Ankyloglossia And Your Infant: Symptoms & Treatment

A review published by the Canadian Medical Association found that 4 percent to 10 percent of children are born tongue-tied. These figures varied over the analysis of five studies, because the assessment and diagnosis of ankyloglossia varies among medical providers. There is currently no standard attachment length or width of the connective tissue that marks what providers consider to be a definitive problem that requires treatment or surgery. In addition, the cause of tongue-tie is unknown, but may be genetically linked.

Proper assessment and diagnosis of tongue-tie syndrome is the first step in treating the condition. Some doctors recommend treating it right away by removing the tight skin connection, while others take a wait and see approach, as cases can resolve on their own. For babies that aren’t symptomatic, this might be an option. If tongue-tie syndrome is causing issues with feeding and thriving, a lactation specialist might help. There are surgical interventions that treat ankyloglossia. The treatments to surgically alter the lingual frenulum include a frenectomy (the complete removal of the frenulum) and a frenuloplasty (slight alteration or reshaping of the frenulum). There is limited evidence available to support which of these surgeries is most successful, and this treatment varies from patient to patient.

Additional follow-up care may be needed for proper speech development following surgical intervention. These therapies may include speech coaching from a speech-language pathologist, accompanied by exercises to strengthen and improve tongue movement. With proper care and early intervention, the problems of ankyloglossia have often completely vanished by the time a patient reaches adulthood.

What is ankyloglossia?

Ankyloglossia (also known as tongue-tie syndrome) is a congenital condition that affects some children from birth. In those with tongue-tie, the thin piece of tissue (lingual frenulum) that attaches the tongue to the floor of a child's mouth is shorter or bigger than typical.

What are the symptoms of ankyloglossia in infants?

This connection limits the mobility of your baby’s tongue. Symptoms in infants may include:

• Difficulty breastfeeding
• Heart-shaped or notched appearance of the baby’s tongue
• An audible “click” during nursing
• Difficulty putting on weight
• An unusually high hunger level

It’s important to note that according to the Rochester Medical Center, only 50% of children with tongue-tie experience trouble breastfeeding.

How is ankyloglossia diagnosed in infants?

Ankyloglossia is usually determined through a physical examination. Screening tools may be used to measure the tongue’s appearance and the ability of it to move. An infant may have tongue-tie syndrome and not experience any problems. 

What complications can arise from untreated ankyloglossia in infants?

If ankyloglossia is severe and impacts an infant’s ability to breastfeed or gain weight, then they may not get the nutrition they need. 

What treatment options are available for ankyloglossia in infants?

According to the Mayo Clinic, the lingual frenulum may loosen over time, resolving tongue-tie syndrome without intervention. If an infant’s tongue-tie persists but doesn’t cause problems, it may not require treatment. Not all babies with tongue-tie syndrome have trouble breastfeeding. Consultation with a lactation consultant can assist with breast-feeding, and speech therapy may help improve speech if it’s affected later on. Surgical treatment such as a frenotomy may be needed if tongue-tie syndrome causes feeding problems. 

Is frenectomy a painful procedure for infants?

The procedure is performed without anesthesia. Though that suggests it could be painful, since the entire procedure takes less than 15 seconds and the frenulum is very thin with few nerves, it may not cause your baby distress. If you are concerned, you can speak to your doctor about pain management options.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.