Does your child have difficulty sticking out his/her tongue? Does your child have difficulty with certain speech sounds (those produced with the tongue tip or a retracted tongue such as /t, d, n, l, s, z, sh, r/), or is he/she unable to move the tongue for what seems like easy to execute movements (e.g licking an ice cream cone)?

If the answers to these questions are “yes”, a tongue-tie may be present. The first step is to accurately assess whether a tongue-tie actually exists. If you lift up your child’s tongue, you will notice a thin, stretchy piece of tissue which anchors the tongue to the floor of the mouth. This tissue is called the lingual frenulum. The function of the lingual frenulum is to allow the tongue free range of motion for oral movements including production of speech sounds (articulation). In typical development, the frenulum should separate before birth, allowing the tongue to move freely.  When the lingual frenulum is unusually shortened, thickened, or remains attached to the base of the tongue, a condition known as ankyloglossia or “tongue-tie” occurs. It is interesting to note that tongue-tie is more prevalent in boys than girls, and it can run in families.

For some, tongue-tie may not pose problems and therefore no intervention may be necessary. It is possible that the lingual frenulum loosens over time, in which case, the tongue-tie would be resolved. In other cases, tongue-tie can result in difficulties with one or more of the following: problems with breast-feeding; eating and swallowing difficulties, dental deficiencies, articulation problems; poor oral hygiene and poor execution of other oral movements.

You may be wondering how tongue-tie is treated. Surgical intervention (frenulectomy) for tongue-tie has been the subject of debate and controversy among professionals, however, if the tongue-tie is causing significant impact on the aforementioned functions, a minor surgical procedure may be recommended to release the frenulum and allow for improved lingual range of motion. While tongue-tie has long been considered a minor anomaly, its’ physical and emotional effects across the lifespan from infant stages to adulthood have been documented. If you think your child has a tongue-tie, it is always best to consult the appropriate professionals (e.g. speech-language pathologists, dentists, ENT, pediatrician) who can help diagnose and determine the necessary course of treatment.

This blog post was written by Allyson Pasternack, MS CCC-SLP, a Child’sPlay Therapy Center Speech Therapist.