Tongue-Tie Explained | Understanding Ankyloglossia in Beacon Falls, CT

What Is Ankyloglossia?

The lingual frenulum normally allows the tongue to move freely. When overly restrictive, the tongue may not lift, extend, or move side to side as it should. This limitation can affect feeding in infants and may occasionally contribute to articulation or mechanical issues later in life.

There are two commonly described types:

• Anterior ankyloglossia – The frenulum attaches closer to the tip of the tongue, making restriction more visible.
• Posterior ankyloglossia – The frenulum is thicker or positioned farther back under the tongue, sometimes making it less obvious.

Currently, there is no universally accepted classification system, and management approaches vary. This is why individualized evaluation is essential.

Signs & Symptoms of Tongue-Tie

Symptoms depend on age and severity. Many individuals with mild tongue-tie have no functional problems.

In Infants:

• Difficulty latching during breastfeeding
• Prolonged feeding sessions
• Poor weight gain
• Maternal nipple pain or irritation

It’s important to note that tongue-tie is only one of many possible causes of breastfeeding difficulty.

In Children:

• Occasional articulation challenges
• Difficulty licking lips or ice cream
• Trouble keeping teeth clean
• Social self-consciousness

In Adolescents & Adults:

• Difficulty cleaning teeth with the tongue
• Problems playing wind instruments
• Mechanical or social concerns

Tongue-tie does not cause sleep apnea or snoring and does not typically result in significant speech disorders.

What Causes Ankyloglossia?

The exact cause of ankyloglossia is not fully understood. It appears more commonly in males and may run in families. In rare cases, it can be associated with certain genetic syndromes.

How Is Tongue-Tie Evaluated?

If tongue mobility is restricted, an evaluation by an ENT specialist (also called an otolaryngologist) may be recommended.

At Naugatuck Valley ENT, we collaborate closely with our in-office Speech and Voice Pathologist to evaluate:

• Tongue mobility
• Feeding function
• Speech articulation
• Swallowing concerns

We also work with lactation consultants and other specialists when breastfeeding challenges are involved.

Because research on ankyloglossia continues to evolve and controversy remains regarding diagnosis and treatment standards, careful evaluation is critical to avoid unnecessary procedures.

Treatment Options for Ankyloglossia

Treatment for tongue-tie depends on age, severity, symptoms, and feeding or speech goals. Many patients improve with conservative care, such as working with a lactation consultant, adjusting breastfeeding positioning, or participating in speech therapy. If symptoms improve, surgery may not be needed.

For persistent symptoms or significant restriction, a lingual frenotomy may be recommended. This minor procedure releases the tight frenulum, improving tongue movement. It is often performed in-office for infants, while older children may require anesthesia. In more severe cases, a frenuloplasty may be necessary.

Not all tongue-ties require surgery, and a frenotomy does not guarantee symptom resolution. Some infants with visible restriction feed normally and need no intervention.

Risks are uncommon but may include bleeding, infection, scarring, salivary duct injury, or airway obstruction. Your ENT specialist will review the risks and benefits before recommending treatment.

Questions to Ask Your Doctor

If you are concerned about tongue-tie, consider discussing:

• Are there other causes contributing to feeding difficulties?
• What nonsurgical options are available?
• Is a frenotomy truly necessary?
• What are the risks and benefits?
• When is the best time to perform the procedure?
• Will insurance cover treatment?