Posterior Tongue Tie – Causes, Symptoms and Treatment

Posterior tongue tie (ankyloglossia) is a shortening of the frenulum of tongue, thereby limiting his mobility. The shortening of the bridle – a birth defect. Newborn posterior tongue tie causes disturbances in the process of sucking. In older children it can be a malocclusion, speech defects and problems with swallowing.

There are four types of posterior tongue tie:

  1. In the first type of posterior tongue tie the frenulum is short and thin and does not contain large vessels.
  2. In the second type of posterior tongue tie bridle short and thick, with a content of large blood vessels and connective tissue.
  3. while the posterior tongue-tie is characterized by the thickening brake (type III)
  4. or a submucosal brake (a wide, flat mound lingual ) which restricts movement to the base of the tongue (type IV).

The classification of braces by Dr. Elizabeth and Catherine Watson Genna Coryllos also allows us to have a global rating scale that gives us understanding.

Posterior Tongue Tie type 1 above:

Frenulum insertion occurs at the tip of the tongue. When the baby cries, tongue or heart-shaped appears bifida, as the bridle pulls the tip of his tongue into her mouth.

Posterior Tongue Tie type 2 above:

The insertion occurs bridle few millimeters further back than type 1. The language is not usually see bifida, but when the baby cries, you can see the tip of the tongue falls down.

Posterior Tongue Tie type 3 Rear:

This type of bridle could be defined as a combination of types 2 and 4, since there is little visible membrane at the back of the tongue but also a submucosal anchor, so not enough to sever the membrane to release the tongue floor of the mouth.This type of bridle may be difficult to observe with the naked eye, but just spend a finger from side to side under the tongue resting baby to notice him. 

The tongue may have a normal appearance and perform extension movements with relative ease, but doing so will warp the periphery and become depressed in the center, and the baby can not raise it to touch the palate with mouth wide open. Depending on the thickness and woodiness of the submucosal component, the tongue may also present a matted and compact appearance.

Posterior Tongue Tie Type 4 bridle later:

Bridle as such is not seen with the naked eye because it is hidden under a layer of mucosal tissue, and almost totally restricted mobility of the tongue, so it is very anchored to the floor of the mouth and can present a compact appearance.The movement of the tongue is usually asymmetric. Often a pointed or narrow palate, a direct consequence of the low mobility of the tongue is appreciated.

Ankyloglossia literally means “tongue tied or anchored” and is a very graphic definition of what happens to babies born with frenulum too short for the tongue: the tongue is attached to the floor of the mouth and can not perform the necessary movements for the baby to suck effectively without compromising the welfare of his mother.

Symptoms of Posterior Tongue Tie

Ankyloglossia, or posterior tongue tie, has has been said congenital, which is detected after the inspection frenum. Among the symptoms of posterior tongue tie are sucking and swallowing problems, speech difficulties, mechanical problems and mandibular growth:

  • Sucking and swallowing (13%): the tie occurs in approximately 5% of newborns (8). This alteration is associated with 25-60% of the incidence of difficulties during breastfeeding for both mother and infant. Thus, you may have damage to the mother’s nipple, breast pain caused by extreme exertion suction, repeated episodes of mastitis, recuso breastfeeding, neonatal dehydration, poor milk supplement for infant causing poor weight gain and premature weaning may prevent the development of adult swallowing mechanism (8,10,12,13,14,20,21,22). These findings suggest that neonatal frenectomy should be considered in this select group of mothers whose infants with posterior tongue tie are also having trouble breastfeeding (8).
  • Speech (32%): the speech problem related to the tie is often overestimated. Sometimes, it can cause errors in the joint and affect the expression of alveolar-lingual and dental-lingual as t, d, l, n and r consonants; because the pronunciation of these requires opposition of the tongue against the socket or palate (22). Most joint failures has been found in people with limited mobility of the tongue when compared to those with normal mobility. Moreover, there is sufficient evidence that a good speech is still possible in the presence of a significant ankyloglossia and speech problems can be overcome without frenectomy, and yes with a speech therapy (10).
  • Mechanical Problems (14%): these are the most underrated problems of posterior tongue tie. The lack of mobility of the tongue causes inability to perform an internal oral self-cleaning, disabled lick lips and prevents often play wind instruments (9), implying social problems.
  • Mandibular growth: mild ankyloglossia no effect on the growth of the jaw except minor dental abnormalities of the incisors or mucogingival recession. The tie may cause more severe and other prognatismo open cases (10,22,23) bite.
  • Retrognathia: although the retrognathia (shorter lower jaw from the top) is physiological in infants and changes with growth, babies with posterior tongue tie usually have an obvious retrognathia.
  • Lingual corn: the corn or callus, tongue indicate that the baby must pull hard to grab the chest and that it causes sores by rubbing.
  • Irregular movements of the language: when the baby cries we can see that the language does not move symmetrically, stands or bends of different areas
  • Clicks: babies with posterior tongue tie can suck making noises with his tongue clicks, very characteristic indicating that occasionally the tongue can not maintain grip.
  • Arched palate: the language, at rest, can not be placed in the correct position it just modifying oral structures. The upper jaw is narrow forming a V, and palate sinks in parallel, which gives a deep look.

Many children with the disease symptoms are not manifested. As children get older lingual frenulum becomes longer and corresponds arisen as a result of disease restrictions in the movement of the tongue. But some children with this disease experience the following symptoms:

  • Low self-esteem and difficulties with adaptation. Child with posterior Ankyloglossia is unable to play wind instruments or using the language clean the teeth from food. Often it causes ridicule from the other guys.
  • Speech defects occur because the tip of the tongue can not rise to the desired level, so the child is not able to pronounce certain letters: l, n, s, s, d, t.
  • Difficulties with nutrition in infancy, because the child is loosely adjacent to the mother’s breast. The solution in such a situation becomes artificial nutrition.

Causes of Posterior Tongue Tie

This is a congenital defect, it is inherited. As a rule, these problems had parents or someone of the other next of kin. In the development of children with this defect often additional anomalies were observed. Normally tongue-tied observed in children whose mothers during pregnancy used cocaine. 

In addition, the disease occurs in people who are diagnosed with a congenital defect, causing deformation of the face and the oral cavity. For example, it may be cleft palate, which is directly related to changes in the X-chromosome.

The prevalence of short bridle of tongue occurs three times more often in boys than in girls. Up to 50% of patients with Ankyloglossia have close relatives with the same pathology. Most of the children otherwise relatively healthy, but in some it can be a manifestation of the syndrome of multiple congenital malformations. Ankyloglossia prevalence is approximately 1: 1000.

My Baby Is Tongue Tied, Do I Need To Worry?

For any new parent, the thought of anything being wrong with their sweet little bundle of joy is scary. Fortunately, in most cases, a tongue tied baby is nothing to be overly concerned about. Posterior tongue tie, also known as ankyloglossia, is a condition in which the piece of tissue which connects the tongue to the floor of the mouth (the frenulum) is unusually shorter in length than what would typically be seen.

For older kids and adults, this may result in restricted speech, which may require speech therapy. The phrase “to be tongue tied,” refers to a person who is unable to speak in public, or may stammer when doing so. Fortunately, for most people, this condition does not cause any great issues with speech or ability to eat and swallow, however, depending upon severity, it may require medical intervention in the form of a surgical procedure.

Complications of Posterior Tongue Tie

Frenulum can affect the baby’s development, as well as the way they eat or speak.

Tongue tie is too short hazards

1, limiting the activities of the tongue in the mouth, affecting articulation and pronunciation, especially retroflex, palatal retroflex sound and greater impact, such as the Chinese phonetic alphabet “L” English letters “R”, and to eat “eat” pronunciation difficulties. Restricted tongue movement also have an impact on chewing.

2, when the infant sucking, because the posterior tongue tie is too short, often by two lower front teeth friction occurs ulcer .

