When someone is "tongue-tied", this usually means that person is timid or doesn't know what to say. But when people talk about an infant being tongue tied, it means something quite different — they have a limited range of movement in their tongue.
There are different types of tongue tie, defined by where the tissue restricting movement is attached. Anterior tongue tie is more common, but it is also possible for an infant to have a posterior tongue tie.
The type of tongue tie a baby has is defined by where or how the tongue is attached to the floor of the jaw. Posterior tongue ties can be tricky to detect and are occasionally misdiagnosed, Breastfeeding USA explains. When a tongue tie is posterior, it's located beneath a mucous membrane. You can't really see it, so you or your baby's doctor has to feel around in the infant's mouth to detect it. Comparatively, anterior tongue ties are easy to spot. They're usually attached anywhere from the tip to the base of the tongue.
Posterior tongue ties are less common than anterior tongue ties. In a study published in the International Journal of Pediatric Otorhinolaryngology, 290 of 618 patients had an anterior tongue tie, while 120 had a posterior tongue tie.
One of the biggest issues babies with tongue tie face is difficulty breastfeeding or eating. As the Mayo Clinic describes it, the baby's limited ability to move their tongue might prevent them from placing it in the right position while feeding. Instead of sucking, the baby might chew on the nipple, which can prevent them from getting the food they need. The chewing can also cause the mother a good deal of pain.
Without treatment, a tongue tie can cause problems later in life. Having limited tongue movement can make speech difficult. Tongue-tied children and adults have trouble producing "th", "l", "r" and other consonant sounds. A tongue tie can also increase a person's risk of tooth cavities and other oral hygiene issues. When your child's first teeth come in, help keep them healthy by starting good oral hygiene habits early. Use a toothbrush with extra-soft bristles for gentle yet effective cleaning.
Treatment for a posterior tongue tie ranges from a "wait-and-see" approach to immediate surgical correction. It is possible for the tongue tie to loosen up and relax with time. But some doctors prefer to prevent any possible eating or speech issues by treating the problem before the baby goes home for the first time.
One of the most common surgical treatments is a procedure called a frenotomy. One study published in the International Journal of Pediatric Otorhinolaryngology found that 85 percent of patients who had the procedure showed an immediate improvement in their ability to breastfeed. During a frenotomy, the doctor cuts the frenulum — the band of tissue that connects the tongue to the bottom part of the mouth. Often, a frenotomy is such a quick and easy procedure that it requires no anaesthetic.
If your infant is having trouble breastfeeding, or your older child is developing speech difficulties, schedule a visit with your pediatrician to confirm or rule out a posterior tongue tie. Since a posterior tie can be difficult to detect, getting the opinion of a medical professional can help you figure out what steps to take next.