10 reasons to celebrate sticking your tongue out!

Why you should consider having your child’s (or your own) ankyloglossia (tongue-tie) released

Ankyloglossia, or tongue-tie as it is commonly called, is a congenital anomaly in which the membrane (frenulum) and/or muscle connecting the undersurface of the tongue to the floor of mouth is unusually short or thick. While we have many frenula in our bodies, in this article we will be discussing those in the mouth, namely the lingual and upper labial frenulum, and in particular, addressing the benefits of direct breast sucking versus use of a bottle for feeding.

This persisting tissue during development should have gone away as the tongue became separate from the throat/GI tract. When the frenulum is shortened, this decreases the mobility of the free tongue, giving the tip of the tongue a notch or whale-tail appearance.

Abnormalities with ankyloglossia generally become apparent at birth with infants having difficulty with breastfeeding because of the decreased ability to elevate and properly curl the tongue around the breast nipple for sucking. What is not often known or discussed are all the other impacts caused by a shortened frenulum.

Here are 10 reasons for correcting this condition:

1. Easier breastfeeding

Having your child’s ankyloglossia released leads to an easier time breastfeeding. The lingual frenulum, by being attached to the floor of mouth, is not able to elevate and curl around the nipple to more effectively pump milk out of the breasts.

Because of the inefficient sucking, infants with ankyloglossia are more likely to swallow air with their increased work of sucking and therefore are more likely to be “gassy,” which can lead being a bit more irritable, spitting up more, and sleeping poorly. Ideally, as soon as possible after the ankyloglossia is identified the intervention should be made.

Within the first two-to-four weeks of birth, the corrective procedure, called a lingual frenulectomy, can be done in the office using no anesthesia or just a topical anesthetic. Overall pain is similar to that of an ear-piercing or receiving vaccinations.

The procedure takes just a few minutes with immediate improvement in the infant’s ability to breast-feed. It is generally covered by medical insurance with minimal if any out-of-pocket cost.

2. Increased bonding

Releasing a tongue-tie in the infant allows for better and longer breastfeeding time, which increases baby-to-mom bonding.

3. Improved appearance

When an infant is able to breast-feed, their tongue in being able to fully elevate and make contact with the maxilla (upper jaw) and mandible (lower jaw). This helps improve the development of the maxilla and mandible by the repetitive contact with the tongue, causing their expansion and proper development.

Kids with ankyloglossia are more likely to have a narrow maxilla and mandible with dental overcrowding. This narrowness overall can lead to a less pleasing facial appearance.  

4. Improved speech

Having a free-moving tongue is important for pronunciation of letters such as L and R. Often if a child is tongue-tied they will need speech therapy as well as intervention for faster and more complete achievement of the pronunciation.

5.  Less need for braces

Having the tongue able to properly elevate and expand the maxilla and mandible leads to less dental overcrowding. This decreases the need for braces, and in particular a repeat set of braces because of future teeth shifting.

6. Better-spaced teeth

A very persistent upper or labial frenulum can increase space between the central incisors; a very persistent lower or lingual frenulum can increase space between the lower or mandibular central incisors. Often braces are then needed to guide the teeth back together after frenulectomy in an older child or adult. By addressing the frenulum earlier on in childhood, the need for corrective orthodontia decreases.

7.  Better sleep

Clinical studies indicate that having a short lingual frenulum may increase the risk for sleep apnea. Because the frenulum is shortened, the tongue sits relatively further back in the throat, causing more airway obstruction and mouth breathing.

8.  Easier ice cream consumption

The ability of someone with ankyloglossia to lick an ice cream cone is significantly diminished. They miss the pleasure of licking an ice cream cone without getting it in their nose. Eating ice cream with a spoon becomes much more practical.

9.  Easier breathing

Having the frenulum released leads to easier and more efficient nasal breathing. When the tongue is allowed to rotate anteriorly as well as to move freely as high up as possible, the posterior airway space becomes much more open, allowing for easier nasal airflow from the nose into the trachea.

Nasal breathing is crucial because the little hairs or cilia in the nose moisturize the air and comb out little particles, decreasing their ability to get to the lungs. Fewer particles in the lungs mean fewer episodes of bronchitis or lung infections.

10.  Improved nonverbal communication  

After all, whatever would you do if you could not stick out your tongue at someone!

Dr. Inell Rosario was born and raised on Andros, an island in the Bahamas. She graduated from Macalester College in 1987 with a Bachelor of Arts and went on to attend medical school at the University of Minnesota. She is board-certified in otolaryngology, head and neck surgery, and sleep medicine. She is the president of Andros ENT & Sleep Center, Andros Medspa and Andros Audiology. When she isn’t working at the clinic, Dr. Rosario likes to exercise, play basketball, and do mission work. She is married and has two children.