What is a tongue or lip tie?

Everyone has what is called a “frenum or frenulum.” The frenulum is a tissue that connects the tongue, cheeks and lips to the gum. Visually identifying a band in these areas does not mean that you are “tied” and this cannot be diagnosed without a functional assessment. It is only a true tongue “tie” if it restricts range of motion or impairs function.

A tongue tie (or ankyloglossia) is an unusually short, thick, or tight frenulum. For most instances of a tongue tie, a lip tie is also present. Similarly, to tongue tie, a lip tie is when the band of tissue that connects the upper lip to the gums is too tight, short, or thick. Ties are congenital issues. In children who are affected by a tongue tie, the frenulum remains thick or attached to the tongue tip and does not recede, which makes it difficult to move the tongue.

Tongue and lip ties can affect an infant’s ability to properly nurse/feed, swallow, and breathe. If the tongue cannot move in a full and functional range of motion, it is unable to properly shape the hard palate (roof of the mouth) which also plays a critical role in normal feeding, movements, and overall growth and development.

What are the signs and symptoms of a tongue or lip tie?

The baby may experience:

·        Clicking while nursing

·        “Colic”

·        Difficulty nursing

·        Excessive drooling

·        Excessive spitting up

·        Fussiness

·        Gagging

·        Gassiness

·        Hiccups

·        Milk blisters

·        Mucous in stool

·        Poor latch or suction

·        Reflux

·        Restricted tongue movement

·        Sleeping with mouth open

·        Slow weight gain

·        Stiffness or back arching

·        Torticollis

·        Uncomfortable or fussy when in a car seat

·        Weight loss

Mom may experience: 

·        Bruising on or around nipple

·        Breasts frequently not feeling emptied

·        Clogged ducts

·        Engorgement

·        Flattened or creased nipple after nursing

·        Mastitis or inflammation of breasts

·        Overactive or delayed milk ejection

·        Pain (during or after nursing)

·        Supply issues

·        Bleeding nipples

How is it diagnosed?

Our assessment of both the baby and concerns / symptoms helps us to determine whether or not a referral to a Pediatric Dentist is necessary.

How is it treated?

Once a tongue tie has been properly diagnosed, often the next step recommended is to have it revised. The procedure is typically very quick and minimally invasive.  Modern techniques with laser revisions are quick and effective. Babies usually can nurse immediately following the correction. Your baby’s revision specialist will typically recommend follow up care including consulting a chiropractor or bodywork therapist along with home care to help with the healing.

How can chiropractic care help my baby?

Chiropractic therapy and bodywork is a crucial part of care when it comes to tethered oral tissues (ties). The tension caused from the tethered tissues can create long-lasting structural changes to the musculoskeletal system; especially in the neck, cranium and face. The muscles and connective tissues are intricately connected from the mouth and jaw, down to the collarbone, sternum, and spine. Abnormal stresses on these tissues cause asymmetry, leading to many common presenting symptoms in babies, children, and even adults.

Unaddressed ties may have long-lasting affects including speech delays or impediments, challenges with normal movement or functional development, vagus nerve interference, behavioral issues, head and neck tension, headaches, TMJ dysfunction, crowding of teeth, and sleep disorders.

Our goal is to make sure the whole body is functioning well especially before and after any revision or intervention. Gentle, specific adjustments will help to reduce tension and create balance throughout the body. It helps the revision process if one’s nervous system is calm and balanced. 

After a revision, musculature in the mouth, jaw, neck, shoulders, and spine can shift. Chiropractic can help balance structural alignment and help the body adapt functionally now that the tethers are released. 

4 ways chiropractic care can help possibly avoid surgery, before or after a tongue-tie surgery or help the baby with feeding dysfunction.

• Reducing Nerve Interference to Tongue Muscles: Tightness in the tongue is not only caused by issues with the lingual frenulum, but can also be created by interference in the transmission of signals from cranial nerve XII (controls the movement of the tongue muscle). Adjustments to the baby’s neck, intra-oral cranial bones, and soft tissue can improve and clear the signals in order to relax the tongue to allow for proper latching and breastfeeding.

• Aligning Bone and Joint Structures that are Attached to the Tongue: The tongue muscle is attached to the bones of the head and neck and if the structures are not aligned in a functional position, then the soft tissues connected to it can become distorted from proper alignment. This can restrict tongue motion. Proper alignment of the structures via chiropractic adjustments optimizes their function to allow for proper movement.

• Ruling Out the Frenulum as the Culprit: The frenulum is not always the cause of tongue restriction. A tight jaw or misaligned vertebra (subluxation) may be the reason for tongue restriction and may also cause an ineffective latch or milk transfer. Receiving chiropractic care prior to a tongue-tie evaluation or surgery will allow a provider to better assess the tongue’s natural state of being.

• Enhancing Results of Tongue-Tie Surgery: It’s important to achieve alignment of the head and neck structures prior to surgery in order for the procedure to be best effective and to allow for optimum wound healing. If surgery is required, chiropractic care can help to rehabilitate the head, spine and tongue; correcting motor skill development of the tongue and spine, support and encourage ideal wound healing and optimize the anatomy to accommodate the change created from surgery.

Chiropractic care in general promotes support for an infant’s growing spine and optimum healing and adaptation from birth stresses, traumas and strains. Seeing a chiropractor can decrease the chance of surgery or support post-surgery in order for your infant to achieve normal physiological function and performance.