For example, can lead to:

Problems of breastfeeding. If a child is not able to move or retain the tongue in the right position, could chew instead of sucking. This can cause pain to the mother and interfere with the child’s ability to receive breast milk. Ultimately, it can lead to malnutrition and growth retardation.

Difficulty speaking. It can interfere with the ability to emit certain sounds such as “t”, “d”, “z”, “s” and “r”.

Poor oral hygiene. For a child or an adult, the condition can complicate oral hygiene, and make it difficult to wipe food debris from the teeth. This can contribute to tooth decay and gum inflammation ( gingivitis ). It can also lead to the formation of a vacuum between the two front bottom teeth (lower central incisors).


Frenulum is usually diagnosed during a physical exam. For children, the doctor may use a light to control various aspects of the language and the ability to move.

In most cases, the diagnosis of congenital allows inspection of cavity growth of the child, as well as relevant symptoms. On examination, the doctor lifts the baby’s tongue and checks whether the normal length of the lingual frenulum, whether it is close adjacent to the tip of the tongue. If the specialist examines an older child or an adult, they take into account the movement of the language and its form, when the tongue protruding from the mouth.

Treatments and cures of Posterior Tongue Tie

The treatment is controversial. Some doctors and lactation consultants recommend to correct the problem immediately, even before the baby is discharged from hospital. Others prefer to wait.

Sometimes the lingual frenulum is loosened in the course of time and the condition resolves itself.In other cases, but it persists without causing problems.

If the ankyloglossia interfere with breastfeeding, it can be treated with a simple surgical procedure called frenulotomy. For older children and adults who have difficulty with this condition, the larger procedure known as frenuloplasty it could be recommended.

In most cases, the diagnosis of congenital allows inspection of cavity growth of the child, as well as relevant symptoms. On examination, the doctor lifts the baby’s tongue and checks whether the normal length of the lingual frenulum, whether it is close adjacent to the tip of the tongue. If the specialist examines an older child or an adult, they take into account the movement of the language and its form, when the tongue protruding from the mouth.

Surgical treatment of Posterior Tongue Tie in children


The frenulotomy can be done with or without anesthesia in the hospital or at the doctor’s surgery.

During the procedure, the doctor will examine the lingual frenulum and then use sterile scissors to cut it. The procedure is fast, and the discomfort is minimal as there are few nerve endings or blood vessels of the lingual frenulum.

Bleeding is often small. After the procedure, the child can breastfeed even immediately.

Frenulotomy complications are rare but may include bleeding, infection, or damage to the salivary glands and tongue. It ‘also possible that the frenulum is paid is at the base of the tongue.

Surgical treatment for older children or adults

The frenuloplasty is performed under general anesthesia with surgical instruments. After the frenulum is cut, the wound is closed with sutures usually are absorbed when the tongue heals.

Complications of frenuloplasty are similar to those of frenulotomy or bleeding, infection or damage to the salivary glands / language. The presence of scars is possible because of the broader nature of the procedure.

After frenuloplasty, language exercises may be recommended to improve the movement of the tongue and reduce the risk of scarring.

How Posterior Tongue Tie Surgery Is Done

When indicated, neonatal frenectomy (He cut the bridle without repair) is a simple procedure that can be performed in the office at the beginning of the consultation 14. In children older than 4 months, anesthesia is usually required because of the resistance and sensitivity of the infant.

However, before this age the procedure can be performed without anesthesia with minimal discomfort to the baby. The tongue is lifted gently with a grooved retractor to expose the frenulum, which is cut with a fine scissors approximately 2-3 mm at its thinnest portion between the tongue and the alveolar process.

The postoperative period.

After the operation the baby can lick your lips, tongue stick out. Often there is an improvement in appetite. After surgery significantly improves the child’s speech, but it does not always occur immediately. You may need some time to wait. If it were implemented later frenotomy language, the child will have to re-learn correct pronunciation of sounds.

Correction of Speech in Posterior Tongue Tie

Need to understand that not had surgery, it must be accurate pronunciation, there are some tongue-tie is too short who despite surgery, articulate remains unclear, after their training is very important.

Since the completion of the human language is a very complex process, relying on the brain and central nervous system, oral cavity, nasal cavity, and many other organs together. The main tongue lisp general tone volume sounds vague tongue and palate, we should strengthen this aspect of voice training, which might play a multiplier effect.

Third, the child pronunciation, routine prevention to do:

  1. to give the child to create a good language learning environment for children more contact with children the same age, because learning and communication easier among children.
  2. when teaching children to learn to speak mainly in kind, so that the child would be interested, memories will be more profound, and the process of teaching children to be more to ask questions, because questions can stimulate the child’s brain, promote language features development.
  3. do not guess the child’s desire to replace the children to speak, but to guide him to speak out, for example, he wants to refer to something by hand, you can pretend not to understand, and guide him to express, if you really do not say, You can say a word, the rest of the children to supplement.
  4. parents should play the role of a role model, imitation is the main way children learn to speak, so parents when their children tend to speak slower, lighter tone, articulation should be clear, let the children hear every one of your hair tone.
  5. do not rebuke and scold the child in the process of educating the children, and do not forcing him to say, to be more praise and encourage him, slowly, he can learn to speak.

in children with tongue-tie can cause problems with the pronunciation of the letters “d”, “n”, “n” and “m”. Often parents bring them to a speech therapist at the age of four years and they can be difficult to re-learn how to pronounce the sounds correctly, even after surgery frenotomy.

Therefore, late surgical correction at ankyloglossia ineffective. Just before surgery can prevent the development of speech, speech problems. In the past, midwives ripped truncated bridle sharp fingernail. Nowadays treatment depends on the child’s age, severity of disease and the availability of a split tip of the tongue.


In conclusion, the posterior tongue tie should be considered in children with breastfeeding difficulties and speech. Obviously there is no consensus on the diagnosis and management of this condition. Based on the available literature we frenectomy consider a proposal for safe, effective and practical treatment in the management of patients with ankyloglossia related to these problems. However, along with the pediatric dentist or dental surgeon audiologist must assess some effects on the function of language before deciding for a conservative or surgical treatment.

Posterior Tongue Tie Diagnosis

how-to-diagnose-tongue-and-lip-ties-3To diagnose if your baby is posterior tongue-tied, have them stick their tongue out while looking at you. This can be hard to do since your baby won’t immediately respond to your request. A good technique to do is to stick out your tongue and let him/her copy you.

If they are unable to fully extend the tongue, or if it has a heart form on the edge, get them checked up by their pediatrician immediately. You can also attempt putting your finger inside the mouth with the pad facing up until they begin sucking it. See if the tongue protrudes over the gum line to cup underneath the finger. If not, you should consult a pediatrician.

This is how pediatricians diagnose posterior tongue tie:

1, feeding weakness, the baby could not wrap his tongue nipple.

2, at the posterior tongue tie when teething recurrent ulcers.

3, Shenshe not stretch lips, or tongue was forked when Shenshe or “w” shape.

4, the speech is not clear.

5, tongue shape does not look good.

6, parents feel their child psychology is not the same with others, my heart sad.

7, the gap between the lower front teeth and posterior tongue tie is sometimes related.

8, “to package Days” children with orthodontic surgeon recommends surgery tongue tie line.

9, eat more difficult to maintain hygiene lips, you can not lick fine.

10, vocal learning needs of individual children due to issue some tone higher than normal pronounce tongue required flexibility doctor.

11, learn special musical instruments such as the flute and other instruments needed to play the tongue with the situation.

How do I know if my baby has a Posterior Tongue Tie?

However, the totality posterior tongue-tied just under the surface causes the because of the time after numbing medicine is injected into the area device called completion surface dissection is carried out into the tongue-tied thereby with his it is important that a session be carried out to the muscle was completed cannot receive fibers fast observing suture and placed the suture typically dissolves away with it.

