Tongue- and Lip-Ties: The Facts

A tongue restriction affects speech differently in each individual. Some children with a to-the-tip tie can articulate well (but may struggle with increased effort when speaking). Other children, with a less visible or posterior tie, may have a speech delay or difficulty producing the sounds for L, R, T, D, N, TH, SH, and Z.

We are currently conducting studies to measure the effects of tongue-tie on children’s speech and the effectiveness of the release procedure. The following issues all saw a significant improvement after a tongue-tie release in our office (p < 0.01): frustration in communication, difficulty being understood, difficulty speaking fast, difficulty getting words out, trouble with speech sounds, speech delay, and mumbling or speaking softly.

We have seen that many tongue-tied children begin saying new words, even just hours or days after the release! One child said four new words the same day as the procedure. Another increased from a total of 10 words before the procedure to 39 in the week following. There is no guarantee that every child will have immediate results, but we often see this type of drastic improvement.

Children that are tongue-tied often have eating issues from infancy, such as trouble nursing or taking a bottle. When transitioning to solid foods, they may choke, gag, or have difficulty swallowing certain textures.

In childhood, these eating difficulties can persist and are evidenced by only eating small amounts of food, slow eating, packing food in the cheeks like a chipmunk, and pickiness with textures (soft, mushy foods and meats are typically the most difficult, but children can struggle with other foods as well). In our recent study, 84% of children with feeding issues saw improvement.

A tongue-tied child will often grind his or her teeth at night, snore, or experience other sleep-disordered breathing problems. Releasing a tongue-tie can help a child to sleep more soundly because the tongue will be able to rest on the palate, as it was designed to do, rather than falling back to narrow or block the child’s airway. Sleep-disordered breathing can cause frequent waking, restlessness, bed-wetting, failure to feel refreshed upon waking and accompanying difficulty focusing (which is sometimes misdiagnosed as ADD or ADHD).

Because multiple factors contribute to the problem, such as large tonsils and adenoids, a narrow palate and tongue-tie, often a child will be seen by multiple specialists to try to remedy the problem. In addition, children with tongue-ties often have a history of multiple ear infections and needing ear tubes. They may have had tonsils and adenoids removed. All of these can be complicated by the mouth-breathing that frequently occurs in tongue-tied individuals, due to the low resting posture of the tongue. We have found that when there is a tongue-tie, sleep often improves dramatically after a simple in-office procedure.