Should I be worried about my son having a tongue tie?

Dear Dr Ombeva,

I was told by a nurse that my son was born with a tongue tie. Is it something I should worry about? Does it have a cure/treatment?

Answer:

Toungue tie is an anomaly in the mouth which a baby is born with. It is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth. It may be mild consisting mucous membrane bands or take a complete form whereby the tongue is tethered to the floor of the mouth. A person who has tongue-tie might have difficulty sticking out his or her tongue.

Tongue-tie can also affect the way a child eats, speaks and swallows, as well as interfere with breast-feeding. The symptoms include difficulty lifting the tongue to the upper teeth or moving the tongue from side to side, trouble sticking out the tongue past the lower front teeth, and a tongue that appears notched or heart shaped when stuck out.

Some cases of tongue-tie have been associated with certain genetic factors, and is more common in boys than girls. Tongue-tie sometimes runs in families. It can lead to breast-feeding problems since breast-feeding requires a baby to keep his or her tongue over the lower gum while sucking. Poor breast-feeding can lead to inadequate nutrition and failure to thrive. Speech difficulties may occur since the tongue-tie can interfere with the ability to make certain sounds.

Poor oral hygiene and formation of a gap or space between the two bottom front teeth may occur. Tongue-tie can be treated with a simple surgical procedure called a frenotomy, done with or without anesthesia in the hospital nursery or doctor’s office. For older children or adults experiencing difficulties with tongue-tie, frenuloplasty, done under general anesthesia with surgical tools is preferred.

After the frenulum is released, the wound is usually closed with sutures that absorb on their own as the tongue heals.  Complications of frenuloplasty or frenotomy are very rare, and may include minimal bleeding, infection, or damage to the tongue or salivary glands and scarring. After frenuloplasty, tongue exercises might be recommended to enhance tongue movement and reduce the potential for scarring.

Dr Ombeva Malande is a paediatrics and child health expert