If you found when feeding live baby feeding nipple and wrapped milk leakage occurs phenomenon should consider the posterior tongue tie is too short may, but parents often ignore it; when most posterior tongue tie is too short children undergo a medical examination to be Doctors discovered by accident. Thus, when there is the following situation should go to hospital for further examination: the emergence of the phenomenon of leakage of milk could not wrap baby feeding nipple; Let children Shenshe, the tongue like being just hold something like; when his tongue was protruding tongue “V” type recessed; short, thick lingual frenulum.



1, need to see whether the lingual frenulum attached to the tongue position is too close to the tongue and gums.

2, need to see whether there is after fronting forked tongue shape or Shenshe heavy activity limitation.   Related Recommended: posterior tongue tie is too short how to do


Of course, in the end there is no posterior tongue tie is too short, only regular oral specialist to check out. However, it is worth noting that the only reason not to pronounce a short posterior tongue tie are not allowed.

1, causing the pronunciation is not accurate for many reasons, the main thing is congenital physical defects: such as congenital cleft lip and palate, tooth loss or deformity and tongue tie is too short will cause the pronunciation is not exactly the case. Secondly, acquired disease caused by child childhood illness causes higher nervous system damage, or due to head trauma, the brain’s motor area of language impairment, or because of hearing impairment, etc. are not allowed to listen to the sound result, the child can not correct imitate that speech is unclear.

2, the impact on the environment can also cause children to speak pronunciation is not accurate. For example, a dialect of the area talk about after the birth of a child has grown up listening to the dialect, Putonghua to learn from nature is poor. Adult around children speak Mandarin enough standard, even ambiguous, then the child will be affected to speak. It is worth recalling that the parents should pay attention to correct the child on child kid speak and pronounce, if not pay attention to school early to speak correct, then a long time, the child is very easy to form habits is not easy to correct pronunciation is not clear.

Second, the surgery may not be accurate pronunciation

Many parents found the child tongue tie is too short, pronunciation is not accurate, it will go to the hospital to let the baby back to normal pronunciation by surgical methods. General surgery pain is very small, less than 1 year old child surgery without anesthesia, immediate surgery. 3-6 year-old children will be anesthetized during surgery in outer posterior tongue tie. Just keep your mouth clean after surgery, often gargle. Usually after a week can be disconnected.


The clinical criteria used to diagnose vary greatly ankyloglossia in the literature. Many authors (8,9,10,12,13,14,15,16). They used based on the physical characteristics of the patient’s anatomy oral criteria. The most commonly used criterion is when the bridle is presented abnormally short and thick, causing the tongue takes a heartshape in the protrusion.

The criterion also includes functional signs of commitment, as the impediment to protrude the tongue past the gingival margin and other indications that cause a reduction in the movement of the tongue. A consensus on the diagnostic criteria for comparing treatment studies (17) is necessary.

We must also remember the importance of interdisciplinary diagnosis, speech therapy and dental evaluation to see if we opt for a surgical or conservative treatment. Opting for the latter are indicated some exercises which can obtain the elongation of the lingual frenulum.

The importance of functional assessment of the language has been emphasized by several authors, who noted that the lingual frenulum may seem short, but may still have sufficient elasticity to fulfill its function. The only tool available and designed to assess breastfeeding in infants with posterior tongue tie and severity of the problem is the “Assessment Tool for Lingual Frenulum Function” (ATLFF) (18). This quantitative tool mark 03 Rating: perfect, acceptable and poor function (19) the latter would dictate the need for surgical indication. It has been used in some previous studies (9,10,19) finding in some cases some limitations in scoring and in others, little use to identify the severity of posterior tongue tie.

Posterior Tongue Tie Clipping

Q: Are there any posterior tongue tip clip complications? My son had a severe tongue tie that was clipped within his first week. My son had his tongue tie clipped under a general anesthetic at 6 days old because he couldn’t latch on to the breast. I asked for a referral to an ENT that could clip the tongue tie. At 10 weeks he was diagnosed with tongue tie and we got it clipped the next day. I know clipping the tongue sounds crazy, but that what the lactation lady suggested.

A: Posterior tongue tie Treatment involves clipping the membrane under the posterior tongue tie, in a procedure called a frenulectomy.

The doctor I consulted with said this: “To fix posterior tongue tie is simple…they just clip the frenum (the fold of skin going from the bottom of your tongue to the floor of your mouth). Simply clipping the flap with a blunt-nose scissor will do the trick. They either have the mother (or a nurse, depending on the oral surgeon you go to), hold the baby very still while it’s quickly clipped.”

If surgery is done before 1 year of age, a procedure to clip the lingual frenulum (frenotomy) is usually all that is needed to release the tongue. In most babies, the frenulum is thin, and there is little to no blood when it’s clipped.

If you feel that your baby’s breastfeeding difficulties may be due to tongue-tie, you may need to work at finding a health care provider who can diagnose the problem and clip the frenulum. If tongue-tie is causing severe breastfeeding difficulties, then the sooner the frenulum is clipped, the better.

If the tongue-tie isn’t identified and the frenulum isn’t clipped until the baby is several weeks or months old, then it may take longer for him to learn to suck normally.

Complications From Posterior Tongue Tie Surgery

Clipping a posterior tongue tie in a young baby is a very minor procedure. Most people have the tongue clipped in a doctor’s office, not the hospital. There is a little bleeding, but the baby appears not to be in pain (I have a friend who had several of her kids’ posterior tongue ties clipped). After the clipping, there may be a couple of drops of blood, rarely more. I would highly recommend clipping the tongue if your child is tongue tied.

He did attempt to clip it in the office, but when he went to do it, he discovered my son’s frenulum was too thick and vascular, and he didn’t want to risk him losing too much blood.

Generally you can safely clip a posterior tongue tie in the first weeks of life because it isn’t very thick, has very few blood vessels if any, and it it easier to hold the baby down/mouth open.

Should I Clip Posterior Tongue Tie?

Tongue ties and lip ties can be clipped, but usually this isn’t done unless it’s severe enough to be causing noticeable problems. For instance, if there is a significant posterior tongue tie restricting tongue movement even when other factors are ideal (mom’s nipple size and shape, mom’s breastfeeding experience, etc.,) it is very desirable to clip, because it will almost always affect speech and dental hygiene.

Up until the nineteenth century, baby’s frenulums were clipped almost routinely. Because the procedure was done so often, even though in most cases it wasn’t really necessary, doctors became very reluctant to clip frenulums at all and the procedure was rarely performed.

Posterior Tongue Tie Clipping in Adults

I had a tongue tie as well which we didn’t have corrected until I was 16. I was having my tonsils and adenoids removed, as well as having my nose straightened, so the ear, nose, and throat specialist told me that he could just clip my tongue as well.

If a tongue-tie is not clipped during infancy, a person may later have a hard time moving food around for chewing or clearing food out of the cheeks or other areas of the mouth. There is no way to know from looking if it will fix itself or cause problems later on. You have to decide for yourself whether you’d rather risk the speech defects or the clipping.

If one decides to have a tie clipped later in life a frenulectomy can be completed under general anesthesia. If it begins to cause problems later on (speech delays, dental spacing issues) it can always be clipped then, once there’s a clear need for it.

I was posterior tongue tied as a baby, and mine was clipped (according to my mother, I had trouble eating) My son is 10 months, and is a tongue tied, but not bad enough to affect his eating, so the doctor left it as is. Tongue-tie surgery (lingual frenectomy) involves more than just a simple clipping or a quick snip, but more involved tissue resection under general anaesthetic.

