A tongue tie, or ankyloglossia, occurs when the piece of skin under the tongue, called a lingual frenulum, is too short or tight, causing the tongue movement to become restricted. 

This restriction can commonly affect the tongue’s movements required for feeding and may impact a mother and her newborn’s ability to successfully breastfeed and cause distress if this occurs. 

The evidence base is mixed, with some studies reporting that tongue ties may impact on speech production, gum inflammation and issues, sleep apnoea and Gastroesophageal reflux disease, however, there is much debate about the strength of the research which has reported these findings. 

Tongue ties can be complex and require management from a multi-disciplinary team, including professionals such as dentists, lactation consultants, surgeons, midwives, speech pathologists, oral health therapists and Ear Nose and Throat Specialists, for example. For a diagnosis of ankyloglossia to be made, the Australian Dental Association recommends a thorough case history should be considered alongside an objective functional assessment and a thorough assessment of the impacted factors by a relevant and qualified health professional. 

Frenectomy, or tongue tie revision surgeries have increased by 420% in Australia in the past decade, which has led to lots of debates about the management of tongue ties. 

Management

Non-surgical management is the recommended first step for tongue ties. The Australian Dental Association recommends non-surgical management strategies for infants and breastfeeding mothers (which can be found on their position statement found below) and includes strategies such as advice on positioning and the use of tools such as nipple shields. 

Some children may receive tongue tie revision surgery, or frenotomy. It is important that the risks associated with this are considered, and families are aware of these risks. Risks associated with surgical interventions include poor feeding, scar tissue, pain, bleeding, and speech difficulties. Some research has suggested benefits for feeding in infants with tongue ties, however, there is limited research for the benefits outside of this. Families should feel confident in their team of health professionals and supported in any decision they make. 

If you have concerns that your child has a tongue tie, feeding issues or speech difficulties, it may be worth seeing a speech pathologist at Hanrahan Health! Contact our friendly admin team on 02 4853 6282 or send an email to admin@hanrahanhealth.com.au