Tongue-tie (ankyloglossia)

Diagnosis  

Typically, tongue tie is identified through a physical examination. Doctors may utilize a screening tool to assess the appearance and mobility of the tongue in infants.  

Treatment

The treatment for tongue–tie is a topic of debate. Some doctors and lactation consultants suggest correcting it right away, even before a newborn leaves the hospital. Others prefer to wait and see if the issue resolves on its own. Sometimes, the tight tissue under the tongue may loosen over time without causing any problems. In other cases, the tongue–tie persists but doesn’t cause significant issues. If breastfeeding difficulties arise, consulting a lactation consultant can be helpful, and speech therapy with a speech–language pathologist can improve speech sounds.  Surgical treatment may be necessary for infants, children, or adults if tongue–tie is causing problems. 

There are two common surgical procedures: 

• Frenotomy: A frenotomy is a simple surgical procedure that can be performed with or without anesthesia in a hospital nursery or doctor’s office. During the procedure, the doctor examines the lingual frenulum and uses sterile scissors to snip it free. The process is quick and minimally uncomfortable as there are few nerve endings or blood vessels in the frenulum. In the rare event of bleeding, it is usually minimal. After the procedure, a baby can breast–feed immediately. Potential complications include bleeding, infection, damage to the tongue or salivary glands, scarring, or reattachment of the frenulum to the base of the tongue.
• Frenuloplasty: A frenuloplasty is a surgical procedure performed under general anesthesia to address issues with the lingual frenulum that cannot be resolved through a frenotomy. This procedure involves releasing the frenulum and closing the wound with absorbable sutures. Although complications such as bleeding, infection, damage to the tongue or salivary glands, scarring, or reactions to anesthesia are rare, they are possible. After the frenuloplasty, tongue exercises may be advised to improve tongue movement and minimize the risk of scarring.