6 Common Misconceptions about Tongue Tie

Clear up confusion on oral restrictions

Over the past few years, the tiny tether of tissue under your tongue has stirred up a surprising degree of discussion. The diagnosis and treatment of oral restrictions such as tongue tie (ankyloglossia) have ardent supporters and vocal critics on either end of the spectrum. There are also many people who are simply unaware of the condition and its impact on overall health.

If you are researching this issue because you or your child might have an oral restriction, you’ve probably run across different opinions about tongue tie and what to do about it.

Feeling confused about the contradicting opinions on tongue tie?

We totally understand. Here’s why people are confused: There is a lack of education, knowledge and research in the area of tongue tie in general.

Medical doctors and dentists have varying degrees of education on oral restrictions like tongue, lip and buccal ties. Most have little to no exposure to them while receiving their education in medical or dental school. This leaves most primary care physicians without basic training to be able to identify the symptoms of oral restrictions, much less diagnose and treat them.

Overall, oral restrictions make up a very small part of the course of study. This lack of education creates fertile ground in the medical field for misconceptions to take root. Today, it really takes a professional that is open-minded and dedicated to seek out their own education to fully understand this concept.

We are excited for what health:latch can do to help fill this void of awareness and education. We have always known that general health is directly related to a patient’s oral health.

health:latch is a leading advocate for education about the importance of treating oral restrictions as early as possible to prevent the serious issues they can cause for overall health over time. “Structural problems lead to functional problems, which lead to behavioral problems.” says health:latch founder Dr. Thomas. “If you solve oral health problems, we know that you can prevent many future gastrointestinal health, mental health, and sleep issues.”

Below are 6 of the most common misconceptions about oral restrictions.


#1 - It is a "magic" or "quick fix" solution for everything

The biggest misconception about tongue tie is that it's a "magic pill."

The human body is complex and made up of many interrelated parts and systems. Over time, an untreated oral restriction can impact the muscles and bony structures of the face and impair important functions such as breathing, talking, chewing, and swallowing. Once the damage has been done, it can take time and therapy to reverse the problems and instill healthier patterns.


Where did the “magic solution” misconception come from?

The idea that an oral restriction release (usually either a frenectomy or a frenotomy) will solve all your problems developed in part by personal anecdotes and testimonials shared on social media.

For example, many nursing mothers report feeling immediate relief after their baby undergoes a release procedure. They describe a palpable difference in the baby’s ability to latch, which makes the breastfeeding experience smoother and more successful for both the baby and mother. These stories of a transformational experience are great! Yet, the leaders in this field will repeatedly state this is it the Functionalists (the myofunctional therapists, lactation consultants, the craniosacral therapists, physical therapists, and others) that maximize the benefits of the oral tether releases.

People often share dramatic “before and after” experiences in which children and adults describe the release of tension that sometimes extends throughout the body immediately after a release procedure. Again, it takes a circle of healthcare providers to experience the full benefits of an oral tether release procedure.

Especially in older patients who have more functional and structural effects due to their untreated oral restriction, supporting therapies with healthcare professionals from various fields are necessary to resolve the many issues that are indirectly related to untreated oral restrictions. Generally, the longer an oral restriction has gone untreated, the more therapy and time is needed to resolve it.

Despite these remarkable examples, more research and clinical documentation is needed for a thorough evidence-based approach. In most cases, a “quick fix” for any given health problem is unlikely to result in long-term health.



#2 - Just a “fad”

Critics have called the rising diagnosis and treatment for oral restrictions a “fad.” Although tongue tie diagnosis and treatment has been documented since the 1600s, it is true that there is growing interest in this issue. The recent resurgence in tongue tie appears to be related to the resurgence of breastfeeding over the past few decades.

Oral restrictions hamper breastfeeding and lead to issues such as low weight gain, failure to thrive diagnosis, and painful conditions such as mastitis and infections for nursing women. As mothers favor nursing to feed their babies instead of formula, they seek support for these issues from their healthcare providers. This is why doulas, nurses, midwives, and lactation consultants are often the first healthcare providers to make a referral for a baby who might have tongue tie.

Many experienced dentists, especially pediatric dentists, orthodontists and oral surgeons that work with growing children, began to notice negative facial growth patterns as a result of a restricted tongue. This has opened passionate discussions by many healthcare providers around the world regarding similar findings within various differential genetic groups.

Many of the experts, unable to turn a blind eye to this issue, began to speak out about the issue of tongue ties. As parents and adults continue to seek answers for “unknown” symptoms, and as long as mothers continue to favor breastfeeding, the demand for proper research, examination, diagnosis and treatment for oral restrictions will likely continue to grow.



#3 - No symptoms, no problem, right? Not really!