Posterior Tongue Tie Reattachment

Q: Is it common for posterior tongue tie to reattach? Carolyn confirmed that her tongue tie had reattached and carried out another division, then stayed with us while the paediatrician checked my daughter. My daughter had hers done at 3 months and its reattached and she is just about to turn 6 months and my mrs doesn’t want to use anaesthetic but Oldham wont allow it. The 2 Ped dentist said we would have to do exercises post surgery to help to the tongue from reattaching. And I have heard others say that it HAS to be done this way in order to make sure that frenulum doesn’t reattach.

avatarAnswer: Reattachment or regrowth of tongue tie does not happen. Afterwards it is important to stretch and massage the tongue at least 4-6 times a day for a month to prevent the tongue from reattaching as it heals. Many LC’s and Dr.’s recommend stretching of the tongue after frenotomy to prevent the wound from healing ‘down’ or ‘reattaching’.

Stretching exercises 3x per day for the first 2 weeks may also be performed to prevent reattachment.

Appropriate post op care is essential to prevent reattachment.

We discuss signs you can use to identify the wound is healing without reattachment and the various current recommendations for aftercare. The lubrication can make it easier to get under the tongue and the coating of the site can delay connection to aid in avoiding reattachment.

Posterior Tongue Tie and Acid Reflux

Q: Can posterior tongue tie cause acid reflux in babies? My daughter was diagnosed with reflux at only a few weeks old and was trialed on Lactose free Formula. After 2 weeks of our new happy baby, I am doing a little experiment to see if I can reduce her reflux medication, so far so good. She also seem less gassy when I give her the bottle (now I can finnally sleep!) I’m currently researching reflux and other issues related to posterior tongue tie.
avatarAnswer: Digestion starts in the mouth, and so posterior tongue ties can lead to digestive problems like colic and reflux. Some babies have problems with excessive gas and may be in pain or suffer from vomiting as a result of swallowing air.

It has long been known that posterior tongue tie causes speech impediments, but there’s now evidence that they also can contribute to dental malformations, indigestion, snoring, and sleep apnea, and even make swallowing pills and licking ice cream cones difficult.

Even if mum finds her baby refuses the bottle or struggles with a slow flow teat, is colicky, refluxy or showing other common signs – it may never be linked to posterior tongue tie. Tongue and/or lip ties is highly associated with reflux, which can cause significant pain for baby and may result in the need for medication.

Heartburn is the most common symptom of acid reflux and it’s caused by stomach acid backing up into your esophagus.

Acid reflux affects children as well as adults and can cause vomiting coughing and difficulty breathing.

Acid Reflux Medication

Posterior tongue tie babies are more likely to slip through the system and even receive medication for the reflux/colic. They may be diagnosed with reflux that doesn’t respond to medication because the underlying cause is air swallowing due to a poor latch.

Looking back, you might sees signs that all wasn’t well – although your baby is thriving, she fed frequently day and night, she was prescribed reflux medication which didn’t really help, and when offered a dummy, it always slipped out of her mouth.

For the baby, it can be falling asleep prematurely at the breast, poor weight gain, poor latch, popping on and off at the breast, frustration at the breast, reflux/colic, etc. Babies may also suffer from poor weight gain with signs of wind and reflux including really bad hiccups. This can cause them to take in excess air during breastfeeding which often makes these babies gassy and fussy.

For other effective medication, click this site.

What is Posterior Tongue Tie?

posterior-tongue-tie-baby-300x225Posterior tongue tie, or “ankyloglossia” is a condition that limits the rear movement of the tongue.

Definition of posterior tongue tie: The medical term for tongue tied, Ankyloglossia, comes from two greek words, agkilos, and glossa. Agkilos stands for loop or crooked and glossa, stands for the word tongue.

By ankyloglossia, the language is unusually short and thick or too adherent to the floor of the mouth. A person who has the ankyloglossia might have trouble pulling off the tongue. This condition can also affect the way you eat, talk and children interfere with breastfeeding.

SYMPTOMS of Posterior Tongue Tie

Symptoms of ankyloglossia are:

  • Difficulty lifting the tongue to the upper teeth or move the tongue from side to side
  • Problems to pull out his tongue over the lower front teeth
  • Aspect of language to heart

If your child has trouble breastfeeding, consult your doctor.

Similarly, check with your doctor if your child complains of problems with the language, or exhibit symptoms typical of ankyloglossia

Causes of Posterior Tongue Tie

Typically, the lingual frenulum is separated before birth to the tongue will allow for the right range of motion. With ankyloglossia, the lingual frenulum sticks to the bottom of the tongue. Why thishappens is largely unknown, although some cases is associated with genetic factors.

Risk factors

Although ankyloglossia can affect anyone, it is more common in boys than girls, and often passed down within families.

When you hear the expression “tongue-tied”, what comes to your mind?

Most people will quickly assume it to be someone who has trouble speaking publicly and stutters anxiously when conversing with others. In reality, tongue-tied connotes something more serious. It is actually a medical condition that affects a lot of people, especially for breastfed infants.

Medically known as “ankyloglossia”, tongue tied is when the band of tissue that connects the bottom of the tongue to the mouth’s surface, also called the frenulum, is too small and tight. When this happens, the tongue has limited mobility. Tongue-tie can either be a congenital defect that is present at birth or a hereditary condition that was contracted from a family member. It appears relatively common; between 0.2% and 2% of infants are born with an abnormal frenulum.

How Many Babies Are Affected?

The tongue tie or anchored tongue is a congenital disorder present from 2.8 to 10.7% of infants in the world, characterized by abridle abnormally short and varying degrees of inability to use the language by classification lingual frenulum. 

Speech Effects of Posterior Tongue Tie

It is totally false that the bridle can be extended to produce growth with normal function. If the degree of posterior tongue tie is severe, speech may be affected, making it necessary to follow a therapy also speaks of surgical correction. When the child is able to extend his tongue enough to moisten the lower lip, then usually it not indicated frenectomy . Ankyloglossia interfere with breastfeeding, language, licking an ice cream, tongue. It may also be a cause of oral candidiasis, among others.


it is not uncommon that a child is born with a mucosal flap under the tongue mobility meeting to breast-feeding difficulties. This is known as time the tongue tied can be either easily visualize the show or hidden under the mucosal lining to the surface. It is known as posterior tongue-tied regardless of what type time sentence with a moderate include prelaunch beatings increase the production of infants may exhibit some test given how small and infant mouth is

 What is the medical term for Tongue Tied?

Up until today, there is no accepted standard on the criteria that is used to diagnose Ankyloglossia, not universally nor practical.  The frenulum, a particular tissue centered in the mouth,is a guide to how the structure of the mouth develops even before babies are born.

When babies begin to grow and develop teeth, the frenulum continues to act as a guide, guiding the way the teeth grows and with each year of age, it thins out and recedes. Tongue mobility problems can come from the frenulum failing to recede or tightening up and this is where many people begin to see problems with speech, either in children or adults.

The tongue is used for swallowing and for speaking and is the main muscle in the mouth that assists people in doing so. People with posterior tongue tie or ankyloglossia can have eating problems as well as speech problems later in life and need to seek the advice of a physician.

Newborn babies often are born with a frenulum that is too tight and parents may notice sucking problems, especially if breastfeeding and the child is unable to latch on properly to the breast. Parents must seek the advice and treatment of a physician.

The medical term for posterior tongue tie, ankyloglossia, will most likely be mentioned by a pediatrician to new parents, especially if there seems to be a problem with feedings. Speech problems in children usually occur around the age of 3, so it is important to get the child checked as to not have any further problems awaiting.

Posterior Tongue Tie Surgery

Sometimes the lingual frenulum is loosened in the course of time and the condition resolves itself.In other cases, it persists without causing problems.

If necessary, the ankyloglossia can be treated with a simple surgical procedure called frenulotomy. If the lingual frenulum is too thick, a procedure known as frenuloplasty might be a better option

Posterior Tongue Tie and Breastfeeding

Baby_with_bottlePosterior tongue tied babies cannot breastfeed correctly. To breastfeed effectively, a baby needs to have a full motion of the tongue – must be able to create a seal with his lips and tongue to form a vacuum. The language has to hollow out the chest and also be able to rise, not only for correct suckling / swallowing (without excessive intake of air), but also to curl in a shot.

