Have you or your child been told that you have a tongue tie?  Are you wondering if tongue ties are just another health fad?  Are you interested in tongue tie release surgery as a quick fix to your symptoms?

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Please read below for more information on tethered oral tissues (TOTs), common misconceptions, and the importance of pre- and post-op therapy when considering a tongue tie release:

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What are TOTs anyway?

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• Perhaps you've heard of a tongue tie but did you know that you can haves ties in other areas of your mouth as well? 

  • Other types of ties:

    • Lip

    • Buccal (cheeks)​
       

• The Oxford dictionary definition of a frenulum is "a small fold or ridge of tissue that supports or checks the motion of the part to which it is attached, in particular a fold of skin beneath the tongue, or between the lip and the gum."  Having a frenulum is totally normal!  In fact you have several of them in the mouth, as well as some other areas in the body.  It is when the frenulum is too tight and impairs functional movement that it is considered a tie.

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Why haven't I heard more about ties? Are ties just a fad? 

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Tongue and lip ties are often labeled as a fad, but this is due to a lack of understanding of ties and their relation to swallowing, facial development, and overall connection to the rest of the body.  Much of this misunderstanding likely comes down to a lack of education.  Many of our healthcare professionals - including speech-language pathologists, ENTs, and dentists - have had very little, or no information at all, provided to them about tongue and lip ties.  Furthermore, there are instances of people having tongue tie release procedures done but then seeing no improvement because the procedure was done by a professional who lacks adequate training and/or no pre- or post-op therapy was provided.  It then becomes easy for doctors or patients to brush aside the value of a release procedure when their primary experience has been with those who have not gone through the proper process.

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Can't I just get a tongue tie released?  Why do I need therapy?

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A tongue tie release is NOT a quick fix! 

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At first glance it may seem like snipping that little band of tissue under the tongue might be the solution to all of your issues.  However, keep in mind that the entire time your tongue has been tethered to the floor of your mouth you have not only not practiced proper tongue movement and placement, but have also developed compensation patterns.

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Imagine you've had one of your arms bound to your torso since birth.  You've learned how to get by without the use of that arm.  However, now you have had someone help you to unbind that arm so that you may have use of that limb as well.  Would you expect that arm to immediately work properly despite the lack of use?  No.  The muscles in that arm have likely atrophied from disuse.  You may not understand how to move the arm properly and would have to practice proper usage.  You would likely have to build up strength over time.  It is the same with a tongue tie.  Someone with a tethered tongue has gone their whole life without being able to move their tongue in an optimal fashion.  Not only has this likely impacted the ability for their tongue to rest properly in the roof of their mouth (palate) but has likely also resulted in muscle weakness in some areas of the tongue.  A tongue which is surgically released without any therapy before or after may not ever gain the range of motion, strength, or proper form needed to correctly perform the tasks for which it was designed.  We all know how hard it can be to break bad habits.  Now imagine that bad habit is the way you swallow and you're never even informed that the way you've been swallowing isn't normal?  It seems pretty unlikely you'll suddenly change that habit doesn't it?

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That may lead you to ask...Well, I understand that I've had years of forming incorrect oral-motor patterns, but why would a baby need therapy?

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Even within the first few weeks of life a baby with tongue, lip, and/or buccal ties may be developing compensation patterns so that it can get the nutrition it needs.  These compensations are reinforcing incorrect oral-motor patterns that they too will have to be taught to replace with more functional motor movements.  

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It is also important to keep in mind that swallowing doesn't just begin at birth.  The oral structures develop early on in utero and research indicates that babies begin swallowing around 12 weeks (roughly 3 months) gestation.  That means that a full-term baby with a tongue tie has already had 6 months of incorrect swallowing before even being born!