oral restrictions

What is an oral restriction?

Tongue tie, lip tie, and buccal tie are oral restrictions present at birth that restrict the normal movement and function of the tongue and mouth.

Research shows that up to 10 percent of babies are born with an oral restriction and up to 25 percent of nursing infants can be affected by shallow latch caused by this condition.

The 3 types of oral restrictions are tongue tie (under the tongue), lip tie (under the upper lip) & buccal tie (inside the cheeks).

• A tongue tie is when the band of tissue connecting the tongue to the bottom of the mouth is too short, too thick, or too tight, restricting the tongue’s normal range of motion. Ankyloglossia is the medical term that refers to a restrictive lingual frenum. This is the most common form of oral restriction.
• A lip tie is when the tissue connecting the upper lip to the gum is too stiff or too thick, preventing the upper lip from moving freely. This condition is less common than tongue tie, yet more prevalent than a buccal tie.
• A buccal tie refers to tissues that attach the inside of the cheeks to the gums, restricting normal movement. This condition is less common than a tongue or lip tie.

What causes tongue tie?

Tongue tie is hereditary and often passed down from one generation to the next.

During the normal development of a fetus in the womb, tissue forms to anchor the tongue to the base of the mouth. In most cases, this tissue naturally dissolves to a small, flexible tether around the 12th week of pregnancy.

In some fetuses, this tissue does not dissolve, leaving a “left-over” tie that is especially short, tight or thick, which can restrict normal tongue movement. A lot of premature babies have an oral restriction because they were born before the tissue separated adequately in utero.

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. It is often present in babies who are born with birthmarks known as “stork bites.”

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
• is more common in boys than in girls

Learn more about the possible causes of tongue tie here.

What are the signs & symptoms of tongue tie?

The symptoms of oral restrictions are varied and can differ depending on the person and their age.

Infants (newborn to 5 months)

Problems related to tongue tie

Oral restrictions can lead to several long-term issues in babies, teens and adults. 

Symptoms usually begin in newborns who have trouble feeding, then progress with age into chronic problems dealing with sleep, speech, behavioral issues — and more — if the oral restriction is left untreated.

How does tongue tie affect breastfeeding?

In babies, an oral restriction can lead to complications with breastfeeding. The lack of tongue mobility can impair their ability to properly latch, suck, and swallow. This is why many oral restrictions are discovered and diagnosed due to difficulties with breastfeeding.

It's a great idea to check for oral restrictions in a baby if its breastfeeding mother has mastitis symptoms, decreasing milk supply, or clogged ducts.
 

Can tongue tie cause long-term problems?

If an oral restriction is not diagnosed or treated at an early stage, it can influence a range of health problems over the course of a lifetime. If ignored or never diagnosed, it can lead to a cascade of developmental issues in the mouth and even in the rest of the body.

Many clinical specialists in this field suspect that oral restrictions are related to serious, chronic conditions such as sleep apnea, asthma, heart issues, mental health problems, and acid reflux causes.

Many parents are concerned about ADHD symptoms in kids, and wonder about the cause of ADD in children. Few would consider that an oral restriction could be a part of the problem. Yet medical professionals are looking into possible links between oral restrictions and attention deficit disorders due to the way this condition affects breathing and sleep.

Read more about long-term problems related to oral restrictions.

What happens in a tongue tie release procedure?

A trained healthcare professional will release the membrane causing the oral restriction.

It is an outpatient procedure that usually only takes a few minutes and heals within a matter of days.

The procedures to release oral restrictions have evolved over time. In the past, scissors or scalpel were the main options available. With the invention of lasers for medical treatment, the procedure can be even more precise and allow for faster healing.

Frenectomy vs. Frenotomy

There are two types of tongue tie release procedures — a frenectomy and a frenotomy. As you explore your options, it's important that you know the difference between them.

Here at health:latch, we offer a tongue tie frenectomy using a CO2 cold laser, which many consider the “gold standard” for this procedure because it provides better visualization (especially for posterior tongue tie, which is harder to see), gives consistent results, minimal pain, and faster healing for the baby.

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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