Before performing frenulectomy can take other measures to optimize the grip of the baby to the breast for breastfeeding is effective.

Here are 4 tips that may help with breastfeeding a posterior tongue tied baby:

  • One is the position to horse : place the child astride the thigh of the mother, to avoid biting the nipple with the lower jaw. The nipple will address the baby’s upper lip, opening the mouth as possible, while compressing the chest to facilitate milking the breast.
  • You can also use liners to reduce cracks and breast pumps to prevent mastitis excess milk production.
  • However if it is hard for the baby to suck properly then the other alternative is that the mother pumps her milk and uses a bottle to feed.
  • If all else fails and you can’t help your baby to suckle properly then you may have to talk to your doctor about getting the simple procedure down to cut the tongue tie.

Not all tongue-tied babies require treatment and this could resolve spontaneously in due time. In some cases all the baby needs is support from the mother to latch on to the nipple.

It can be very frustrating for the baby and mother if he or she cannot suckle properly but you will be able to notice this quite quickly if the baby is fussing or falling off the breast when you try to breastfeed him or her. But this is a common problem and about 1 in 7 babies have a tongue tie. It can be rectified quite easily if needed.

How Infants Breastfeed

To breastfeed, infants should cling to the nipple of the mother through the upper ridge of the gums, of Bichat fat balls and tongue. Suckling begins with the advancement of the jaw and tongue. The language provides a better seal of the feeding, but plays a minimal role.

The previous peak of the tongue thins and bulges to begin a peristaltic ripple towards the throat. The lower jaw simultaneously extract milk from the milk ducts. [18] Clearly, the tongue movements must be extremely hampered to harm the feeding and swallowing. [2] It also appears that the breasts, nipples or Some of the mothers milk ejection have special characteristics that enable them to breastfeed a baby with a problem ankyloglossia

Normal time mobility is an important factor is speech development. However, in a newborn. It is also essential for breast-feeding. However, it is not uncommon that a child is born with the mucosal flap under the targeted causing relative mobility leading to breast-feeding difficulties.

Breastfeeding A Posterior Tongue Tied Baby

Babies with tongue-ties may not be able to open their little mouths wide enough to grip onto the mother’s breast to drink their milk. Because they cannot get to the milk then they then can slide off the breast and cannot suck the nipple well which makes the mother become sore and the baby tends not to gain much weight. Breastfeeding a tongue tied baby is quite hard if the baby is becoming upset when it feeds.

The baby needs to be able to suck onto the breast and the nipple and if you have a baby that is finding this hard to do then you should check to see if he or she has a tongue tie. Obviously if your baby can breastfeed well even with a tongue tie then there is no problem. It is only when the baby can’t feed properly and doesn’t gain much weight that it becomes a problem.

Ankyloglossia and breastfeeding problems

Several studies have examined the association of ankyloglossia to breastfeeding problems. One study compared the rate of ankyloglossia in infants attending an outpatient clinic on breastfeeding issues to the general population of newborns healthy term and concluded a higher incidence of infant ankyloglossia having breastfeeding problems (12.8% versus 3.2%). [8]

Another study involved a cohort of 201 newborns with ankyloglossia and reported a high incidence of feeding disorders (44%), but has not established a link between gravity and ankyloglossia breastfeeding problems. Thisstudy also showed that 56% of infants with tongue-tie can feed properly. [6]

A prospective trial revealed a higher incidence of breast hold disorders (19% versus 0%) and breastfeeding problems (25% vs. 3%) in a group of 36 newborns with ankyloglossia compared to a control group of infants without ankyloglossia.

Thirty of the 36 infants with posterior tongue-tie (83%) were breastfed without problems during the study period, compared with 33 of the 36 control infants (92%) (P = 0.29). The duration of breastfeeding was similar in both groups. [9] Furthermore, this study has revealed no significant difference in the degree of tongue-tie (moderate or mild) or the thickness of the brake in infants with breastfeeding problems. [9]

Failure to Breastfeed

The success of breastfeeding is largely determined by the fact that the baby massage the nipple mother tongue, stimulating the release of milk. Some babies with posterior tongue-tied tongue instead bitten nipple. It hurts the mother and does not stimulate lactation. These children quickly get tired and fall asleep while feeding. However, not sated, they wake up early, demanding of breastfeeding. Some eat almost continuously, while tiring themselves and tiring mother. Artificial feeding last bridle in children with prune Ankyloglossia midwife at birth, since already at that time it was known that it interferes with breastfeeding. Bottle feeding is often for children with tongue-tied, as they can bite the nipple. Therefore, some babies donated pathology being translated in breast to artificial feeding.

Lactation Consultants

Tongue tie may potentially cause latch problems for breastfed babies. Because an improper latch could have a negative impact on a baby’s nutrition and result in possible weight loss, a visit from a lactation consultant would be advisable.

Other commom issues that nursing mothers may experiene from breastfeeding a posterior tongue tied baby with an improper latch include mastitis, nipple trauma and plugged ducts. A lactation consultant is well trained in how to effecively breastfeed a tongue tied baby and will help mothers achieve an appropriate latch technique to work around the issue.

Surgery to Correct Posterior Tongue Tie

 In some infants, there may be an association between tongue-tie and some breastfeeding problems. This subgroup of infants may benefit from frenotomy (surgical division of the lingual frenulum). When a marked association between severe tongue-tie and breastfeeding problems is clearly established and that surgery is deemed necessary, a frequent clinician at the frenotomy must perform the procedure and use appropriate analgesia. To make more definitive recommendations on the management of ankyloglossia in infants, it will be clear diagnostic criteria and well-designed clinical trials.

The decision to cut the posterior tongue-tie, often depends on whether the doctor thinks that affect breastfeeding. Currently, doctors are divided on the belief that the tie may affect breastfeeding, which can be confusing for parents.

Physicians should base your decision on how ankyloglossia affect breastfeeding (ie, do you get the baby enough milk?), Whether or not the mother nipple pain and after evaluation of the baby’s mouth. If breastfeeding is painful, milk transfer is poor and the sublingual frenulum is usually necessary to significantly cut short. However, not all babies with very short frenulum have problems and some with an apparently normal sublingual frenulum (but it really is a little short) may have problems with breastfeeding (both maternal and artificial).

Posterior Tongue Tie Symptoms

tongue-tie-1This conditions is known as posterior tongue-tied and symptoms for the mother include prolonged feedings, painful levels, and decrease milk production. Infants may exhibit noisy suckling gas pains, and gave me also be present though these symptoms could also be indicative of something more serious.

The symptoms of posterior tongue tie in include both the infant and mother:


  • Poor latch when breastfeeding
  • cramps and excessive gas
  • Backflow
  • Inability to eat enough milk
  • Slow weight gain
  • the baby is awake long chest
  • Long feedings
  • Inability to maintain a grip deep chest
  • Inability to keep pacifiers in their mouths
  • Early Weaning

For the breastfeeding mother:

  • Difficulty or inability to breastfeed
  • Sore nipples
  • Mastitis
  • breast engorgement
  • candidiasis
  • vasospasm
  • Anxiety, stress, fatigue
  • Postpartum Depression due to complications generated
  • broken Nipples
  • Lower milk production due to the low amount ingested by the infant
  • Feelings of guilt

Posterior Tongue Tie and Speech

In some situations, the frenulum retracts on its own during the baby’s first year, and causes no issues in how he/she speaks and feeds. Several different factors contribute to the degree of the condition. If the points of connection are on the very edge of the tongue and the top rim of the bottom gum, speech development and feeding have a higher chance of getting affected than if the frenulum is connected from a further distance at the rear end.

Serious cases of tongue-tie can lead to speech development issues. Some sounds are complicated if not even impossible to produce if the tongue cannot move to its fullest potential, particularly TH, S, D, and T.

