What are Tongue-Ties & Lip-Ties?
A physical condition that restricts the use and function of the tongue is called a tongue-tie. This restriction often causes a range of issues including difficulties with breastfeeding, speaking, swallowing, healthy breathing, and overall facial growth and development. On the other hand, a lip tie is a condition where the upper lip is restricted and cannot move normally. It can also cause difficulty with nursing, make it harder to brush the top teeth, and can lead to speaking and swallowing challenges in some children.
The tongue and lip are made up of a very complex group of muscles and tissues and are important for all oral functions. While some children may adapt and compensate for restricted tissues, other children may not. This can create major quality-of-life issues for your child, even if the appearance of the restriction seems to be minor.
Symptoms
If you or your infant have more than a few of these symptoms, even with good weight gain, your child should be properly
evaluated for a tongue-tie or lip-tie.
Mother's Symptoms
Painful Nursing
Creased or flattened nipples
Blistered or cut nipples
Incomplete breast drainage
Plugged ducts or mastitis
Inability to nurse without using a nipple shield
Decreased milk supply
Baby's Symptoms
Poor latch
Poor weight gain
Reflux or frequent spitting up
Frequent gassiness and fussiness
Clicking or smacking noises when eating
Dribbling milk out of mouth
Frustration when eating
Inability to hold a pacifier
Prolonged nursing or bottle-feeding sessions
Symptoms
There are many children who have difficulties related to tongue-ties and lip-ties, but unfortunately, these conditions are often not identified until later in life. They can cause speech and feeding difficulties, sleep issues, and a wide-range of other concerns.
If your child is unable to touch the roof of the mouth with his or her tongue when opening widely, is struggling with speech delay, or speech issues that aren’t resolving, has difficulty eating or getting a good night’s sleep, please explore the sections below.
Speech
A tongue restriction affects speech differently in each child. We work with a team of local experts to make sure your child’s speech difficulties can be related to the presence of a tongue or lip tie. Some children with a “to-the-tip” tie can produce speech sounds clearly (but may struggle with increased effort when speaking). Other children, with a less visible or more posterior tie, may have a global speech delay or difficulty producing the sounds such as L, R, T, D, N, TH, SH, and Z.
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Feeding
Children that are tongue-tied often have eating issues when transitioning to solid foods. They may choke, gag, or have difficulty swallowing certain textures. These children can get labeled as “picky-eaters” when in reality they simply refuse a pattern of foods that are difficult for them to easily swallow.
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Sleep
The tongue is meant to rest passively in the palate (top of the mouth) with the lips closed during sleep. This promotes healthy nasal breathing and greatly reduces the risk of abnormal facial growth patterns and a number of other issues later in life. When the tongue is held down in the floor of the mouth from a tongue-tie, a child compensates his or her breathing pattern toward open mouth or noisy breathing, which can disrupt healthy sleep. A tongue-tied child will often grind his or her teeth at night, snore, or experience other sleep-disordered breathing problems. Sleep-disordered breathing can cause frequent waking, restlessness, bed-wetting, failure to feel refreshed upon waking and accompanying difficulty focusing (which is sometimes misdiagnosed as ADD or ADHD).
Because multiple factors contribute to the problem, such as large tonsils and adenoids, a narrow palate, and tongue-tie, often a child will be seen by multiple specialists to try to remedy the problem. In addition, children with tongue ties often have a history of multiple ear infections and needing ear tubes. They may have had tonsils and adenoids removed. All of these can be complicated by the mouth-breathing that frequently occurs in tongue-tied individuals, due to the low resting posture of the tongue. We have found that when there is a tongue-tie, sleep can improve dramatically after a simple in-office procedure.
Results can take a little time.
It’s important to understand that, when your child has a tongue- or lip-tie released, improvement isn’t always instantaneous. It’s typically just the first step in treatment.
