What is Tongue Tie (Sublingual Frenulum)?

Known among the public as tongue tie, it is the soft tissue seen under the tongue being shorter and fibrotic than it should be.

Why Does Tongue Tie Occur?

When the baby's tongue develops in the womb, the tongue is initially attached to the floor of the mouth, then it separates from the floor of the mouth and thus becomes mobile. However, it is attached to the floor of the mouth with a ligament called frenulum. As a result of the disorder that occurs during this period, the frenulum that connects the tongue to the floor of the mouth either cannot be fully released or becomes thick due to cell proliferation, preventing the tongue from being released. This condition is called Ankyloglossia (tongue tie/ hypertrophic frenulum linguale/ short frenulum).

How is Tongue Tie Diagnosed?

A tongue tie can sometimes be seen under a simple examination light, sometimes with the help of a tongue depressor. The tongue has taken the shape of a "V". In a child with a tongue tie, movements such as sticking the tongue out, lifting it up and touching it to the palate are asked, and since the patient cannot do these completely, the diagnosis is confirmed. In the evaluation of articulation disorder, especially after the age of 3, the patient is asked to make sounds such as "l, r, s, t, z", where the front part of the tongue is actively used, and the patient has difficulty in making these sounds.

What Complaints Do Patients Apply With?

In children with tongue ties, the functions of the tongue will be affected. Speech and articulation disorders, poor oral hygiene and dental problems (especially the separation of the front two teeth) due to the deterioration of the cleaning function of the mouth, sucking, eating/swallowing problems, tongue shape disorders and psychological and social problems as a result of all these can be seen.

There are two patient groups that we frequently encounter in polyclinic applications, one of which is newborn babies and the other is children who cannot speak. Since newborn babies do not have speech disorders, families usually understand that there is a tongue tie from sucking problems, which is a rare condition. If the baby has serious swallowing difficulties, other causes should definitely be investigated.

In children who cannot speak, it is wrongly believed that the speech problem is due to tongue tie. However, tongue tie only causes impaired speech and articulation disorders, in other words, a tongue tie may be present in a child who does not speak, but it is not the reason for not speaking. Other causes should definitely be investigated in such patients.

How is Tongue Tie Treated?

It is a simple procedure performed with local anesthesia, especially in babies up to 3 months old and whose tongue tie is thin and transparent. Since this tissue will thicken as the child grows, it is more appropriate to perform it with general anesthesia. After the tongue is lifted upwards surgically, the fibrotic tissue that becomes visible is cut with scissors or bipolar cautery. Although stitches are not required in most cases, bleeding control with absorbable stitches may be required in some cases.

 

 

What are the expected benefits of the procedure?

After the procedure, this congenital anomaly and the mechanical obstacle that may cause problems with feeding and speaking will be eliminated. However, it should not be forgotten that good speech cannot be achieved without good hearing. Many families think that children who do not speak will be able to speak by cutting the sublingual ligament. Or they hope that the impaired speech will be corrected. The speech disorder that a tongue tie can create is only the difficulty of pronouncing some letters. However, speech disorders are very diverse and therefore occur due to different reasons. These issues should be investigated before the intervention.

Are There Any Complications of the Procedure?

If general anesthesia is given to older children, it may cause complications. The only complication of the surgery is bleeding if care is not taken.

Can Tongue Tie Reoccur?

No, it does not reoccur.

*** The information provided here and the content of the website are arranged for the purpose of informing visitors, especially families. No information should be considered as advice by visitors and should not lead to any decision or action. The patient should definitely be examined by a pediatric surgeon, and a decision should be made by consulting him/her and consulting his/her personal knowledge.