What is a Tongue Tie?

Everyone has an attachment under their tongue.  This attachment is known as a frenum, frenulum, or frena.  Just because you can see the frenum does not mean that it is abnormal or problematic.  A frenum is deemed restrictive or "tied" if it is inhibiting normal movement.  If the tongue is restricted, the body will recruit other muscles to help the tongue move, which can lead to dysfunctional muscle movements, breathing patterns, and more.

Symptoms Associated with Tongue Ties

  • snoring and/or mouth breathing
  • difficulty falling asleep or staying asleep
  • not feeling well rested in the morning/throughout the day
  • enlarged tonsils/adenoids
  • chronic bedwetting
  • inability to sit still
  • difficulty focusing/anxiety
  • clenching/grinding
  • sleep apnea
  • neck/facial tension
  • oral habits (thumb/digit sucking, chewing on pens, blankets, etc.)

Full Body Impact

  • altered facial development (under or overdeveloped lower jaw)
  • narrow nasal cavity (impacts ability to nasal breathe)
  • postural changes (forward head posture to open airway)
  • neck and facial tension
  • full body tension

Functional Approach to Treatment

Dr. Annie takes a functional approach to treating tongue ties.  This means that she evaluates symptoms as well as structure.  She works with families to determine if and how a tongue tie may be impacting the patient.  Prior to having a tongue tie released, the patient will be required to participate in an orofacial myofunctinoal therapy program.  This helps to strengthen the tongue and facial muscles as well as begin to eliminate muscle compensations both before and after the tongue release takes place.  Similar to pre and post-operative physical therapy required for a knee release, a tongue release is not a "stand-alone" treatment.

The Procedure

Once the patient has completed enough orofacial myofunctional therapy sessions (typically 4 sessions) and they are deemed ready for release by their Orofacial Myofunctional Therapist, Dr. Annie will perform the functional frenuloplasty.  She uses a state-of-the-art LightScalpel CO2 laser which optimizes patient comfort, procedure speed, safety, and healing.  The area will be numbed with local anesthetic and the procedure typically takes about 30-45 minutes.  Dr. Annie will check completedness of the procedure by having the patient do some of their orofacial myofunctional therapy exercises.  She will check for any residual tension and, once the release is complete, she will suture the area closed with resorbable sutures that will remain in place for 3-5 days post-operatively.  She will see the patient for a 1 week post op and they will continue to work with their Orofacial Myofunctional Therapist post-operatively to achieve the best surgical results.