A tongue-tie is also known as a restricted lingual frenum or a tethered oral tissue (TOTs). The frenum is the line or band of tissue under the tongue - we all have one. It connects the tongue to the floor of the mouth. In some people however, the frenum is too tight or too short, and it can actually restrict the movement of the tongue, as well as prevent it from resting in the correct place. Lips can be tied as well!
Tongue tie is known for its ability to cause breastfeeding difficulties and speed impediments in children, but did you know that it can also lead to sleep apnea.
WHY DOES IT MATTER?
If your tongue is in the right place, your teeth will grow in straighter and your face will develop properly.
A tongue-tie keeps your tongue in the bottom of your mouth and may lead to:
TONGUE TIE AND OBSTRUCTIVE SLEEP APNEA
Tongue tie is heavily correlated with multiple issues that can contribute to obstructive sleep apnea, including:
DO YOU HAVE A TONGUE TIE?
If you suffer from obstructive sleep apnea, it is possible that tongue tie is the primary culprit behind your condition. Additional signs that you have this physiological abnormality include:
ADDRESSING TONGUE TIE
Under ideal circumstances, tongue tie is diagnosed early in a child’s life. They can undergo a frenectomy, which is a simple and fast surgery to loosen the lingual frenulum. Sadly, though, tongue tie is not always caught in a timely manner, and it can cause multiple problems, including sleep apnea, throughout the individual’s life.
If you suspect you have tongue tie, you may be a candidate for a frenectomy. However, a frenectomy is unlikely to automatically cure your OSA. You may need myofunctional therapy to train your tongue to rest in the proper place. These exercises strengthen and repattern muscles, while teaching the patient to breathe properly through their nose, especially at night.
Dr Rodrigues might also recommend that you begin sleep apnea therapy to help you breathe easier at night while you are considering other treatments to help you recover as fully as possible from the effects of tongue tie.
Tongue tie is a serious problem that can rob you of sleep! Fortunately, treatments are available to address this condition and help you get the rest you deserve.
A 2015 study published in the International Journal of Pediatric Research titled Short Lingual Frenulum and Obstructive Sleep Apnea in Children looked at children aged 2-17 years of age. The study demonstrated that a short lingual frenum is a clear risk factor for the development of sleep disordered breathing.
Most often, a tongue-tie must be treated surgically. The procedure can be called a frenectomy, frenotomy or frenulectomy. It's a simple, fast, and painless procedure. It can be done by a dentist using a laser or scalpel and should only take a few minutes. Finding an experienced doctor to perform the procedure is very important
It's critical to do myofunctional therapy exercises before the procedure for a successful outcome! Your myofunctional therapist will prescribe a series of exercises to help strengthen and prepare the muscles of the tongue for the new range of motion they'll experience post-surgery
The mouth is very good at healing after a surgery, which is why caring for the wound is an integral part of the process. If the wound is not managed properly, it's possible that the the tongue will reattach back the way it was before the frenectomy.
The tongue and oral muscles will need to be retrained and strengthened after the frenum is released. Think of it just like any other surgery where rehabilitation is required. The muscles in tongue have never learned to move or rest properly, so in this case, myofunctional therapy is just like physical therapy, only for the mouth
The lifelong consequences of tethered oral tissues (TOTs) are becoming much more widely known, and dentists and hygienists are ideal health-care providers to screen for these issues. TOTs can also make life very difficult for new babies and their parents.
Tethered oral tissues (TOTs) can include ties of the tongue, lip, and even buccal tissues. This is when the frenulums are short and/or thick and limit movement of tongue, lips, or cheeks.
Oftentimes, these anomalies produce symptoms like acid reflux, colic, and even failure to thrive—all of which have treatments that will not help with the true condition itself.
Babies who have one or more of these oral anomalies show symptoms of poor, difficult latch or popping off frequently when breastfeeding; gumming or chewing while nursing; gasping for air or clicking or wheezy sounds while nursing; and excessive drooling. This leads to excessive air swallowing during feedings, causing hiccups and gassiness, which can in turn cause colic and reflux issues.
Infants can also become sleep deprived due to falling asleep during feedings only to wake up shortly after to nurse again. When the baby is not getting enough nutrients during feedings, he or she has poor weight gain, and in some cases this can become so extensive that the baby is diagnosed with failure to thrive—what new parent wants to hear that?
A tie in a toddler showing rounded tongue tip, anterior ankyloglossia with minimal vertical lift, and beginning effects on lower anteriors
This is not just uncomfortable for the child, though. Mothers of newborns with oral anomalies also suffer. They suffer from discomfort while nursing; blanched, cracked, blistered, or even bleeding nipples; plugged ducts, thrush, and mastitis due to the baby being unable to fully drain the breast. Most new mothers are already tired just from the adjustment of having a newborn, but can suffer from sleep deprivation since babies with TOTs need to be nursed more often and wake up every two to three hours to do so. This can lead to low milk supply, and eventually the mother may stop breastfeeding altogether while the infant is still very young.
Many mothers and their families manage to get through this stage without a proper diagnosis (for example, by bottle feeding), but that does not mean the symptoms just go away. As the baby ages, more problems associated with these oral anomalies present themselves. As the baby begins to develop teeth, the lack of movement can lead to increased caries risk due to being unable to clear the mouth of milk and food debris.
Gaps between teeth, TMJ dysfunction, and bruxism can be present. Difficulty eating and pronounced gag reflux are also more common. Once children become old enough to talk, walk, and do things for themselves, the symptoms become less bothersome unless there is a speech impediment, which is often treated with speech therapy, which again does not look at the root of the problem.
Today, there are many adults with oral anomalies. Signs and symptoms include being more likely to have mouth breathing, enlarged adenoids and tonsils, snoring, and sleep apnea issues. When feeding and breathing are affected, the brain will often overcompensate to protect these functions, leading to other body issues such as posture, chronic back and neck pain, and chronic stress due to poor sleep