To add up to producing specific sounds, the condition can also make it difficult for the baby to perform other activities like licking a Popsicle, learning a wind instrument, or French kissing. Although these inabilities may seem insignificant to new parents, it can someday be a huge deal for the child.
What are the effects of Ankyloglossia?

The effects of tongue tie can vary from one person to the next. Dental growth may also be impacted with serious cases sometimes causing a distance between the two bottom front teeth. But a more important effect that merits immediate concern is the infant’s ability to breastfeed effectively.

To be able to extract milk from the mother’s breast, the infant needs to move his/her mouth and force the tissue against the top palate of the mouth. This constricts the lactiferous sinuses and enables the milk to enter the mouth. If the baby is restricted to move his/her tongue, then the option to breastfeed or even bottlefeed them is crossed out.

Developtment of Posterior Tongue Tied Babies

Normal tongue tie can make the tongue so easily, can be naturally extended extraoral tongue, or lick up the upper gum.But few children’s tongue tie growth is not normal, there may be tongue tie is too short (commonly known as climbing tongue) phenomenon, clinical manifestations of the tongue can not normally reach freedom, tongue protruding mouth portion is less than the length of normal children, and When tongue protrusion tongue because the tongue is pulled tendons and appear sunken, tongue W shape (when normal V-shaped tongue out tongue), may also affect breast-feeding or friction with the lower front teeth, ulceration.

When a child can not be upturned mouth tongue, the gums can not lick or extends through the upper lip, after the older affected the normal pronunciation. For the lingual frenulum is too short question, many parents there are several errors.


Some parents found the baby tongue tie is relatively short, when the mouth tongue can not bend, tongue activities are not flexible, it is not considered normal. In fact, the baby’s tongue tie is in the developmental stage. In the neonatal period , tongue tie is extended to the tongue or near the tip of the tongue.

During the development of the tongue, the tongue tie gradually tongue portion back, normal children 2 years of age gradually away from the tongue tongue tie. So, with more tongue tie infancy into tension, the situation tongue tie “too short” may appear, this is a temporary physiological phenomenon, it should not be considered unusual. With age and deciduous eruption, tongue tie attachment will gradually shift to the bottom of the mouth, gradually becomes thin and loose, the activity of the tongue will become more flexible, tongue tie is not short.

Children are not allowed to pronounce tongue tie is too short due

Some parents of the children are not allowed to be attributed to pronounce with the tongue tie is too short , as long as the children speak a little unclear performance, they take their child to the hospital for cutting tongue tie. Pronunciation, articulation errors although with tongue tie is too short related, but this is not the only reason to pronounce allowed.

Tongue tie is too short, generally only affect a child’s pronunciation of certain words is not accurate, the whole pronunciation can not afford a major role. The main cause of pronunciation are not allowed, there are two: First, congenital birth defects, such ascongenital cleft lip and palate , tooth loss or deformity and tongue tie is too short; the second is caused by acquired diseases, such as childhood children because the nervous system vocal organ disease causing uncoordinated movements, due to circumstances caused by the hearing impaired, etc. are not allowed to listen to the sound but can not imitate correctly, the brain and so can cause developmental disorders in pronunciation.

In addition, the children before the age of 3 to vocabulary gradually increased, they would like to use language to express their thoughts, it is also often voiced allowed the phenomenon, especially some of the more complex sound. This is because they learned how to talk, but the brain’s language center and the vocal organs is not yet mature, or affected by locale in the process of learning to talk caused.

For example, after the birth of a child has grown up listening to the dialect, Putonghua adults around the child could not be standard, children learn Mandarin pronunciation might have allowed the phenomenon. Experts believe that the child’s pronunciation and auditory function, language environment, intellectual development, pronunciation and other factors, and these factors generally 4 to 8 years of age gradually improved.

Therefore, do not have to worry too much about pronunciation are not allowed, children have a certain self-correcting capabilities, will gradually clear articulation 4 years later, part of the normal children to go to school in the future by learning to be fully corrected.

Posterior Tongue Tie Surgery

1280px-US_Navy_060426-N-5174T-001_Cmdr._George_Linville,_ship's_surgeon,_and_Hospital_Corpsman_1st_Class_Cynthia_Donaldson_perform_a_surgeryA simple medical procedure known as “frenectomy” can be opted to immediately correct posterior tongue tie.

Another painless procedure that can be done in the pediatrician’s office is by simply clipping the frenulum to extricate it and enable the tongue a full range of motion. The procedure only takes a few minutes and does not require any anesthesia or stitches.

Here’s how posterior tongue tie surgery is done:

  1. The dentist will consult with parents to explain the normal sequence of development of speech and language in children, the process in which speech occurs, the main disorders, and professional services for the diagnosis and treatment of disorders communication.
  2. Then the dentist will apply a small hemostat and snacks right on the bridle, just below the tongue, and another curve but on insertion into the floor of the mouth, being careful not to crush the salivary ducts with hemostats. 
  3. The triangular piece will be delimited by the forceps is cut with scissors, above each gripper spend 1 or 2 points of silk or catgut, and to remove the hemostat, were league. If phonation not improve within a few days of the operation, the speech therapist should be consulted. 6 
  4. During surgery blocking the lingual nerve on both sides is promoted by local anesthesia, tongue freezes to better expose the surgical field and the bridle is lit with a hemostat; 
  5. A stitch on the tongue will help the surgeon to tension on the lingual frenulum, with surgical scissors a horizontal cut occurs in the middle portion of the relaxed bridle. 
  6. Suturing the wound is made ​​with isolated points. 4-6,8-10 
  7. During the incision and suture, you must be careful not to injure or suturing the excretory duct or holes in the submandibular gland, which open near the site. We must remember that as the tongue is an organ of great mobility, the postoperative course is quite painful.

When to do Tongue Tie Surgery?

Parenting is a challenge almost from the moment of conception as parents truly only want what is the absolute best for their child. Medical issues tend to crop up from time to time and some are small and others are large and looming.

One of the more common medical issues that can impact a baby is what is being called posterior tongue tie or ankyloglossia. This is where the flap of skin residing under the tongue is too taunt, tight or short to allow for full protrusion of the tongue. This really means that the child cannot stick their tongue out as far as others can who are not considered to be tongue tie.

Though the initial diagnosis of having a child with a posterior tongue tie may seem hard to understand and actually sound rather frightening; it is a common occurrence and one that really is not as bothersome to the child as one may think. In fact, the majority of children with a tongue tie lead and live normal lives without ever having to have the issue medically addressed.

Though some parents may be presented with worse case scenarios that allude to the fact the extreme cases of being tongue tie can impair speech and even the ability to chew and swallow properly; for the most part it is a minimally relevant issue in terms of the child’s overall well being.
Tongue Tie Surgery?

The matter is one that is a personal choice and many medical professionals agree that correcting a tongue tie is more about aesthetics above anything else. This is why the majority of those children who have been diagnosed with a tongue tie never have a posterior tongue tie surgery to correct the issue and never suffer any ill consequences as they can speak, eat, chew and swallow properly.

The fact that perhaps the child cannot stick their tongue out as far as another child really is not just cause to perform a medical procedure to correct the issue. This is why in roughly 90% of all tongue tie cases the issue is left go and no treatment is needed, necessary or even warranted.

Frenectomy Surgery


Usually, in most cases of tongue tie, the frenulum will recede on it’s own within the first year on life and presents no additional problems with speech development.There is no reason to be too concerned for a tongue tie baby if he or she is still able to drink.

Many times, the severity of the tongue tie will depend on the placement of the shortened frenulum. Typically, the further up the tongue that the frenulum deficiency is located, the more likely a child is to experience feeding problems, as well as speech development problems down the line.

If the posterior tongue tie is found to have a negative impact on the baby’s ability to feed, then a simple procedure called a frenetomy can be preformed. This simple, outpatient procedure is preformed in office by a trained physician and is relatively quick and painless (the pain being no worse than getting one’s ears pierced).

