tongue tie

#DidYouKnow the tongue has 8 muscles which can exert 500gms of force? We have almost always neglected this tiny structure.The tongue is a mighty muscle which is essential for sucking, swallowing, eating, drinking, chewing, breathing, speech, jaw growth and improving digestion.


What is the tissue between the tongue and floor of the mouth?

That is called the lingual frenulum. The lingual frenulum is a small fold of mucous membrane that extends from the floor of the mouth to the midline of the underside of the tongue.


How can you assess on your own?

Stand in front of the mirror, open your mouth and stretch your tongue towards the palate. You may or may not see a band beneath your tongue? Now that's your lingual frenulum which is very tight for some people and is visible as a band

Can you touch your tongue to the palate with your mouth wide open without closing the mouth?

Do you feel the stretch or strain in the floor of the mouth or your neck because it's taut ?


This tight frenulum is given different names like ankyloglossia, tight tongue, tongue tie, tight frenulum etc.which restricts tongue movements essential for the above mentioned functions. A tightness in the fascial tissues is represented by a tongue tie.


What is Fascia?

Fascia is a connective tissue more like a spider web that provides our body a continuous 3-dimensional matrix of structural support surrounding our muscles, bones, nerves and even the internal organs


This may surprise you! “The anterior deep fascial line starts from beneath the tongue and goes till the lungs to the pelvic bones down to the arches of your feet.” This means there is a direct connection between the orofacial function-tongue function- diaphragmatic breathing - cervical posture.



What happens when your fascia's tight because you have a tongue tie?

Your body is a beautiful piece of architecture that is going to compensate if the fascia coat is too tight. It’s like you’re walking around in a Spiderman suit that's too tight. The tongue is going to pull forward with the floor of the mouth causing strain on the neck and shoulder muscles. But when you release this fascial tension, everything can open up!


Here are a few videos to watch to help understand fascia better.



What effects can a tongue tie have?

Restricted and incomplete tongue movement due to taut lingual frenulum can affect breastfeeding, speech, nasal breathing, development of the jaws, eating habits and sleeping patterns.


Infants with tongue ties may have significant trouble breastfeeding that is because they are unable to latch correctly and create suction. They have also been reported to have issues gaining weight and falling asleep during feeds due to the extra exertion. In addition, mothers with infants who are tongue tied can experience significant pain in their nipples, to the extent that they can become cracked and bleed.


The ideal position of the tongue is resting on the palate. In children, Tongue ties can restrict growth of the jaws due to the low lying tongue posture which also leads to a narrow upper jaw with a deep palate as the tongue is not able to function as the natural expander of the palate. This results in lack of space and crooked teeth.


The tongue houses in the upper part of your mouth called the palate. The roof of your mouth is the floor of the nose. Hence as the upper jaw narrows and deepens due to a low resting tongue posture; infants, children and adults start to mouth breathe instead of nasal breathing.


Since the tongue lies in a low resting posture, the back of the tongue falls into the airway. In order to protect the airway, a child or adult doesn’t transition into the deep stages of sleep resulting in a disrupted sleep pattern.


Tongue ties can lead your child to be a fussy and picky eater who takes long to complete his/her meals.You may also find your child pouching his/her food in the mouth leading to cavities in his/her teeth. This is because the tongue is not able to move freely in all directions causing it difficult for your child to swallow his/her food thus developing an incorrect swallow pattern. Not all tongue ties cause speech developmental issues but sometimes distorted and disrupted speech can be observed when the child attempts to say one continuous sentence.


What can be done?

It would be ideal to meet with a pediatric dentist, an ENT or a pediatric surgeon who has advanced training in tongue ties and frenectomy, frenotomy or a functional frenuloplasty procedure.


Please feel free to ask me any questions. Contact Us


Keywords : tongue tie, lingual frenulum, frenotomy, frenectomy, functional frenuloplasty, speech, picky eating, mouth breathing, crooked teeth


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