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Adults develop methods of speech which mask their difficulties with sounds. Both adults and children often try to speak with a small oral aperture, so that they can make the lingual contacts required for pronouncing consonants; others speak slowly, softly or loudly. Nearly all patients past toddler stage are aware of the movements their tongue cannot make.
Clarity in rapid speech is almost always impossible for a tongue-tied person to achieve. The movements that tongue tie renders difficult may vary from patient to patient but some movements — such as lingual elevation to the upper teeth and horizontal lingual protrusion — are consistently difficult or impossible to achieve because of the pull of the tight lingual frenum on the floor of the mouth and on the tongue.
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Other movements whether articulatory or unrelated to speech can only be achieved under optimal conditions: during careful speech, after prolonged speech therapy, when concentrating, and when talking slowly. Thus it is seen that many with tongue tie learn to compensate for their limited tongue mobility by adopting alterations of movements. These are rarely successful since they are often conspicuous or inefficient.
The cumulative effect of these barriers in the way of normal development all too often has negative repercussions on self esteem and confidence and emotional or behavioural problems soon follow, complicating diagnosis especially in children. Once past infancy, our interactions with people are increasingly verbal; indeed, some people once out of school hardly read or write at any length. They interact through speech and body language. It hardly needs to be stressed that if our verbal messages are not received and understood, we can become isolated from our fellows or overly dependent on interpreters.
Both children and adults can then lack self confidence, and sometimes, fail to achieve the success that brings financial and social comfort. The tongue tie picture is seen to cause many more side effects than those expected, some problems being more or less important than others. These little known side effects of tongue tie can and do occur, and contribute both to a poor prognosis in therapy, and to a long term reduction in the quality of life of the patient. Consequences of Untreated Tongue Tie. Introduction The consequences of an untreated tongue tie can be many and varied, depending largely on the age of the subject and the severity of the condition.
For Infants Inability to breastfeed successfully in the presence of a tongue tie can cause a variety of challenges for the infant, the mother and the family. For the baby, these may include: Impact on milk supply Termination of breastfeeding The baby failing to thrive Poor bonding between baby and mother Sleep deprivation Problems with introducing solids The maternal experience of breastfeeding a tongue-tied baby may include: Pain Nipple damage, bleeding, blanching or distortion of the nipples Mastitis, nipple thrush or blocked ducts Severe pain with latch or losing latch Sleep deprivation caused by the baby being unsettled Depression or a sense of failure For Children Children with a tongue tie have to contend with difficulties which may only be discovered as they grow older.
The specific challenges an adult with a tongue tie may face include: Inability to open the mouth widely affects speech and eating habits. Multiple effects in work situations. Effects on social situations, eating out, kissing, relationships Dental health, a tendency to have inflamed gums, and increased need for fillings and extractions Sensitivity about personal appearance Emotional factors resulting in rising levels of stress Tongue tie in the elderly often makes it difficult to keep a denture in place.
More on Side Effects The following sections provide more information on some of the little understood side effects of tongue tie. Cosmetic Appearance On first observing a neonate with tongue tie, the cosmetic appearance of the tongue and the tie will stand out. Read more under Breastfeeding… Bottle Feeding Bottle feeding is often commenced when there is a tongue tie — whether with expressed breast milk or formula.
Bottle feeding may sometimes have a negative impact on dental health. Eating Difficulties Difficulties can also be experienced when attempting to introduce solids. When the tongue is resting in the correct position, it shapes the maxilla upper jaw and guides the growth of the face. The tongue also provides an internal support system for the upper jaw.
This causes the palate to develop smaller and narrower, and the teeth to grow in crooked. Also, the mandible lower jaw is often smaller and set back, and the airway is restricted. Because of this, children who grow into adults without having their tongue tie treated often experience a range of oral myofunctional symptoms including:. Tongue ties are just one of many conditions caused by this mutation. Breastfeeding is one of the first ways a tongue tie can be noticed. When mothers have trouble breastfeeding, a tongue tie can often be to blame.
However, if babies are bottle fed, or meet weight-gain and growth markers, the tongue tie can be missed or overlooked. Many times, a nurse or lactation consultant will notice a tongue tie but not recommend a release because the baby is gaining weight.
From a myofunctional perspective, the tongue tie still needs to be released so that proper oral development can take place. However, as I explained above, it comes down to much more than speech — growth and development of the jaws and teeth will be impacted by a tongue tie.
In most cases, tongue ties are treated with a minor surgical procedure to release the tie.
This procedure is called a frenectomy but is also known as a frenotomy or frenulectomy. The frenectomy is a simple procedure that only takes a few minutes. This helps prepare for the procedure by strengthening the muscles of the tongue. After the frenectomy, caring for the wound is also critical. So I meet with my patients immediately following the release to guide them through caring for the wound, and to teach them new gentle exercises. This allows the tissues to heal without reattaching and affecting the end result.
Think of it like this — if your arm had been in a sling for a year, and you removed the sling one morning, your arm muscles would be weak and uncoordinated. In this case, the tongue has literally been tied down.
Tell Me About Tongue Ties! | Breastfeeding USA
Some babies may need a frenotomy. This is where the frenulum causing the tongue-tie is released in a minor operation. A trained healthcare professional performs the frenotomy procedure. It's usually done without an anaesthetic, although a local anaesthetic is sometimes used. Your baby will be swaddled in a blanket and supported at the shoulders to stabilise the head.
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The tongue-tie is then divided by scissors. There should be little or no blood loss. You can continue breastfeeding immediately. It is important that both you and your baby are checked on after the procedure. Skilled breastfeeding information and support is essential following a frenotomy. Friends of Breastfeeding provide social support at their Mum2Mum groups. Advice on getting started and local support with specific queries answered by our breastfeeding experts.