A tongue tie is an abnormal tightness of the lingual frenulum, the thin tissue that connects the bottom of the tongue to the floor of the mouth. A lip tie, also known as a labial frenulum, is the thin piece of tissue that connects the upper lip to the gums. These ties can prevent a baby from moving their tongue or lips freely, which can affect their ability to breastfeed or speak.
What is a tongue tie?
A tongue tie is a thin piece of tissue that tethers the tongue to the floor of the mouth. This restricts the movement of the tongue, which can lead to problems such as difficulty breastfeeding and speech impediments if left untreated. At your appointment, your dentist will remove the restrictive ties, so your tongue has full mobility.
How are tongue ties diagnosed?
The most common causes of tongue ties are a genetic issue, resulting in an overly-narrow or short frenum, and certain behaviors, such as latching on to breastfeed for too long. An overly-narrow or short frenum can make it difficult for babies to nurse properly. A lip tie is simply the upper lip’s frenum being too short, usually due to genetics. The condition often causes spaces between the teeth when a child is young but typically goes away naturally, as the orthodontists explain in this article about baby teeth falling out.
However, there are conditions where surgery is necessary to fix a tongue tie. This is particularly true if the child has trouble eating solid foods, speaking clearly, breathing easily, sleeping well at night, drooling excessively, and/or having jaw pain. Birth defects can also lead to the need for these procedures. For example, a baby may have missing or extra teeth which need to be corrected through orthodontic procedures. In these situations, an orthodontic surgeon can work in conjunction with the dentist to provide proper care for the child.
Dentists will often diagnose stretches of the frenum by gently pulling on the tissue to see if it loosens. If it is overly tight, they can confirm it with an ultrasound scan. For infants, a pediatrician may perform the same procedure to confirm the presence of a tongue or lip tie. If the dentist thinks that the condition is causing issues for the patient, they may recommend removing part or all of the tissue that is causing the restriction.
What are lip ties?
The skin of the upper lip, or vermilion border, is bound together by fibrous tissue that can form a string-like attachment called a frenulum. This tissue connects the lip to the gum just behind the upper front teeth. A “tongue-tied” person has an unusually short frenulum that doesn’t separate the lips from the gums as it should. This can be a minor problem that causes some speech impediments, but in severe cases can lead to problems with eating and swallowing.
In fact, an abnormally long frenulum can also be a problem. When this occurs, it can block the flow of saliva between the mouth and the sinus cavity—leading to chronic sinusitis. This condition is called maxillary sinus hypoplasia. Treatment involves surgically cutting the frenulum to release the blockage.
Oftentimes, dentists can diagnose this condition in the waiting area during routine examinations. If your dentist notices the frenum is a bit too short or too long, he or she can refer you to an oral surgeon for surgical correction.
Whether a short or a long frenulum occurs, treatment is typically safe and effective. Please contact a local oral surgeon to schedule an appointment if you are concerned your child has a tongue tie.
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