Definition   

This condition occurs when free movement of the tongue is restricted.

Causes and risks   

Tongue tie is a condition in which the midline sheath of tissue attached to the base of the tongue (lingual frenum) is attached too far forward on the tongue, causing restriction of tongue motion.

If the lingual frenum extends to the tip of the tongue, a V-shaped notch may be seen in the tip of the tongue. Tongue-tie may cause feeding problems, problems with teeth, and also has the potential to affect speech.

Symptoms   

• Inability to protrude tongue
• V-shaped notch in tip of tongue
• Excessive attachment of tongue to floor of the mouth by a membrane (lingual frenum)

Signs and tests  

Physical examination confirms that the lingual frenum is attached too far forward.

Treatment   

Surgical intervention is seldom necessary. If surgery is deemed necessary, it should be postponed until the child is approximately 9 months old.

Surgery involves cutting of the lingual frenum either in the office (mild cases), or in the operating room (more advanced cases). A surgical reconstruction (z-plasty closure) maybe required to prevent scar tissue formation.

Prognosis   

Surgery, if performed, is usually successful.

Complications   

The complications are rare, but recurrence of tongue tie, tongue swelling, bleeding, infection, and damage to the ducts of the submandibular salivary glands can occur.