Tongue Tie Treatment: Does Your Child Need Surgery?

The suspicion of tongue tie is a source of anxiety in parents. The need for tongue tie treatment is one of the reasons worried parents approach a pediatric surgeon when their infants are diagnosed with ankyloglossia (tongue tie).

Technically, tongue tie is a congenital birth condition where a short, thick band of tissue (called the lingual frenulum) tightly tethers the tongue’s tip to the floor of the mouth.

Here are some queries Dr. D.K. Mitra, Pediatric Surgeon at Sitaram Bhartia Hospital, South Delhi answers for parents.

How do I know my child needs tongue tie treatment?

“Even though this condition does not cause issues in all infants, tongue-tie surgery may be required if your child starts facing difficulties in feeding, speaking, or sometimes swallowing,” says Dr. Mitra.

The child’s pediatrician may suspect the condition immediately if they are exhibiting common symptoms of tongue-tie such as:

  • Difficulties while breastfeeding where the lactation counsellor or mother may suspect a superficial latch
  • Problem sticking tongue out or notched tip
  • Difficulty in lifting their tongue, or moving it from one side to the other
  • Older children complaining of problems while eating, speaking, etc.
  • Certain words are not clearly pronounced especially those where the tongue has to touch the palate

If your child’s oral development speech starts getting affected, you should discuss the possible treatment options with your pediatrician today.

Consulting Dr. D.K. Mitra for the first time? Avail a free second opinion for all your questions, please call us on +91 8826391002.

How does tongue tie affect breastfeeding?

Due to the presence of a short or tight lingual frenulum, this condition can restrict the infant’s tongue movement which is necessary for comfortable and effective latching and breastfeeding.

Some signs for mothers that suspect superficial latching are:

  • Severe nipple pain and damage
  • Functional compromise in feeding ability of newborn

Subsequently, your child may begin experiencing:

  • Early weaning
  • Poor weight gain
  • Failure to thrive

The lingual frenulum may be short, but it is not always tight or fibrotic. This means that some tongue-tied infants may be able to breastfeed without difficulty.

There are certain tongue exercises that the mother can help the infant to carry out and also different positions and latching techniques. Consult our lactation consultant, Suhani Grover (IBCLC) at +011 4211-1111 for further queries.

What causes tongue-tie (ankyloglossia) in infants?

This is a congenital condition, which means your child’s tongue is attached to the bottom of the mouth since the day he/she is born.

Can tongue tie resolve itself?

Tongue tie as a condition is not treated unless the child is facing problems in feeding or articulation of certain words because it is expected to loosen over time. As the infant grows older and the mouth starts developing, the condition may sometimes resolve itself.

If the lingual frenulum, however, does not loosen over time then it is possible that the child may require surgical intervention. Untreated tongue-tie can cause issues such as:

  • Poor weight gain as the child faces issues with breastfeeding, or eating certain foods as they grow old
  • Speech problems, as the child is growing with a tongue-tie may have difficulties forming certain sounds that hinder their speech.
  • A gap between the two lower incisors may develop due to the presence of frenulum between the teeth.
  • Poor oral hygiene

Can tongue-tie be corrected?

Yes, it can be corrected.

“Tongue-tie treatment is a simple surgical procedure that involves cutting the thin tissue that binds the tongue to the floor of the mouth together.”

The procedure, known as frenotomy or frenuloplasty, is quick, almost painless, and can be carried out with or without local anaesthetic for infants. But it safer to perform it under anesthesia to avoid risks of aspiration, and to have the child calm and asleep in order to allow manipulation within the mouth.

“The nerve endings are few in the area around the floor of the mouth, due to which the procedure is not painful for babies. We may use a general anaesthetic for older children.”

Consult your child’s pediatrician early in order to determine the best course of treatment for them.

Tongue Tie Treatment – Lakshay’s Story

Lakshay Roy, 4, was brought to Dr. D.K. Mitra as he was not articulating certain words clearly. Although his parents could understand his speech, his teacher or friends were not able to do so.

The child was carefully examined and his speech problems were attributed to tongue tie. Much to his parents’ worry, Lakshay was advised surgery. They were, however, reassured that it is a painless surgery that requires only a few hours of hospital stay.

To their relief, the child safely underwent excision of the fraenulum under anesthesia and was sent home after recovery within a few hours. His speech also showed marked improvement with speech therapy.