In this procedure, the physician simply clips the frenulum to allow the tongue more room to move and the amount of blood is minimal. After this procedure is completed, the baby will attempt to feed in order to ascertain whether the feeding difficulties have been resolved.

Many physicians, however, prefer to not preemptively cut the frenulum, instead waiting to see whether the tongue tie will have a negative impact on the child’s quality of life. While this procedure was routinely preformed in the 19th century, many physicians are reluctant to do it now, except in cases where the baby’s ability to feed is severely restricted and causes a negative impact on weight gain.

Fortunately, most babies are able to thrive just fine with ankyloglossia. As many tongue tied babies grow and develop during their first year of life, the frenulum lengthens and matures and no further complications arise. However, there is a simple surgical procedure which can also correct this relatively harmless issue.

Surgical Procedure

Given how small and infant mouth is the following footage depicts toddlers for illustrative purposes. Steps are identical in newborns. However, in order to correct this problem. Numbing medicine is first applied either topically using Q-tips or by injection. The mucosal flap is then clamped for about ten seconds to crush any blood vessels which minimizes bleeding after the releases performed after releasing the clamp scissors are used to size along the clamped Xhosa, the infant may immediately breast-feeding after the procedure

Should I Wait to Do The Surgery?

Posterior tongue tie newborn under normal circumstances is an extension to the tongue near the tip of the tongue or in the process of development in the tongue, lacing gradually retreat to the base of the tongue. After 2 years of normal children gradually away from the tip of the tongue frenulum. Only a few children with normal development is not only appearedtongue tie is too short .

Therefore, infants should not be short lingual frenulum that is not considered normal, is best observed after 2 years, if the tie is too short of tongue protrusion, impede clear voice, generally simply front lacing film cut open, no local anesthesia. If the lace happen fibrosis , short and stubby, that tongue tie short shrink, they should perform the surgery.

Some parents worry that tongue tie is too short will affect the child’s pronunciation, speak, let the doctor insisted on surgery early that early surgery without anesthesia, not stitches , less bleeding. As everyone knows, early surgery (2-6 months old), easily lead to surgical wound scarring, so some children need a second surgery.

Moreover, the surgery most children are not well with the doctors, the slightest mistake is likely to cause injury, but also easy to infection. In addition, the impact of forced surgery will bring to the children psychologically worse than the physical damage suffered. So, posterior tongue tie is too short when surgery is appropriate it? Most experts agree that the best age to the age of 4 and a half to five years of surgery is better, then the child is able to cooperate with the doctors surgery, but also for the child after the pronunciation, literacy will not be affected.

Posterior Tongue Tie Treatment

Posterior tongue tie treatment is recommended ONLY if it is causing a problem. The treatment is very gentle so there is no risk to baby. Furthermore, a minor posterior tongue tie may not need to be treated if an upper lip tie and/or anterior tongue tie is present and corrected first.

I believe my almost 3 yr old has a posterior tongue tie that was missed when she had her anterior tongue tie treated as a baby. Treatment of posterior tongue tie is fairly straightforward, but a bit more involved compared with anterior tongue tie. Appropriate treatment for tongue tie (ankyloglossia) is the subject of much debate.

Treatment of tongue tie is a procedure called a frenulectomy, which is clipping the membrane under the tongue. The earlier lip tie and tongue tie are treated, the better your nursing relationship will be. This paper reviews what is known about tongue movements and the significance and treatment of tongue tie.

For: Breast & bottle fed infants Specialising in difficult to resolve feeding problems, treatment of tongue tie and follow up support as required. Both you and your baby will need treatment at the same time. With growing awareness of gentle cranial osteopathic treatment, we hope fewer babies are missed, breastfeeding is successful and long term problems such as neck and jaw tightness are avoided.

However we have also had very good results from osteopathic treatment of toddlers and preschool children who usually have had a big problem with breastfeeding as a baby and present to our practice with drooling and having difficulty speaking clearly due to the tongue tightness near the base. Tongue tie division (frenotomy) is a surgical procedure. However a tongue tie that is interfering with breast feeding may require assessment, which may lead to possible treatment (frenotomy).

Best Answer: go to an oral surgeon & get it corrected.Later if not corrected you will get spacing in the front lower teeth & you will need to frenetomy & orth treatment. Different doctors have differing levels of experience with diagnosing and treating tongue tie and lip tie. Treatment is not necessary if your baby has a piece of skin connecting the underside of their tongue to the floor of their mouth, but they can feed without any problems.

A. Tricare Prime does cover treatment of total or complete ankyloglossia (tongue tie) to remove extra connective flesh under the tongue that can cause young children to have trouble swallowing or speaking. The book was the first of its kind and remains the definitive text on the subject and an invaluable manual for the diagnosis and treatment of Tongue tie or Ankyloglossia. Sometimes there may be a tongue tie but it may not be what’s causing the problem, other times underlying issues may need resolving before treating the tie to improve outcome.

As such, Tricare Prime does not cover treatment of partial tongue tie. Final update about my own tongue tie release, last year at age 66: Edith Kernerman IBCLC, Dr. Newman’s partner, said my own tongue tie was not completely released by my oral surgeon. In the trial, two groups of babies were immediately returned to their mothers for breast-feeding, either after division of the tongue tie or without treatment.

A lactation consultant will help identify the causes of breast feeding difficulties and if tongue tie is severe and causing problems will refer you to a surgeon. Many tongue ties are minor and do not require treatment. Children should be assessed by a SLP/SLT prior to tongue tie surgery.

Tongue tie surgery, called a frenulotomy, is rarely needed. Even with a complete tongue-tie where the frenulum attaches to the tongue tip, the baby might be able to breastfeed without treatment if the floor of the mouth is flexible and can be pulled up to allow more tongue movement, but the compensations involved are fatiguing and make feeding less efficient. When tongue tie surgery (frenulectomy) is recommended in an infant, it may be done in the office.

I cannot tell you just how heartwarming that is after the battle to get his TT treated…he’s clearly an advanced speaker & I wouldn’t like to think too much about how frustrated my boy would be if that TT was still there to the tip of his tongue…but I’m pretty sure his speech could not have become so clear & encouraged him to try so many new words & sounds. Treatement of tongue tie is done early, to improve tongue mobiity for breast feeding and speech development. However, the American Academy of Pediatrics and others have documented the negative effects of ankyloglossia on breastfeeding There are also several studies showing that frenotomy improves breastfeeding Finding a practitioner who routinely works with infants with tongue mobility restriction can answer your questions and help you figure out if your baby’s tongue needs treatment.

First, there is disagreement and a lack of objective data in the medical community about the need to surgically correct partial tongue tie; anything short of total or complete tongue tie generally is considered to be of no medical value. Some children don’t need treatment because they adapt to the way their tongue is or the problem gets better as they grow. Infants generally recover very quickly from surgery but for an older child or adult recovery from a conventionally done tongue tie surgery take a week to 10 days and is painful plus the recovery from general anesthesia and the risks of it make many reluctant to revise any but the most severe tongue ties past infancy.

Treating a tongue tie for breastfeeding difficulty is a time sensitive matter and needs to be readily available to families. Also, please explain the different types of surgery for the removal as stated above (frenotomy and frenuloplasty), what the differences are, and how each procedure is done. The surgical procedure to treat tongue tie is typically a frenotomy, which involves clipping or cutting the frenulum.

Tongue-Tie from confusion to clarity: A guide to the diagnosis and treatment of ankyloglossia (tongue-tie). Kotlow, L. A. Ankyloglossia (tongue-tie): a diagnostic and treatment quandary. The most important consideration in determining whether the baby might need to be evaluated for treatment is how well the tongue functions.

In addition, the authors also state that it is uncertain as to which patients will have a speech disorder that can be linked to ankyloglossia and that there is no way to predict at a young age which patients will need treatment. Dr. Marjan Jones, a dentist from Enhanced Dentistry who has treated over 1,000 patients within the past couple of has noticed (along with others who work in this field) that in almost every case an anterior tie will also have a posterior tie as well. These babies are likely to benefit from treatment to release the restriction that the membrane is having on the tongue and enable to baby to feed effectively.

