Ankyloglossia

Ankyloglossia is the medical term for the condition more commonly called "tongue-tie." Children who have tongue-tie may have difficulty moving their tongue enough to allow for normal feeding and speaking.

CAUSES

A band of tissue called the frenulum runs from the underside of the tongue to the bottom of the mouth. This band should be thin enough and long enough to allow the tongue to move freely in all directions. When this band is too thick or too short, it can prevent the tongue from moving normally. This can cause a baby to have a hard time sucking, or can prevent a child from learning to speak clearly.

SYMPTOMS

Symptoms may include:

  • Problems sucking during nursing or bottle feeding.

  • Poor weight gain, due to difficulty feeding.

  • Problems learning to speak.

  • Difficulty being understood while speaking.

  • Speech impediments, inability to pronounce certain sounds (especially those made by the letters l, r, t, d, n, th, sh, and z), slurred speech.

  • Large gap between the bottom front teeth.

  • Inability to lick a lollipop or ice cream cone.

DIAGNOSIS

In most cases, the diagnosis is very obvious based on the symptoms. During a physical examination of the child, the caregiver may see a v-shaped notch at the tip of the tongue. The child will not be able to move his or her tongue normally, including being unable to perform the following tasks:

  • Stick out the tongue.

  • Touch the tongue to the roof of the mouth.

  • Touch the tongue to the inside of each cheek.

TREATMENT

Some children with ankyloglossia will not need treatment. The frenulum will simply increase in length over time. But children who are having significant problems with feeding or speech may need to have a simple procedure called a frenulectomy or frenulotomy. During this procedure, the band is clipped, allowing the tongue to move more freely. In some cases, this can be done in the caregiver's office. Numbing medicine may be used. In other cases, the procedure will need to be performed in an operating room, and the child will be given a drug to help them sleep (general anesthesia) through it.

HOME CARE INSTRUCTIONS

Follow through on recommendations for feeding or speech therapy.

SEEK IMMEDIATE MEDICAL CARE IF:

Your child experiences increasingly severe pain.