Ankyloglossia (Tongue Tie)

Ankyloglossia Definition

Ankyloglossia is popularly known as tongue tie. It is a condition where the frenulum of the tongue, a fibrous band of tissue connecting the tongue to the floor of the mouth,  is short or located too much towards the front of the tongue. The abnormal frenal attachment leads to limitations in the movement of the tongue tip and tongue movements. It a congenital disorder and is commonly seen affecting families. The mild form of the condition may causes slight discomfort or speech defect, whereas the severe forms can cause complete attachment of the tongue to the floor of the mouth.

Ankyloglossia Symptoms

Speaking and Feeding

Most commonly ankyloglossia is associated with speech defects. Lisping and the difficulty with pronouncing certain sounds is very common in patients with tongue tie. The ability to enunciate alphabets such as  “T”, “D”, “N”, “L” and syllables sych as “AS” or “TA” are generally hampered in these affected individuals. Recurrent tongue biting is also very common in these patients. Difficulties in chewing certain types of foods are also commonly experienced. In infants ankyloglossia can lead to feeding and nursing problems, as it creates difficulty maintaining suction inside the oral cavity.

Teeth and Jaws

The fusion of the frenum can be complete or partial. When the patient attempts to stick the tongue out a “V” shaped notch may be visible at the tip of the tongue. There is mild to moderate spacing is present between lower central incisors. The individuals with tongue tie also tend to lick the lower lip more frequently. The long term effects of tongue tie include malocclusions such as open bite and lower jaw prognathism. The oral hygiene is also compromised due to the tongue tie.

Ankyloglossia Causes

The exact causes of tongue tie are not known. However the disorder has a familial tendency. Most of the cases of tongue tie are congenital and are associated with minor variations in the attachment of genioglossus muscle.Traymatic injuries in early age may also lead to development of tongue tie.


Tongue tie is often associated with presence of certain syndromes such as :

  • Rainbow’ syndrome
  • Fraser’s syndrome
  • Ankyloglossum superious syndrome
  • Orofacial digital syndrome

Ankyloglossia Treatment

In cases with tongue tie in infants,  parent education and reassurance is the first step in the management of the condition. The feeding problems can be managed with few precautions and techniques. There is no medication to treat the condition and it does not significantly change with age. Tongue tie can be completely corrected by using surgical methods.


Surgery is indicated in cases with complete fusion of the tongue to the floor of the mouth. In infants with severe feeding problems and children in early ages with impaired speech due to tongue tie; surgery is often recommended. Complications may occur in new born after the surgery; hence the procedure should be delayed till the child is at least 6 moths old.

Surgical manipulation of the lingual frenulum is done under anesthesia in a hospital set up. Laser surgeries and elctrocauterization can also be considered as treatment options. Speech therapy is an important aspect of the treatment of tongue tie and it can either be employed alone or after the surgical procedure is completed.

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