Pediatric Tongue-Tie

At some point in our lives, we all find ourselves in a situation where we have difficulty speaking because we are too excited to speak. However, sometimes being tongue-tied is actually a result of a medical condition.

Before we are born, a strong cord of tissue that guides development of mouth structures is positioned in the center of the mouth, under the tongue. It is called a frenulum. After birth, the lingual frenulum continues to guide the position of incoming teeth. As we grow, it recedes and thins. This frenulum is visible and easily felt if you look in the mirror under your tongue. In some children, the frenulum is especially tight or fails to recede and may cause tongue mobility problems.

The tongue is one of the most important muscles for speech and swallowing. For this reason, having tongue-tie can lead to eating or speech problems, which may be serious in some individuals.

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When Is Tongue-tie a Problem That Needs Treatment?

In Infants

A new baby with tongue-tie can have trouble sucking and may have poor weight gain. Such feeding problems should be discussed. If you are a nursing mother who experiences significant pain during feeding, or, if your baby has trouble latching, you should have your child evaluated for tongue-tie.

In Toddlers and Older Children

Many children with tongue-tie are able to develop speech and language without difficulty, but others may exhibit problems with the articulation of certain sounds beyond the age when errors are appropriate. These can include: l, r, t, d, n, th, sh, and z. A speech and language evaluation may be needed if more than half of a three–year–old child’s speech is not understood outside of the family circle. As a simple test, caregivers or parents might ask themselves if the child can lick an ice cream cone or lollipop without much difficulty. If the answer is no, they cannot, then it may be time to consult a physician.

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