Tongue Ties

Tongue Ties

For a long time, people just didn’t seem to know much about tongue ties.  In the early years of my practice, few of my patients had ever heard of it!  When I pointed out that they or their children might be tongue tied, I was often the very first practitioner who’d mentioned it to them.  

When I told them that a tongue tie might actually be the root cause of the oral myofunctional issues, or even their sleep apnea, I’m sure that some of them thought I was crazy!

But in the last few years, tongue ties have gained centre stage as more families put an emphasis on the importance of breastfeeding.

Diagnoses have been skyrocketing.  Dentists and orthodontists also began reaching out more frequently to discuss the application of myofunctional therapy exercises to tongue tie treatment.  Today, that little bit of interest has become a surge of awareness.

Tongue ties and their impact on health and craniofacial development are finally becoming mainstream.  This is great news because it means that fewer people will suffer from undiagnosed and untreated symptoms of a tongue tie.

Catching and treating a tongue tie early is vitally important, so I’ll cover everything parents need to know about tongue ties.

What is a tongue tie?

Tongue tie is the improper development of the tissue that anchors the tongue to the floor of the mouth which results in limited tongue movement.  The frenulum, which is what attaches the tongue to the floor of the mouth, is too short, too thin or too tight to allow for proper tongue use.

Being tongue tied isn’t just a figure of speech – it’s a very real medical condition.  Tongue tie affects oral and facial development and has a range of other serious health consequences that may not appear for decades.

We all have a lingual frenulum (or frenum) under our tongue.  If you lift your tongue and look in a mirror, you’ll see it.  The frenum is the tissue that connects the tongue to the floor of the mouth.

Normal lingual frenulum function means that the tongue, with the mouth closed, rests on the top of the mouth (palate) and touches the tissue just behind the front teeth.  In some people, the frenum is tighter or thicker than it should be which can physically restrict the movement of the tongue.  The important thing to remember is that not just the FRONT of the tongue touches the palate but the WHOLE tongue needs to rest on it.

Diagnosing a Tongue Tie

There are a few ways to classify or identify tongue ties and recently, a template to guide us in identifying consistencies in appearance, function and compensations has been very helpful.  Not all tongue ties can be seen with the naked eye and some “normal” looking tongues suffer from limited range of motion and must be treated.  That’s why it’s important, ultimately, to have the tongue assessed by a knowledgeable professional. 

One of the most missed ties is the submucosal or posterior tongue tie. These are frequently missed by untrained eyes and subsequently not treated. There have been studies done that link this type of tongue tie to sleep apnea and mouth breathing. With this type of restriction, even with appropriate exercises, it is physically impossible to get the back 1/3 of the tongue to rest on the soft palate. Check yourself. Where is YOUR tongue right now??

There have been many recent developments in the diagnosis and treatment of tongue ties that it is so important to find someone who is up to date on all the latest research and findings.  As a member of the International Consortium of Ankyloglossia and Tethered Oral Tissues Professionals (ICAP), I am current and constantly educating myself on the latest news in the TOT field.

One of the leaders in TOT (tethered oral tissues) is Dr. Larry Kotlow.  He is a pediatric dentist in Albany NY and I have had the priviledge to visit his office and see him in action.  He truly cares about babies who cannot eat and moms who are frustrated with their lack of progress in their breastfeeding journey.  If you want to learn from the best, visit his website at

Another leader in TOT but specifically posterior tongue ties is Dr. Saroosh Zaghi.  He has a practice in Los Angeles and has people visit him from all over the world to have him perform his amazing surgical procedures.  He revises ties in people who suffer from sleep apnea with much success.  Check out his website at

One of the most common signs of a tongue tie is open mouth posture and mouth breathing.  We should breathe through our mouth as often as we eat through our nose!!  Nose breathing is vitally important for good and healthy development of the mouth, face and jaws.

If you think that you or your child may have a tongue tie, contact me and book a visit to have it checked out.  Remember, the younger the better because my goal is to help your children grow into healthy, beautiful adults.