Tongue-tie (ankyloglossia) is a condition in which your child’s tongue remains attached to the bottom of their mouth. Symptoms include difficulty with breastfeeding and speech. A simple surgical procedure can treat the issue.
Tongue-tie — also known as ankyloglossia — is a condition in which a person’s tongue remains attached to the floor of their mouth. This occurs when the lingual frenulum (a thin strip of tissue connecting your tongue and the floor of your mouth) is shorter than usual. A short frenulum can restrict your tongue’s movement.
Ankyloglossia is most common in newborns and young children, but adults can have it too. It’s associated with breastfeeding (chestfeeding) difficulties and speech problems. Tongue-tie is a congenital condition, which means people are born with it.
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An anterior tongue-tie is in the front of your child's mouth near the tip of their tongue, just behind their lower teeth and gums. It often looks like a thin web. A posterior tongue-tie (sometimes called a “hidden” tongue-tie) is further back where the floor of their mouth meets their tongue, making it more difficult to see.
Anterior tongue-ties are more common than posterior tongue-ties.
Anyone can develop tongue-tie. In some cases, ankyloglossia is hereditary (meaning it runs in families). Tongue-tie mostly affects newborns and young children. But it’s possible for older children and adults to have the condition.
Ankyloglossia occurs in up to 10% of newborns (depending on the study and definition of tongue-tie).
In some instances, children learn to adjust to tongue-tie as they grow older. But if ankyloglossia is causing problems, it’s best to treat it early, as some symptoms worsen with age.
Symptoms of tongue-tie range from mild to severe. Your child's tongue may appear to be heart-shaped or may have a notch in it. In many cases, ankyloglossia is mild enough that symptoms don’t interfere with daily life.
Newborn tongue-tie may result in:
If you're breastfeeding, you may also have symptoms related to your child's tongue-tie, including:
In young children, tongue-tie symptoms may include:
Adult tongue-tie may result in:
The tongue and the floor of the mouth fuse together during fetal development. Over time, the tongue separates from the floor of the mouth. Eventually, only a thin band of tissue (the lingual frenulum) connects the bottom of the tongue to the floor of the mouth.
As a baby grows, the small band of tissue under the tongue shrinks and thins. In children with ankyloglossia, the band of tissue remains thick, which makes it difficult to move the tongue.
In infants, ankyloglossia is often diagnosed by a pediatrician or a lactation consultant.
Dentists often diagnose tongue-tie in older children and adults.
The true impact of tongue-tie on speech isn't clearly understood. Your child's tongue needs contact with the roof of their mouth when pronouncing the lingual sounds “t”, “d”, “z”, “s,” “th,” “n,” and “l.” When their tongue is severely restricted and can't reach the roof of their mouth, your child can have problems with articulation (pronunciation).
Speech therapy is beneficial for many children with ankyloglossia. Tongue-tie surgery may also be necessary for optimal results.
In order to create an adequate seal when breastfeeding, your infant must extend their tongue over their jaw line. If your baby has tongue-tie, this isn't possible. They often attempt to use their gums to keep the nipple in their mouth during breastfeeding. This can be painful.
In some cases, tongue-tie isn't severe enough to cause noticeable symptoms. Infants and young children who have tongue-tie but don't have problems with feeding, swallowing or speaking may not need treatment.
If your child has tongue-tie and has trouble feeding, their healthcare provider can perform a tongue-tie surgery in which they cut their lingual frenulum. This is called a frenectomy (also known as frenulectomy, frenotomy or tongue-tie division). It's often performed without sedation on infants.
Tongue-tie surgery causes minimal discomfort for infants. Young children and adults may receive pain medications or general anesthesia before the procedure.
As with any surgical procedure, a tongue-tie procedure carries risks of complications, including:
Left untreated, moderate to severe cases of tongue-tie can cause problems including:
Since people are born with tongue-tie, there’s no way to prevent it. For more severe cases of tongue-tie, early diagnosis and treatment are key to a successful recovery.
Most infants and children with tongue-tie recover completely with minor surgery and/or speech therapy. Some may not need treatment at all.
If your baby has a tongue-tie, here are some questions you may want to ask their healthcare provider:
A note from Cleveland Clinic
Tongue-tie is a relatively common condition that can lead to potential feeding problems or speech issues. People who are born with tongue-tie may improve without treatment over time. But tongue-tie surgery is necessary in most cases. During this simple procedure, your child's surgeon clips their lingual frenum, allowing their tongue to move freely and without restriction. Tongue-tie surgery is a straightforward way to ease ankyloglossia symptoms. Ask your child's healthcare provider about treatment options and timelines.
Last reviewed by a Cleveland Clinic medical professional on 07/19/2022.
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