Tongue Tie Release (Lingual Frenectomy)

  • A tongue tie, medically known as ankyloglossia, occurs in approximately 5-10% of newborns. During fetal development, the separation process between the tongue and floor of the mouth is disrupted, resulting in a short lingual frenulum. This is the connective tissue that attaches the tongue to the floor of the mouth. The severity of tongue tie can vary, affecting the range of motion of the tongue. This condition may impact oral motor skills, feeding abilities, and even breathing patterns in infants. It's important to note that the presence of a frenulum under the tongue does not necessarily indicate functional impairment; a comprehensive assessment by qualified specialists is crucial to accurately diagnose and determine if intervention is necessary. Research suggests that tongue tie can be hereditary, and its effects can extend beyond infancy if left untreated. Early diagnosis and appropriate management can significantly improve a child's oral health and overall well-being.

  • During fetal development, the tongue initially forms completely attached to the floor of the mouth. By around week 8 of gestation, as the tongue matures, it begins to separate from the base of the mouth, allowing it to move more freely. The lingual frenulum, a connective tissue remnant under the tongue, forms during this process. It serves to support and restrict the movement of the tongue in various directions. It's important to note that every person is born with a lingual frenulum. Its length and thickness can vary naturally among individuals.

  • A lingual frenectomy is a minor surgical procedure to release a tight or restrictive lingual frenulum (tongue-tie). The procedure is typically quick, lasting only a few minutes. Recovery is rapid, with minimal discomfort, and feeding improvements are usually noticed immediately or shortly afterward.

Infant Tongue Tie Symptoms

Babies may experience:

  • A repetitive clicking sound during feeding, signaling a struggle to maintain suction.

  • Milk dribbling from the corners of the mouth due to an ineffective latch.

  • Increased air intake, leading to gas, reflux, or colic-like symptoms from an incomplete seal.

Mothers may experience:

  • Flattened nipples post-breastfeeding

  • Nipple pain and damage

  • Extended feeding sessions

  • Inadequate breast drainage

  • Reduced milk production

Facial and Airway Development

Form Follows Function:

How we nurse as infants, swallow, chew, and breathe are all vital actions that stimulate the proper growth of our jaws and airways.

The correct development of the jaws is crucial, as it directly influences airway formation and has a significant impact on how we sleep and grow. A deficiency in this area can often lead to misdiagnoses in children. To help children reach their fullest potential, Dr. Ehde regularly assesses the function of the tongue, nasal breathing, and overall growth to ensure optimal development.

However, we are witnessing a concerning trend of decreasing jaw and airway size in our society, coupled with an increase in sleep-disordered breathing among children. This can contribute to a range of issues such as ADHD, bedwetting, speech impediments, and anxiety or panic disorders.\

Lack of Growth and Sleep
Signs and Symptoms

  • Mouth Breathing

  • Gummy Smile

  • Inability to keep the lips closed at rest

  • Crowding of the teeth or lack of spacing between all baby teeth

  • Inability to chew with lips closed

  • Improper swallowing

  • Forward Head Posture

  • Dark Circles under the eyes

  • Inability to focus

  • ADHD

  • Bedwetting

  • Behavioral Issues

  • Failure to Thrive

  • Sleep Terrors

  • Restless sleep

  • Learning Difficulties

  • Snoring

Treatment Modalities

To address this growing concern, we utilize several treatment methods, including:

  • Scanning to assess the size of the adenoids and tonsils

  • Laser therapies to reduce enlarged tonsils

  • Buteyko Breathing techniques to balance the nervous system and encourage proper nasal breathing

  • Myofunctional therapy 

  • Sleep studies to screen for apnea and other sleep disorders

  • Facial growth guides

  • Clear aligner therapies

  • Orthodontics/Expansion

These treatments aim to support proper craniofacial development, promote healthy breathing, and improve overall well-being for children.

Sleep and Breathing

During sleep, a growing child's body and brain undergo many vital processes, including:

Growth Hormone Release
 The pituitary gland releases growth hormone, which helps children grow, build muscle, and repair tissue.

Brain Development
 The brain remains active throughout all stages of sleep, processing information and consolidating learning. REM sleep, in particular, helps the brain eliminate unnecessary memories and retain important ones. Dreams play a crucial role in brain maturation, supporting emotional balance and mental health.

Immune System Strengthening
 Sleep strengthens the immune system, making children less prone to illness.

Appetite and Metabolism Regulation
 Consistent, quality sleep helps regulate hormones that control appetite and metabolism, reducing the risk of obesity.

Sleep deprivation can hinder a child's growth and development. It can also contribute to issues such as obesity, poor academic performance, ADHD, bedwetting, and anxiety.

For children undergoing growth treatments, we often recommend an at-home sleep test to screen for potential sleep disorders. This test involves wearing a small ring on a finger, and it can be used with children as young as 4 years old.