Ankyloglossia (Tounge Tie): Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

"Tongue-tie" (ankyloglossia) is a condition that restricts the tongue's movements from birth. The lingual frenulum, an unusually short, thick, or tight ring of tissue that tethers the tip of the tongue to the floor of the mouth, can make breastfeeding difficult. 

It could be challenging for someone with a tongue tie to stick out their tongue. Additionally, tongue-tie might affect a child's swallowing, eating, and speaking abilities. Occasionally, having a tongue tie won't be a problem. In some cases, correction may only require a simple surgical operation.

Causes Of Ankyloglossia

Normally, the lingual frenulum separates before birth, allowing the tongue to move freely. When someone suffers tongue tie, the lingual frenulum remains connected to the base of the tongue. While certain cases of tongue-tie have been connected to particular genetic markers, the underlying cause of tongue-tie is still mostly unknown.

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Symptoms Of Ankyloglossia

Symptoms and indicators of tongue-tie include:

• Having difficulty lifting the tongue to the upper teeth or moving it back and forth
• Having trouble pushing the tongue over the bottom front teeth
• A tongue that looks notched or heart-shaped when it protrudes

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Risk Factors Of Ankyloglossia

Although tongue-tie can happen to anyone, men are more prone than women to get it. Tongue ties can occasionally run in families.

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Diagnosis Of Ankyloglossia

To diagnose tongue-tie, a physical examination is typically performed. The doctor may rate many aspects of the tongue's appearance and movement in neonates using a screening tool.

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Treatment Of Ankyloglossia

Treatment for tongue tie is a matter of opinion. Some doctors and lactation specialists recommend correcting it as soon as possible, even before a newborn is discharged from the hospital. Some may prefer to hold off and observe.

The lingual frenulum may loosen up with time, relieving the tie in the tongue. In other cases, tongue-tie persists without causing problems. Therapy from a speech-language pathologist can help with speaking sounds, and in some cases, instruction from a lactation consultant can help with breastfeeding.

If tongue-tie bothers children, adults, or newborns, surgical treatment may be necessary. Surgical techniques include a frenectomy or frenuloplasty.

Frenulotomy

 A frenotomy is a simple surgical procedure that can be carried out under general anesthesia or not in a hospital nursery or doctor's office.

The doctor examines the lingual frenulum and then uses sterile scissors to cut it loose. The lingual frenulum has so few blood vessels and nerve endings that the procedure is quick and the pain is minimal.

If bleeding occurs, it most likely will be limited to one or two drops. After surgery, a baby might immediately begin nursing.

Complications from a frenotomy can include bleeding, infection, damage to the tongue or salivary glands, and more, even if they are rare. There's also a chance of scarring or the frenulum reattaching to the tongue base.

Frenuloplasty

If the lingual frenulum is too thick for a frenotomy and additional repair is needed, a more complicated procedure known as a frenuloplasty may be recommended.

A frenuloplasty is performed under general anesthesia with the assistance of surgical instruments. When the frenulum becomes loose, sutures are typically used to repair the wound; as the tongue heals, the sutures gradually absorb.

As with a frenotomy, rare adverse effects from a frenuloplasty can include bleeding, infection, or damage to the tongue or salivary glands. Scarring and anesthesia-related reactions are possible because the operation is more extensive.

After a frenuloplasty, tongue exercises could be recommended to enhance tongue movement and reduce scarring.

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Complications Of Ankyloglossia

Tongue-ties may affect a baby's oral development, as well as how he or she swallows, speaks, and eats.

For example, tongue tie can cause:

• Difficulties in nursing: It is necessary for a newborn to keep their tongue over their bottom gum while nursing. If the infant is unable to move or keep their tongue in the appropriate position, they may choose to chew instead of sucking on the breast. This can cause excruciating nipple pain and impair the baby's ability to absorb breast milk. Ultimately, poor nursing can lead to malnourishment and stunted growth.
• Speech issues: The inability to make many sounds, such as "t," "d," "z," "s," "th," "r," and "l," can be attributed to tongue-tie.
• Inadequate dental care: For an adult or older child suffering from tongue tie, cleaning their teeth of food particles might be difficult. This could worsen gum disease and cause dental decay, or gingivitis. tongue-tie complications include difficulty with additional speech activities and the development of a space or gap between the two bottom front teeth. Tingling with your lips might make it difficult to do actions such as kissing, licking an ice cream cone, and playing an instrument.

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