Tongue-Tie

Tongue-tie is a condition where the piece of tissue that connects the tongue to the floor of the mouth is too short, thereby restricting the tongue's range of motion. Tongue-tie can cause breastfeeding difficulties, speech impediments, and sleep apnea. A restricted tongue can additionally alter facial development. As your child grows, the tongue typically rests in the roof of the mouth, contacting the palate. Tongue-tie causes the tongue to adopt a lower resting position. The lower resting tongue position interferes with the palatal development, causing it to be abnormally high and arched. Because the roof of the mouth is the floor of the nose, a high-arched palate makes breathing through the nose difficult.

What we offer at Sleep and Brain

At Sleep and Brain, we strive to diagnose and treat a tongue-tie early in life before the damaging effects occur. Our physician will conduct a detailed history and specialized examination to determine if an underlying tongue-tie is present and contributing to your health concerns. 

The detailed clinical history will, in part, include the following:

• Speech issues

  • Hard to understand

  • Stuttering

  • Unable to speak fast

  • Speech delay

  • Trouble with sounds

• Breastfeeding issues

  • Painful nursing

  • Poor latch

  • Losing milk out of the corner of the mouth

  • Gagging

  • Nipple damage

  • Plugged ducts, engorgement, and mastitis

  • Frequent feeding every 30 to 60 minutes

• Feeding issues

  • Hard time transitioning to solid foods

  • Slow eater

  • Grazes on food throughout the day

  • Choking on food

  • Aversion to specific textures of foods

  • Unable to open the mouth widely

  • Poor weight gain

• Sleep issues

  • Restless sleep

  • Bedwetting

  • Grinds teeth

  • Sleeps in strange positions

  • Snores

  • Reflux

  • Mouthbreathing

• Brain issues

  • ADHD

  • Anxiety

  • Headaches

In addition to a tongue-tie, it is possible to have a lip-tie and cheek-tie. Collectively, tongue-ties, lip-ties, and cheek-ties are called TOTs, or tethered oral tissues. The lip-tie can also contribute to nursing problems and independently make breastfeeding painful and difficult for mom. The significance of cheek-ties is unknown. In addition to taking a detailed clinical history, we will conduct a specialized physical examination evaluating for all the tethered oral tissues listed below: 

• Tongue-Tie

  • Anterior

  • Posterior

• Lip-Tie

• Buccal-Tie

Once a tethered oral tissue is confirmed, we can offer treatment remedies to undo the tie and rehabilitate the muscle.

• A frenectomy is a fast and straightforward surgery to loosen the lingual frenulum. We can refer you to surgeon with expertise freeing tethered oral tissues if necessary.

• We may also recommend beginning sleep apnea therapy to help you breathe more comfortably at night.

  • Positive airway pressure

  • Mandibular advancement splint

  • Palate expansion

  • Allergy evaluation and treatment

  • Surgery

    • Maxillo-mandibular advancement

    • Bone-based palate expansion