What if there aren’t any symptoms? While one tongue tied baby might have all of the classic symptoms, another might not present any symptoms at all. Why is this? The baby showing no symptoms might be compensating for their restriction. This compensation can lead to a “domino effect” of related problems throughout their lifetime.


My baby is growing bigger, can I rule out tongue tie?

Even if your baby is getting bigger and fatter, they could still have tongue tie.

One thing we do know is that babies want to feed! If they are not, they sure will try to tell us. However, many babies with oral restrictions get tired quickly. After a short period of time babies who are tongue-tied go from active feeders to passive feeders. Essentially, they get tired of compensating for their restriction and they give up on feeding.

As mentioned earlier, most babies will tell us something is wrong. Be attentive to signs that your baby’s neck hurts, gas and bloating, or whether they are “always hungry” and not fully satisfied. If your baby stops feeding and their weight drops, this is an important clue that demands further investigation.

The hardest concept that we will have to teach healthcare professionals is that a baby can continue to grow despite having an oral restriction if its mother has an abundant milk supply or if the baby is able to feed passively from a bottle.



#4 - You'll "grow out of it"

Babies and children with short or thick tongue tethers are often not diagnosed or treated for their condition because of the false idea that the tether will naturally stretch so they will “grow out of it.” The legitimate concerns of parents of children with an oral restriction are often brushed aside because “it isn’t causing a problem.”

Rather than minimizing the importance of an oral restriction, it's important to pay special attention and find out if there is more going on than meets the eye. For example, a baby with an asymptomatic restriction may use otherwise “passive” muscles to form an irregular suck and swallow habit. If this dysfunctional pattern is repeated on a daily basis, it can lead to dental and other medical issues in the future.



#5 - It's not a big deal

It's easy to see how such a tiny membrane in the mouth could be written off as inconsequential in the scheme of the entire body. Yet as parents and patients explore whole-body healthcare models, it becomes evidently clear that even small components can affect the entire body over time.

If left untreated, oral restrictions affect long-term airway development for children and adults. Clinical observations compiled by specialists in this field show patterns that point to the serious effects of untreated oral restrictions.

A growing number of healthcare professionals are helping to highlight the link between oral restrictions and health outcomes throughout life. If left untreated, oral restrictions can be indirectly related to a cascade of developmental issues in the mouth and even in the rest of the body. Tongue restrictions may even play a role in serious, chronic conditions such as sleep apnea, asthma and heart problems.

The best results accompany an accurate and timely diagnosis, tongue tie surgery and follow-up with support.


Can the way we move our muscles shape our bones?

The short answer is yes! Experts are learning more about how our bony structures (form) are guided by our muscles (function). By placing pressure on the bone, a restriction such as a lip, tongue or buccal tie can indeed impact bone development over time. This has huge implications for health and wellbeing.

Repetitive movements that a baby or child must resort to in order to compensate for an oral restriction can lead to serious problems. The sooner oral restrictions are diagnosed and treated, the more functional problems can be prevented. Tongue tie is a prime example of how structural changes can lead to serious chronic conditions that degrade quality of life.

Over time, an oral dysfunction (such as mouth breathing) can lead to functional and structural changes as the body tries to compensate for the restriction.

How often do you think about everything involved to allow you to breathe when you go to sleep at night and stay alive until you wake the next morning? Proper breathing during sleep requires your body to unconsciously coordinate the muscles of the head, neck and tongue.

Sleep apnea is a condition that impairs a person’s ability to breathe correctly while asleep. A baby that was unable to suck and swallow correctly due to an untreated oral restriction can grow into an adult with sleep apnea, who relies on a CPAP machine to breathe through the night.



#6 - No one knows what causes tongue tie

Although much more research is needed to better understand the cause of oral restrictions, there is growing evidence that points to a genetic link, specifically one known as the MTHFR (methylenetetrahydrofolate reductase) mutation during the development of a fetus in the womb.

In most babies, the membrane that anchors the tongue to the bottom of the mouth naturally dissolves to a small string by the 12th week of prenatal development. In some babies there is an abnormal tissue that remains beyond birth and restricts the tongue’s normal mobility.

What we do know is that tongue tie:
  • is a condition present at birth
  • appears to be hereditary
  • is common in babies who are born prematurely
  • is common in babies who are born with other mid-line traits like “stork bite” birthmarks


Finding help & treatment for oral restrictions

The team at health:latch can help you or your child before, during and after a tongue tie release procedure.

Treating an oral restriction like tongue tie requires more than just a simple "snip or clip." Oral restrictions can cause short- and long-term health issues that are different for each age, which requires a custom treatment plan built just for you.

To set yourself up for success, you want a team that communicates with each other across disciplines for a holistic health approach. A custom, multi-disciplinary approach to address accompanying issues like oral dysfunction, speech & language issues, and airway health & sleep will help your family have the best possible outcome.

Learn more about the health:latch clinic and how we can help with your family's specific needs here.

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