Old Alabama Family Dentistry

Are You Tongue-tied?

Probably many teenagers have been teased with "What's the matter; are you tongue-tied?" when they were thirteen and had just discovered the opposite sex. But being tongue-tied is nothing to snicker at because it refers to a condition that affects many people of all ages. The technical name is ankyloglossia, but it's better known by its common name "tongue-tie."

Your lips are attached to the gums, and your tongue is attached to the floor of the mouth by a fold of skin called the frenum, or sometimes called the frenulum. If you look in a mirror, open your mouth and lift your tongue, you can see the lingual frenum. Pull up your upper lip and you will see the labial frenum. The frenum had an important purpose before you were born, but after birth it apparently serves no useful task.

Why bother?

You may wonder that if it serves no useful purpose, why fuss about it? The length of this stretchy rubber band is more important than you might think. In some people, the lingual frenum may be too short. This can cause the person to not be able to correctly form and pronounce words because the tongue is "tied" to the bottom of the mouth. The tongue performs many necessary tasks besides helping you to speak. It helps to sweep away food particles in your mouth, cleans the teeth, helps you chew and suck, eat, drink and even kiss. Your teeth depend on your tongue to lick off the food debris left behind when you eat. Without that important action, plaque would build up on your teeth and eventually result in tooth decay. An abnormally attached frenum can prevent baby teeth from properly erupting.

If the frenum on your top lip is too long, it will show when you smile. Being gangly and thirteen is difficult enough, let alone having a weird-looking fold of skin show every time you break into a broad grin. Some people are painfully self-conscious when they have a feature that might cause someone to stare at them or say an unkind remark to them.

If you wear braces or a denture, an elongated frenum will have to be shortened so that the braces and denture fit well. A frenum that is too short can cause the gums to pull away from the front teeth and may also pull the teeth apart, leaving a big gap. Gingivitis can result from the gums pulling away from the tooth structure. A thickened frenum can make it impossible to close up a gap between the teeth.

Generally, babies who are diagnosed with a long or short frenum will outgrow the condition, or the mouth will compensate for it. However, some babies need surgical intervention because the frenum is interfering to the extent that the baby can't properly breastfeed or suck on an artificial nipple on a milk bottle. An abnormally attached frenum can prevent baby teeth from properly erupting. But, a cranky frenum can affect anyone of any age, not just babies. Older children might notice that their friends can stick out their tongues father than they can. Or their frenum can get caught between their teeth. Ouch!

What next?

Once someone has been diagnosed and the decision has been made to surgically correct the frenum, a procedure called a frenectomy is performed, usually in our office. It is a minor procedure that takes about 10–15 minutes. A local anesthetic is applied and the frenum is clipped or cut away. A few stitches are used to close the wound site. If a laser is used instead of a scalpel, no anesthetic is needed and no stitches are required. The patient has less discomfort and heals more quickly with laser surgery.

There is minimal aftercare. We would recommend that you rinse with warm salt water and carefully brush and floss around the area. We would check on your progress in about one week. If we used dissolvable stitches, you wouldn't need to have the stitches removed.

My child?

There are several things you could look for to see if your youngster has an abnormal frenum. You might see a heart-shaped tongue-tip when your baby tries to stick out the tongue. Or the baby could have difficulty sticking out the tongue or can't easily move the tongue from side to side.

There are other signs, but it's best to let us evaluate the situation and make recommendations. Call and schedule an appointment so that we can help you or someone you love have a healthy, happy smile.