue tie is not interfering with feeding or the development of speech and can be left alone.
For others, not treating it can mean more complicated problems down the road, including:
- Difficulty eating, including both chewing and swallowing food
- Risks of speech impediments or delayed speech
At AZ Dentist, we believe the best treatment approach for both lip and tongue tie is a gentle laser surgery known as laser frenectomy. This procedure may also be referred to as lip tie and tongue tie revision. The doctor uses a low-powered laser that severs the tie and cauterizes the small wound at the same time.
While the idea of surgery on a small baby is a frightening thought for parents, lip and tongue tie revision is a wise choice. A frenectomy generally heals very quickly, is relatively painless, and is the best option to treat a tongue tie. Mothers may see immediate improvement in their feeding times, and babies who previously struggled to gain weight and sleep restfully should begin to do both almost immediately after surgery. Early intervention is less traumatic and offers a better chance for quick recovery.
Dr. Janne Lynch is a Phoenix area family dentist who can gently and safely treat your baby with a tongue tie revision. Contact us today for a full evaluation.