Every day, we see patients come to see us for a tongue-tie consultation who were told their baby or child’s tongue-tie was “mild” or “would stretch out” and is “unlikely to cause issues.” Then we look in the mouth, lift up the tongue, and the attachment is to the tip or close to it! It’s remarkable. If the tongue is attached to the tip, this is NOT “mild.” That is a severe restriction. Often, if it’s 90% or 95% of the way to the tip, parents are told there is “no tongue-tie.” Meanwhile, it’s still severe!
There are two main rating scales, the Kotlow and Coryllos being the most widely used. Essentially, if a tongue is attached 75-100% of the way to the tip, this is severely restricted. If it is 50-75% restricted, that is moderately restricted. 25-50% is minimally restricted. Less than 25% is often normal mobility. However, some babies still have a less noticeable “posterior” tongue tie, aka “mid-tongue restriction” (maybe 10% attachment), and can have significant symptoms because they can move the front of their tongue but not the middle of their tongue.
Interestingly, most babies that cause severe pain for moms during nursing have less obvious tongue-ties. Sometimes, babies have to-the-tip tongue-ties and are still gaining weight well and have minimal symptoms. So, you must combine the current symptoms, the appearance, and the feel of the restriction to determine if a tongue-tie release is warranted.
If you are told your baby has a “mild” or even “no” tongue-tie and there are significant feeding struggles, or your child has speech, eating, or sleeping issues, it is worth getting an evaluation by an experienced tongue-tie release provider. If a healthcare provider mentions anything about a tongue-tie, in our experience, that means it is often at least 75% of the way to the tip and is, in fact, “severely restricted.” Many infants and children have significant quality of life struggles from this degree of restriction and would benefit from releasing the tight tissue.
Imagine if they were learning to walk, but their shoelaces were tied together. Eventually, they would learn to walk, which would be significantly more challenging. Babies with tongue-ties will survive; they might get a “C” on their milestone tests, but our goal is for them to thrive – to have the ability to get an “A+” on their milestones or quality of life.
If your child is struggling to breastfeed or bottle-feed (colicky, gassy, reflux, spitting up, etc.), talk (delayed speech, clarity issues), eat solids (slow, picky, gagging, spitting out foods), or has sleeping issues (mouth breathing, snoring, restless sleep) get an evaluation with a knowledgeable provider. How do you find one? We would be happy to help. We treat patients from all over the country and around the world. Another easy way is to check for an online support group like “[State Name] Tongue and Lip-Tie Support Group” or just “Tongue-Tied Babies Support Group” and ask another parent. Sadly, medical knowledge of tongue-ties is lacking, so simply asking a dentist, ENT, or primary care provider does not always mean they are up-to-date on the latest research, and the condition may or may not be appropriately identified.
You can reach out by sending us a message or calling our office at 205-419-4333 and we would love to assist you and your family.