A tongue frenulum is the name for the skin/tissue that connects the tongue to the floor of the mouth. Having this connection can be completely normal however if it is shorter or thicker than usual and it restricts the normal movement of the tongue then it is a tongue tie.

The exact cause of tongue tie is not known, but it is a congenital condition, meaning it is present at birth. Genetics almost certainly plays a role as it tends to run in families.

Tongue tie is diagnosed through the examination of both structure and function. This means looking at what the tongue frenulum looks like and if tongue function is affected. How function is assessed depends upon the age of the person assessed.

Tongue-tie affects approximately 4-10% of newborns. It is more common in boys than girls.

The structure of tongue tie can be classified into four types based on the location and the extent of the frenulum attachment: Type 1 (anterior), Type 2 (just behind the tip), Type 3 (mid-tongue), and Type 4 (just ahead of the base). This is the Coryllos classification system. Those with a type 1 or 2 are very likely to have interference of normal function. Those with type 3 or 4 are more likely to have normal function but some will be tongue tied.

Yes, tongue tie can impact speech and language development, particularly in making certain sounds or the speed or fluidity of speech. Early intervention can help mitigate these issues.

Tongue-tie can make it difficult for an infant to latch properly during breastfeeding, potentially leading to poor feeding, inadequate weight gain, and pain for the breastfeeding mother.

Signs include difficulty latching onto the breast, making a clicking sound while nursing, colic, reflux, and poor weight gain.

Tongue-tie can make it difficult for an infant to form a proper seal around the bottle nipple, leading to poor feeding, excessive gas or colic, and prolonged feeding times. Some infants can overfeed as they seek comfort from the gas pain and thus have increased weight gain.

In children, tongue-tie can affect speech development, leading to difficulties with articulation. It can also impact eating habits and oral hygiene.

Symptoms include difficulty pronouncing certain sounds, especially "t," "d," "z," "s," "th," "l," and "r," as well as problems with licking, and eating certain foods.

Not always. Some children have oral dysfunction but without restriction. These children will benefit from retraining through oral motor exercises to normalise function.

Children with untreated tongue tie may experience social difficulties due to speech problems, which can affect their confidence and interaction with peers.

Yes, tongue tie can lead to dental issues such as overcrowding, poor oral hygiene due to difficulty cleaning the mouth, and an increased risk of cavities.

Yes, if not treated in childhood, tongue tie can persist into adulthood and may cause ongoing issues with speech, eating, and oral hygiene.

Adults with tongue tie might experience speech difficulties, challenges with oral hygiene, discomfort while kissing, and difficulty eating certain foods.

No, it is never too late to treat tongue tie. Many adults find significant improvement in symptoms after treatment. There is more preparatory and post-surgery work to do in order to change the habits learnt over the lifetime.

Adults with tongue tie may have difficulty reaching certain areas of their mouth with their tongue, leading to plaque buildup and a higher risk of dental problems.

Tongue tie can contribute to obstructive sleep apnea and snoring by restricting tongue movement, which can affect airway patency during sleep.

Recovery is usually quick, especially for infants and children. Pain and discomfort are typically minimal and can be managed with over-the-counter pain relievers. Exercises to improve tongue mobility are important before and after surgery.

As with any surgical procedure, there are risks, but they are low. The risks include:

Bleeding - one in five hundred to one in a thousand

Reattachment - less than one in a hundred with correct aftercare

Infection - one in ten thousand

Reattachment can occur if the edges of the diamond heal back together in the same orientation they were before surgery. Correct tongue resting posture and achieving normal tongue elevation during feeding are essential to ensure optimal healing and normalise function and minimise the risk of reattachment.

You are always welcome to attend the National Tongue Tie Centre. There are also specialist directories on the following websites: https://icapprofessionals.com/public-resources/professional-directory/  https://tonguetieprofessionals.org/directory/  https://www.tongue-tie.org.uk/find-a-practitioner 

A frenotomy or frenectomy is a simple procedure that involves dividing the frenulum to release the tongue leaving an open diamond. A frenuloplasty is a slightly more complex surgery that involves releasing the frenulum with a horizontal incision and bringing the skin edges back together vertically with sutures.

Untreated tongue tie can lead to ongoing issues with speech, eating, oral hygiene, and may contribute to dental problems and social or psychological challenges.

Post-operative care includes taking regular pain relief and performing tongue exercises as demonstrated in clinic to ensure optimal healing.