In our work we see a significant number of children with restricted tongues or “tongue ties”. A tongue tie limits the movement of the tongue so that the other muscles of the face have to adapt during speech and swallowing. Many children have a restricted tongue that is not picked up early as they have been able to adapt their speech and swallowing at an early age.
Tongue tie is defined as ‘embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal tongue movement’.
They estimate as many as 4% of people globally have a tongue tie or restriction. Severe tongue tie is usually picked up at birth or soon after. Infants with tongue tie have difficulty in the elevation of the tongue, and according to tongue tie experts, this is one of the most important aspects of breastfeeding. On the other hand, babies with tongue tie who are bottle-fed often remain undiagnosed as the tongue often still has the ability to thrust forward to stop the flow of milk from a bottle.
Elevation is responsible for the clear pronunciation of the letters “D”, “T”, “N”, and “L. Another clue to a restricted tongue frenum is a lisp at the front or sides of the teeth when pronouncing the “S” sound. Adequate movement of the tongue is also key in proper swallowing of liquids and food.