Feeding difficulties may be a reason to consider early surgery to cut the lingual frenulum and loosen the tongue. As any treatment at this age will require a General Anaesthetic, there is an even greater need to be able to justify any action. I treat problems with tongue function, not simply the presence of something under the tongue.

Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review. Every attempt to find a non surgical resolution should be attempted before considering a tongue tie release. Dr. Ochi, one of the nation’s leading experts in diagnosis and treatment of tongue tie in newborn babies, has developed a brief survey to help new mothers learn if their baby may be suffering from ankloglossia.

Frenotomy-a procedure to clip the tissue that connects the tongue to the floor of the mouth- was once well accepted as a simple intervention to treat certain breastfeeding difficulties. If the condition is causing problems with feeding, conservative treatment includes breastfeeding advice and counselling, massaging the frenulum, and exercising the tongue. Treatment for tongue-tie consists of clipping” the membrane with surgical scissors or by laser to release the tongue.

I think the more conservative treatment is the way to go. Laser surgery allows a layer by layer, thorough removal of the attachment of lip and/or tongue tie. There are different regional referral patterns, but all three types of surgeon would be equally good at dividing it. They would all expect to do this under a general anaesthetic, as a day case, i.e. with you asleep and no overnight stay in hospital.

As discussed above not all ties need intervention to breastfeed, however parents should be aware that a tongue tie can impact in other areas at a later stage – when treating is a much bigger procedure. Whether most babies and children with tongue-tie need treatment is still controversial. A tongue tie release is a small and simple surgical procedure, however like all surgical procedures especially on infants they should be avoided if possible.

Most newborns diagnosed with tongue tie can be treated with a single visit to the doctor’s office and a simple procedure called a frenetomy. Evidence supports treating tongue tie for breastfeeding difficulty , but it isn’t a cut and dried solution to all problems, and is woven into the intricacies of modern parenting. And by behaving I mean that if he goes to the gate and you get him to go away and stand still for at least 15 seconds, then pet him, get off, give a treat if you want, and tie him up (or put him in the round pen) for at least an hour to make him think about what just happened.

It is the preferred surgery for tongue-tie in babies younger than 1 year of age. I have a girlfriend and i’m getting serious with her, because of my tongue tie condition i can’t kiss her properly, referral to surgery on the NHS takes up to 18 weeks to finally have surgery. Some parents/caregivers like to seek two SLP/SLT opinions to help them make their decision whether to not to proceed with tongue-tie surgery.

I can assess and treat tongue tie privately, both in the home and in my fortnightly Cambridge and Bury St Edmunds clinics. Some parents decline to even have the tongue attachment medically evaluated and some health care providers deny the need to treat ankyloglossia. If the tie is sever enough, an oral surgeon or ENT may be called in to do the procedure.

Not at all surprised the paediatrician advised against treatment. Failure to achieve this may require surgical division of the lip tie. Evidence-based research states that early diagnosis and treatment for this, coupled with skilled post-procedural support, can make a big difference to feeding success ‘ sometimes making the difference between continuing to breastfeed and giving up altogether.

There has been a tremendous amount of new information from research studies, especially about posterior ties, and the use of lasers for very delicate surgery has revolutionized the treatment. Treatment can be safely performed on a child as early as few days old. Some babies have frenulums attached near the front, but the frenulum is very elastic and allows effective breastfeeding without treatment.

A week later he was treated and we were made to feel very comfortable during something that could be very distressing. If they find anything unusual they will discuss their observations, and if they do not treat tongue tie themselves or perform the full oral assessment to confirm, should advise seeing someone who specialises in this field. The treatment for tongue-tie is a simple operation called a frenulotomy.

If your Dr isn’t very informed ask if they know someone who is. You could also contact your local La Leche League leader and ask her if there is a local Dr or dentist who is able to diagnose and treat tongue tie. Before any procedure is carried out there would be a full analysis of the movement of the tongue and other factors that would influence whether the procedure was necessary or not and then you can decide whether or not to consent to treatment.



Tongue tie is too short treatment and care

First, the operation time

Currently, the medical profession tongue tie is too short there is no uniform view of age at surgery, most experts believe that the best age for tongue-tie dressing operation is about 5 years old. Because:

1, the child’s pronunciation and auditory function, language environment, intellectual development, pronunciation and other factors related. These factors within the period of 4 to 8 years of age to complete, therefore, before the age of 4 or more young children, if they have to predict the future is very difficult dysphonia.

2, tongue tie also with children age gradually shifted backward. Even tongue tie is too short, can be improved through training, the majority of children with developmental dysfunction does not occur.

Children 3,5 years old, about to go to school, already have a certain ability to think, as long as the patient and the children speak clearly the stakes of surgery, most children can still meet the medical staff successfully completed surgery.

Second, the surgical method

1, a simple local anesthesia: scissors, electric knife or laser cut attachment abnormal tongue tie, generally do not suture. This method is suitable for children with tongue tie thin children with little bleeding and wounds difficult to cut adhesions after children. Pros: Simple. Disadvantages: Some children may surgery less effective, may not be entirely possible to reach normal levels, there is likely to need a second surgery.

2, complex anesthesia: general 6 years of age can be used with children can be, incision tongue tie after the wound needed stitches to reduce the chance of adhesions. Advantages: local anesthesia, better surgical results. Disadvantages: children fit.

3, anesthesia: more for not combined with surgery and the wound needed stitches children. Pros: You can basically reached an operation satisfactory results. Disadvantages: need to be hospitalized, the relatively high cost of surgery.

Third, the indications for surgery

1, newborn infants can only be judged by the tongue-tie attachment position to judge the tongue tie is not short, usually six months or so as the children teething tongue tie position may be some changes, but for direct attachment to Children may be more obvious changes in the tongue, and with the eruption of the lower front teeth, may be repeated sublingual ulcer , so the tongue tie is really close to the tip of the tongue attachment surgery earlier recommendations, within six months local anesthesia surgery patients children crying is not severe, surgery is better than the bigger children. But not all children can be at this time surgery under local anesthesia, some of the children is relatively thick tongue tie, hair cut can not suture surgery under local anesthesia, easy adhesion, may require general anesthesia.

2, with the increase in children (1-5 years old), tongue tie some middle a little tongue tie children will muscle thickening ingredient than before, local anesthetics postoperative bleeding more, and children for hospital fear of children crying so heavy so that the procedure is not easy to force a small portion lacing thin children can be tongue-tie surgery under local anesthesia in the enforcement case, but the child will have to have a certain spiritual trauma . Part lacing children also due to the relatively thick bleeding, postoperative adhesions, etc. occur recommendations were general anesthesia will be better.

Children 3 and 6 years of age because most available with the completion of this outpatient surgery can choose local anesthesia.

4, the tongue tie is too short may not be entirely affect the pronunciation, there are some children very short tongue tie pronunciation but no problem, this may be different in different children compensatory ability is a very big relationship, but may generally speaking tongue tie is too short pronunciation unclear children will be more than normal chance of some children. From the perspective of pronunciation, surgery should be performed before surgery in children one to two years, but because children at this stage in the process of development since the voice of them, not to judge the short tongue tie is not necessarily affect the operation, it is recommended to check if indeed shape Earlier surgery may be abnormal attachment, check if the attachment was abnormal shape, Shenshe activity also can pronounce the kids bigger observe the situation say.

5, speaking tongue tie from the perspective of improving the appearance with short correction is no absolute indications, if the fear of the children feel that they and others do not affect self-esteem or to communicate with other children, you can always consider surgery.

6, for other reasons need surgery for an appropriate surgical approach based on needs and children with their own circumstances.   Related Recommended: pronunciation baby scissors are not allowed in respect of tongue tie it?