"The Tongue-Tie Will Stretch Out" And Other Common Myths, Part 2. - Alabama Tongue-Tie Center | Dr. Baxter & Dr. Trego

“The Tongue-Tie Will Stretch Out” And Other Common Myths, Part 2.

by TongueTie | Aug 25, 2019

Myth #5: “The tongue-tie will stretch, or the child will fall and break it, so it doesn’t need to be treated.”

That would be nice if it just stretched out, so we could “wait and see.” Unfortunately, this is not the case. The frenum is made of a thick webbing of fascia (connective tissue) that is itself made of dense type 1 collagen bundles, which happens to be resistant to stretching. So the most stretching you might get would be 1%, but it will not disappear, stretch out, or change over time without intervention.

38 year old with a to-the-tip tie. She did not have speech difficulty, but she had many other issues she didn’t know were related.

If your fingers are stuck together, they will not separate magically. Neither will a tongue-tie. We see 30-year-olds, 50-year-olds, even 70-year-olds still with a tight-as-ever tongue-tie. You can certainly survive with a tongue-tie, but you may have compromised function and difficulty with chewing, speech, and sleep; neck and shoulder pain; and even headaches.

36 year old who was “clipped” as a baby. And after a proper release.

A child may fall and rip the lip tie when learning to walk, or later in preschool, but this does not help the nursing mom! Trauma is not a treatment strategy.

For a preschooler, it also is not a treatment strategy. Almost always when the child falls and rips the lip-tie, it only puts a small nick in the tissue (see below) and does not remove the tissue between the teeth. When we do it properly with the laser, all the tight tissue disappears, and then the teeth can properly close. There is now nothing to prevent the migration of the teeth toward the midline (mesial drift). Gap closure works best if done before 18mo old or when the permanent teeth are erupting.

This shouldn’t need to be said, but just in case anyone hears this myth…you cannot fall and rip a tongue-tie… unless the teenager is doing a Michael Jordan-style dunk with his tongue out (which he can’t stick out anyway) and hits the rim!

Just fix it correctly the first time, and get all the restricted tissue.

Myth #6: Since treating a posterior tie is new or novel, it must be wrong.

When a concept in medicine is new, or novel, it is often met with resistance from the establishment and other providers. This dogma is a common finding in medicine. The most common and prevailing practice (ignoring a tongue-tie and its effects in our case) is generally not the best one, nor is it always supported by sound science.

A recent NYT article read: “10 Findings That Contradict Medical Wisdom. Doctors, Take Note.“

Researchers identified around 400 common medical practices and theories that were contradicted by rigorous studies. Did you know that taking fish oil does not reduce the risk of heart disease?

Almost all new ideas have a certain aspect of foolishness when they are first produced. Alfred North Whitehead

In 1846 when lots of women were dying in childbirth from childbed fever, the midwives had lower rates of women dying than the male OBGYNs. One person, Ignaz Semmelweis, looked into this, and eventually discovered it was likely because the OBs performed autopsies, and the midwives didn’t. They also did not wear gloves or wash their hands back then, so he thought there must be particles that were transferred from a corpse to the mother. (This is before they knew about germs.) He suspected the OBs were spreading germs that were causing the new mothers to get sick and die. His solution: Wash Your Hands.

Everyone balked when he told them they needed to wash their hands. That was crazy talk to wash hands between patients! He fought long and hard to get doctors to wash their hands (again, they didn’t have gloves back then…can you imagine??) He ended up being put in a mental asylum for his crazy ideas. He literally went insane because people thought he was nuts for suggesting something that today we take for granted. He eventually died of sepsis, a blood infection, which is ironic.

Treating a tongue-tie can seem radical to those who have been taught in their speech therapy program that a tongue restriction has “no effect” on speech. Most if not all doctors, dentists, and nurses have not been taught much if anything formally on tongue-tie and its effects. Most will rely on asking their peers or professors in training and their practice when first starting out “what should I do with this patient with a tongue-tue? Oh, it doesn’t cause a problem. Ok!”

We will keep fighting the good fight, helping patients, and educating providers. Hopefully, it will become more common knowledge before I go crazy myself!

Myth #7: “Just give it time, and it will improve.”

All doctors and dentists take an oath to “First, Do No Harm.” This Hippocratic Oath is used by some to say, “We shouldn’t cut the tongue-tie.” However, leaving a patient with an easily diagnosable and correctable condition that can significantly limit their function and cause a host of issues in the present as well as in the future is medical negligence. It’s best to stay up-to-date and provide the best level of care to patients.

This child has clearly had dental work (there is a silver crown), and no one mentioned the to-the-tip tongue-tie. Not checking for a restriction of the tongue is a rampant problem since dental and medical schools are not teaching proper assessment, diagnosis, and treatment of this condition.

Sometimes inaction can be more harmful than action when it comes to breastfeeding babies and developing children. A “wait and see approach” is not helpful, for example, when mom has toe-curling pain every time the baby eats. The mom will try for a while, but there’s only so much time she can struggle through.

Many pediatricians will say to “give them time.” Wait it out. Don’t treat the infant’s lip tie, wait till they fall and rip it (See #5). Wait and see might work for minor speech delay when they’re just a little behind. But when there is an apparent restriction (or even not easily visible, and all the symptoms of a tie) then that is not the right course of action.

When there is a medical problem, and we have a treatment that works, it’s foolish to wait and see and let worse habits develop, risk a breastfeeding relationship, etc.

If it’s not causing current issues, then yes, leave the lip or tongue-tie alone (unless a tongue-tie is close or at the tip). If it is causing problems, then delaying will only harm the child or family.

Myth #8: “They charge too much; they must be doing it for the money.”

One family received a bill from Children’s Hospital with the charges after their halfway “clip” at the pediatric ENT. For a scissors clip of the tongue, no hospital stay, just an office visit, they were billed $5,500. Their Insurance paid $3900, and they still owed close to $1,000 for a simple clip (that wasn’t even done correctly, and we had to redo)! This is 100% true. They brought me a copy of the bill.

Our fee for an exam and the tongue tie fully released with a CO2 Laser, with as many follow up visits as needed, a phone call from me personally that night to check on the baby, and we will redo it for free if required in the first year…less than $550. That’s 10x less!

Trust me; we don’t do this to get rich. Regular pediatric dentistry is more profitable than tongue-tie releases! If we only cared about money, we would not open up a business focused on treating tongue-ties.

Why do we do it then? Honestly, we do it because it is so rewarding to help these families, and they are so grateful we help them with their struggling child.

Why do we keep going despite all these myths patients report to us from other providers nearby? (Many of which are quite hurtful.) We persevere knowing that we are making a big difference for the families we help who are struggling and now see results.

When we hear that our autistic, non-verbal patient said “mama” for the first time at nine years old after his tongue-tie release, and is sleeping better, with better behavior at school, and he’s eating better too… That’s encouraging.

When you hear a child can eat without choking (finally!) at age 3, and the family can now go out to eat at a restaurant… That’s encouraging.

When a sweet, speech delayed little girl who is almost two years old with ten words now has 29 new words a week later, and she’s now sleeping soundly through the night for the first time in her life… That’s encouraging.

When we have babies who have been struggling to gain weight, crying nearly all day, are frustrated when taking the breast or bottle, and now they are content, gaining weight well, stopped spitting up, and mom says “it’s like he’s a new baby”... That’s encouraging!

Listen to these parents stories below: