Posted by Dr. Julie Boudreault On 2-09-2019
Milton patients who have tongue-tie suffer from a condition that limits tongue movement. This is due to improper development of the frenulum, the piece of skin that attaches the tongue to the floor of the mouth. The condition can be caused if the frenulum is too short, too thin, or too tight. Tongue-tie causes many issues, including difficulty feeding for babies, as well as oral and facial development. Here are the things parents should know about tongue-tie that children might experience.
How to Diagnose Tongue-Tie
There are a few ways to classify or identify tongue-tie. There are four classifications for tongue-tie based on the severity and the distance of the tie to the tip of the tongue:
- Class 1: Mild, 12–16 millimetres
- Class 2: Moderate, 8–11 millimetres
- Class 3: Severe, 3–7 millimetres
- Class 4: Complete, less than 3 millimetres
However, we also consider if the tongue-tie has anterior or posterior ties. Anterior ties are visible and measurable, while a posterior tie is noted by touch. In some cases, dentists might use different measurements in hand with the thickness of the frenulum and the restrictions.
In babies, we look for the following:
- Heart-shaped tongue
- Unusually thick frenum
- Breastfeeding difficulties
- Prolonged drooling
- Difficulty raising and moving the tongue
In older children or adults, we look for:
- Speech difficulties
- Problems with eating
- Inability to stick out the tongue
- Issues with kissing
Symptoms of Tongue-Tie
Common symptoms of tongue-tie include:
- Breastfeeding problems
- Improper jaw/facial growth
- Sleep disorders
- TMJ pain
- Slowed orthodontic treatment and orthodontic relapse
- Problems with oral hygiene
- Digestion issues
If your baby is having trouble breastfeeding, you should visit our office right away. Improper feeding puts both your baby and mom at risk. Your baby will not be able to thrive, while mom can have infections of the breast.
In older children, if their speech is difficult, they should also set up an appointment to see if tongue-tie is the cause. They might also complain of tongue problems such as difficulty eating, moving their tongue, licking ice cream, or kissing.
What are the risk factors for tongue-tie?
Although it is unclear what causes tongue-tie, recent research shows that this condition is linked to a mutation in the MTHFR gene due to “methylation.” This affects the body’s ability to process folate. Folate is vital in prenatal nutrition, and when not managed by the body properly, one of the effects of methylation is tongue-tie.
Methylation is a genetic cause, which means you might have tongue-tie as well. However, this is not the only cause, and there is not believed to be substantial evidence that tongue-tie is hereditary.
Being male is a risk factor, as it is more common in boys.
What are the treatments for tongue-tie?
Tongue-ties are commonly treated with a minor surgical procedure called a frenectomy. It is a simple procedure, especially when performed on babies.
At Milltown Dental, Dr. Julie uses laser surgery to separate the frenulum from the tongue quickly. The soft tissue laser does not cut the tissue, making it quicker and safer than traditional surgery. You can hold your baby during the procedure, so they feel safe and calm.
Your baby will not be aware of the surgery and, therefore, there is no need for needles. Laser frenectomies also improve the healing process, as the laser cauterizes the site. This means there is no need for sutures, and there is rarely any bleeding or infection.
Your baby will experience very minimal or no postoperative pain at all because the lasers will seal the nerve endings during the procedure. This also means there is no recovery time for your baby, and you can begin successful feeding following the procedure.
In more serious cases, a frenuloplasty might be recommended. The procedure allows for additional repair such as when the lingual frenulum is too thick. This procedure is performed under general anesthesia and will require sutures to seal the site.
What happens if tongue-tie is untreated?
It is always advisable to proceed with treatment. The laser surgery is simple, painless, and heals quickly. If tongue-tie is not treated, it can affect the growth of the face and jaw. It can also impact craniofacial development and overall health. Often, the negative effects will not be noticeable until adulthood.
People with tongue-tie will often have difficulty speaking, as it can make it hard to pronounce certain letters and sounds such as “t,” “d,” “z,” “s,” “th,” “r,” and “l.” This can lead to self-esteem issues for your child as they become more social. It can also lead to oral hygiene issues, putting them at risk for tooth decay and gum disease.
What are the benefits of a frenectomy?
As already mentioned, tongue-tie can lead to many issues, especially the health and well-being of your baby due to breastfeeding challenges. There are many reasons a frenectomy should be performed, including:
- Successful, pain-free breastfeeding.
- Stimulating milk production.
- Breastfeeding will be a pleasant experience and improve mother/baby bonding.
- Psychological relief for parents with better sleep.
- The baby will thrive and develop better, healthier sleep habits.
- No serious long-term issues with palatal development, tooth spacing, dental caries, and speech impairments.
- Avoiding speech issues.
- Allowing the development of a normal swallowing pattern.
- Allowing the tongue to self-cleanse the mouth, thus, lowering the risks of gum disease and decay.
- Allowing basic tongue functions, such as licking, kissing, and sticking the tongue out.
- Reducing the risks of choking and developing an atypically strong gag reflex.
Although tongue-tie can be frustrating for both you and your child, it is easy to diagnose and treat. It is always best to seek help as soon as you see signs of difficulty, especially when it is affecting breast-feeding. A quick exam will tell us if your child does have tongue-tie and we can set up an appointment for their frenectomy right away. We can also provide tips on how to prepare for the frenectomy.
If you have any questions or would like to book a consultation with Dr. Julie, please call Milltown Dental at 905-878-8528 or contact us here.