How Tongue-Tie (Ankyloglossia) Affects Breathing, Speech & Oral Development

The medical name of tongue-tie is ankyloglossia. This condition can occur in people of all age groups. In this condition, the tongue movement is affected because of the thick, short, or tight lingual frenulum. The lingual frenulum is a tissue that makes a connection between the tongue and the floor of the mouth. This condition can lead to various other issues, like speech development, feeding, breathing, growth, and oral health.

The research conducted in recent years revealed that tongue-tie is caused by the following:

• Mouth breathing

• Speech delays

• Sleep issues

• Orthodontic problems

• Posture-related issues

Early recognition of tongue-tie and proper management can lead to long-term health outcomes.

In this blog, we will discuss the effects of tongue-tie symptoms and treatment options.

What Is Tongue-Tie (Ankyloglossia)?

Tongue-tie occurs when a tissue called the lingual frenulum does not let the tongue move properly. This condition may not always occur at the time of birth. The condition can be mild or severe and can occur in individuals of any age group.

Types of Tongue-Tie

Tongue-tie is of different types and is mentioned below:

• Anterior Tongue-Tie – Visible, tight frenulum near the tip of the tongue

• Posterior Tongue-Tie – Hidden under mucosal tissue, harder to diagnose

• Complete Tongue-Tie – Severe restriction affecting all tongue movement

• Partial Tongue-Tie – Limited but noticeable restriction

How Tongue-Tie Affects Breathing?

Tongue-tie affects breathing in different ways, which are discussed below:

• Impaired Nasal Breathing: The tongue maintains an open airway, and it is a crucial task. The following issues occur when the tongue is not able to rest properly against the roof of the mouth:

  • The airway may become narrow

  • Mouth breathing becomes habitual

  • Oxygen intake can be compromised

  • Mouth breathing is linked to:

  • Dry mouth

  • Snoring

  • Sleep-disordered breathing

  • Increased risk of infections

• Sleep-Disordered Breathing & Sleep Apnea: The tongue may fall backward during sleep, and this can lead to partially blocking the airway. If the airway is blocked, the following conditions occur:

  • Snoring

  • Restless sleep

  • Sleep apnea (in children and adults)

  • Daytime fatigue

  • Behavioral issues in children

• Poor Oral Posture: The airway and facial growth occur properly due to the proper tongue posture. The tongue-tie prevents the following:

  • Tongue resting on the palate

  • Proper jaw expansion

  • Optimal airway size

The issue can lead to narrow dental arches and also cause problems in breathing.

How Tongue-Tie Affects Speech Development?

Tongue-tie affects speech development in different ways, which are discussed below:

• Difficulty in Tongue Movement: The tongue has to be moved for speech. The tongue-tie can cause problems in speaking the letters listed below:
  

• L

• R

• T

• D

• S

• Th

• Speech Delays in Children: Tongue-tie may lead to speech delays in children. They will face the following problems:

• Children will struggle with pronouncing certain letters

• They will lose confidence due to unclear speech
  

• Muffled Speech: Adults may face the problem of unclear pronunciation. They may also get tired during longer communication.

How Tongue-Tie Affects Facial and Oral Development?

Tongue-tie affects oral and facial development. The problems that people face are discussed below:

• Problem in Jaw Growth: The tongue helps in the development of jaw growth. The restriction in the tongue movement causes the following problems.
  

• It can make the upper jaw narrow

• It can lead to teeth crowding

• Open bite, overbite, and other bite problems may occur

• Dental Problems: Tongue-tie may cause different dental issues mentioned below:

• Teeth can get misaligned

• Tongue-tie causes gum recession and makes the teeth sensitive to hot, cold, and sweet

• Tongue-tie can build up plaque

• Tongue-tie can also lead to an increase in the number of cavities

• Difficulty in Feeding and Swallowing: Infants face the problem of poor weight gain and difficulty in latching. Children and adults may face problems in chewing food, swallowing dysfunction, and discomfort in food digestion.

• Changes in Facial Development: Tongue-tie may also cause problems in facial development. These problems are discussed below:

• The face becomes long and narrow

• The chin is recessed

• Cheekbone development is improper and poor

• Facial symmetry is altered

Symptoms of Tongue-Tie

Tongue-tie has many symptoms, which are discussed below:

• Symptoms in Infants: Infants often face problems with breastfeeding, and a clicking sound can also be heard during feeding. The weight gain in infants is also slow. Other symptoms of tongue-tie in infants include reflux or gassiness.

• Symptoms in Children: The tongue-tie symptoms in children include delays in speech, snoring, mouth breathing, and orthodontic issues.

• Symptoms in Adults: Tongue-tie can also occur in adults, and the symptoms include jaw tension, speech fatigue, tension in the neck and shoulders, problems in sleeping, and more.

How is Tongue-Tie Diagnosed?

Tongue-tie diagnosis includes the following:

• Speech evaluation

• Tongue mobility assessment

• Feeding assessment

• Physical examination

The specialists who diagnose tongue-tie issues include

• Pediatricians

• Dentists

• ENT Specialists

• Lactation Consultants

• Speech-Language Pathologists

Tongue-Tie Treatment

There are various ways of treating tongue-tie, and some of them are discussed here in detail:

• Frenotomy or Frenectomy: The tight frenulum is released through a minor surgical process. It is a quick procedure performed with scissors or a laser. It is a quick process, and patients feel very little discomfort.

• Myofunctional Therapy: Myofunctional therapy includes exercises to train the posture of the tongue and oral muscles. The therapy is performed before and after release. Myofunctional therapy aims to correct the swallowing patterns and improve breathing.

• Speech Therapy: Speech therapy is performed to improve articulation and communication skills.

Conclusion

Tongue-tie is a condition in which patients experience difficulty in moving their tongue properly due to a tight lingual frenulum. Tongue-tie can lead to various problems in infants, children, and adults. Infants may face the problem of breastfeeding. Children face the problem of speech delays, snoring, mouth breathing, and more. Adults face sleeping problems, neck and shoulder tension, chronic mouth breathing, and more. Tongue-tie can be treated through a minor procedure, and patients have to go through myofunctional and speech therapies to improve breathing, swallowing patterns, and communication skills.

Frequently Asked Questions

1. What is the difference between tongue-tie and lip-tie?

Tongue-tie is a problem where the tongue has a limited range of motion. Lip-tie is a problem where the lips may have limited range of motion.

2. How can I know that my baby is suffering from tongue-tie?

If your baby struggles with latching, or is colicky during or after nursing that may be a sign of a tongue tie. Any abnormalities with nursing should be evaluated by a lactation specialist.

3. What are anterior and posterior tongue-tie issues?

Anterior tongue-tie is a condition in which the restrictive frenulum can be easily seen in front of the tongue. Posterior tongue-tie is a condition in which it is difficult to see the restrictive frenulum, as it is at the back of the tongue.

4. What are the causes of tongue-tie?

Doctors are not aware of the exact reasons for tongue-ties. They can be passed down genetically. The frenulum may form in different ways in the womb, and if not released, will be present in adults.

5. How soon do patients recover?

The initial discomfort resolves within 3-7 days, but the full healing time can take up to 6 weeks.