Tongue tied: Signs, symptoms and whether to clip

Peter Piper picked a peck of pickled peppers. This popular pre-school limerick is sure to get you to slip a time or two. Getting tongue-tied is common when you’re talking faster than your brain is thinking. However, did you know there is another condition that shares the name? Luckily, it’s nothing to be alarmed about.

The condition, called ankyloglossia (try saying that five times fast), is very common and restricts the tongue’s range of motion. “Ankyloglossia comes at birth and is an excess of the fibrous tissue,” said William Wathen, DMD, associate professor at the Texas A&M College of Dentistry. “It’s a thick ligament that holds the tongue down. Sometimes the tissue overgrows.”

What is ankyloglossia?

The condition itself doesn’t tend to have many complications and sometimes does not even present with symptoms. In cases where symptoms are present, the excess tissue may make it difficult for the child to maneuver their tongue out of their mouth.

The main symptom that can present early on is trouble breastfeeding. If this is an issue for your infant, ask your health care provider if ankyloglossia is the problem.

Other symptoms can present later and include trouble pronouncing certain letters of the alphabet—like “t,” “d,” “z,” and “s”—or problems playing a wind instrument. The condition is seen more often in boys than in girls, and it can sometimes run in families.

Sometimes, the frenulum, or the tissue that connects the tongue to the floor of the mouth, will loosen on its own over time, but if not, surgeries to correct the situation are very common.

How is ankyloglossia treated?

“The solution is usually a simple surgical procedure to remove the excessive tissue,” Wathen said. “There are two types of surgeries that the patient can get, and they are both fairly routine. The surgery to correct ankyloglossia can be done right away after birth, or it can be done later if the ‘wait-and-see’ approach doesn’t lead to the problem resolving on its own.”

A frenotomy is a simple procedure that simply cuts the excessive tissue that is holding down the tongue and does not usually require anesthesia. A frenuloplasty is a more technical surgical procedure and is done in more severe cases. This procedure requires anesthesia and stitches and can lead to scarring due to the more extensive nature of the procedure. The recovery time for these procedures can last from 10 days to a couple of weeks.

The recovery usually goes well. “After surgery, there are not a lot of directions that the patient has to follow in regard to their recovery,” Wathen said. “There’s very little risk of complications because the tissue is normal, so it’s not more prone to infection, and it’ll heal on its own regardless.”

When should parents talk to their child’s dentist?

Getting your child to be comfortable at the dentist can be tricky, but a dentist is the best person to evaluate your child’s ankyloglossia. Wathen recommends taking your child with you to your dentist when you go for your cleanings or checkups, as well as taking them to the dentist for their own checkup between six months and their first year of age.

The child’s first visits to the dentist will be quick, routine exams. Sometimes X-rays are taken to check if teeth are growing properly. The hygienist or dentist may play with the toothbrush and share tips with you and your child about brushing.

“We want the child to get comfortable in a dentist’s office at an early age,” Wathen said. “I, personally, like to make a game of it and put them in the chair and play ‘elevator’.”