Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Ankyloglossia (Tongue Tie)


What is tongue tie?
The lower lingual frenulum is a strip of tissue that connects the tongue to the floor of mouth. Everyone has one, but in some people it is too tight, which is known as ankyloglossia, or tongue tie. This causes difficulty with elevating the tongue (to touch the roof of the mouth) or protruding it (sticking it out).

Does everyone with tongue tie require treatment?
Sometimes the child has no problems related to the tongue tie, and in that case it is best not to do anything. There are two major reasons to treat ankyloglossia. The first tends to be seen in young babies, where they have difficulty latching on during breastfeeding. This causes pain in mom, and unusually long feeding periods. Sometimes these babies can have problems with a spoon with the introduction of more solid foods. The other situation occurs when children have difficulty with their speech, usually in saying certain sounds like "t", "d", "z" or "s".  More rarely, other problems of a more social nature, such as the inability to stick out their tongues like their friends, or having food get caught under the tongue, can be bothersome enough that treatment is warranted.

How is tongue tie treated?
The procedure, called a "frenuloplasty", or "frenotomy" is usually performed in the clinic on the younger babies. Older babies and children typically are briefly placed under sedation in the operating room to do the procedure. It only takes a few minutes and consists of clamping the tight frenulum followed by cutting it with scissors or a cautery pen. Sometimes sutures are also placed at the time of the frenuloplasty.

The child is allowed to eat immediately afterward. Pain is similar to a canker sore in the mouth. Tylenol or Motrin can be used for pain, or applying some teething gel to the area of the surgery. Please note that it is normal to have a whitish-yellowish coating on the area of the frenulum for a week afterwards.

Last Edited: September 4, 2014
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