The Truths About Tongue-Ties
You Don’t Know What You Do Not Know…
How can you diagnose what you do not know how to examine?…
How can you diagnose when you do not understand how the tongue physically moves and functions with feeding, swallowing, sleep, speech?…
How do you comment/diagnose with minimal to zero education on tongue mechanics, feeding mechanics, oral anatomy?…
1. Tongue-tie / short lingual frenum / restrictive tethered oral tissue is an embryological tissue leftover present at about 8 weeks of gestation. It can manifest as tissue that extends to the tip of the tongue, or as a short band of tissue or somewhere in between. Assessment is nuanced; an experienced tongue-tie provider will assess not only what the tongue-tie looks like, but the function of the tongue.
When it comes to a tongue-tie, looks are not everything. If you are told that it’s only a small tongue-tie, your child will outgrow it, or it does not look too bad, that is an assumption of an inexperienced and uneducated professional.
2. The genetic component of tongue-tie is in the gene(s) that regulate methylation and allows for programmed cell death. This is a natural embryologic process for deleting unneeded cells. In other words, it is not an inherited feature like hair color or eye color.
3. You do not outgrow tongue-ties (this is stated in the literature.) You “adapt” with compensations and dysfunctions and the individual will pay a price.
You cannot ignore a restriction; it will affect the human at some point, whether it be transitioning to and swallowing solid foods, sleeping through the night, snoring, speech, cavities, developing the face, and more. It is a matter of time. Why wait??
4. It is estimated that up to 50% of the population has some anatomical restriction of the tongue, limiting movement, and optimal function. The incidence is grossly underestimated in older literature cited by medical professionals who denounce the presence of tongue-tie.
If the diagnosis is strictly on visual inspection, >50% of restrictions will be missed. But, if you listen to the story and history of the patient, assess function/dysfunction, the surrounding structures affected by a dysfunctional tongue (high palate, crowded teeth…there is a different picture to understand.
5. There is more clinical efficacy in treating a tongue-tie than to circumcising a male baby. Surgical discomfort is minimal in comparison to other early childhood surgeries. More importantly, the long-term health benefits will be substantial and long-reaching for a baby, child, or adult.
6. There are many detrimental effects of not treating a tongue-tie. There can be potential difficulties with breastfeeding, latch problems, oral issues, improper swallowing, higher risk of choking, difficulties with speech, underdeveloped jaws as well as other dental challenges. It also increases the risk of developing breathing-disordered sleep, the potential for headaches/neck pain/poor posture, and more.
7. Tongue-tie assessment and treatment requires proper education, proper positioning, proper training, and surgical skill. To properly assess an infant, the provider has to physically examine the baby over the top of the head and lift the tongue with their index fingers. They also need to have optimal lighting (a headlamp) when performing the examination. They should know the difference between an anterior and posterior tie.
Additionally, they should know that there is a mucosal component and an underlying connective tissue component. The surgeon has to treat both.
8. Not all medical providers are surgeons. The mouth, especially the underside of the tongue, has a lot of structures that can be damaged by an inexperienced surgeon. Dentists are surgeons of the mouth!
9. Wound healing, no matter the size of the human, wound healing takes 30 days. Aftercare is REQUIRED for 30 days post-surgery, as you cannot rush this basic biological process.
A professional who does not understand the concept of wound healing, is not properly trained in this procedure.
