Tongue tie, medically known as ankyloglossia, is a relatively common condition in newborns that can cause concern among parents. In essence, it refers to a shorter-than-normal membrane (the lingual frenulum) connecting the tongue to the floor of the mouth, restricting its movement. 

While this condition may not always be serious, it can have significant impacts on a baby’s ability to breastfeed, develop proper speech, and even swallow effectively. 

One of the most pressing questions new parents often ask is, “Should we consider surgery, and when is the right time?”

At the Tongue Tie Institute, part of Upbeat Pediatric Dentistry, we understand how overwhelming this decision can be. Below, we explore the signs of tongue tie, its potential impacts, and the important considerations when deciding whether to proceed with surgery.

Recognizing the Signs of Tongue Tie in Babies

Identifying tongue tie early can help determine if intervention is necessary. Some of the most common signs include:

Difficulty Breastfeeding

Babies with tongue tie often struggle to latch correctly during breastfeeding. This is because the restricted tongue movement prevents the baby from sucking effectively, leading to poor weight gain, extended feeding times, and frustration for both mother and baby. In many cases, this can result in the baby not getting enough milk and experiencing slower weight gain than expected.

Discomfort or Pain During Breastfeeding

When the baby’s latch is compromised due to tongue tie, mothers may experience significant pain, discomfort, or even nipple damage during breastfeeding. Cracked or injured nipples, along with insufficient milk transfer, are often indicators that tongue tie might be contributing to these issues.

Swallowing and Chewing Issues

As the child grows, tongue tie can affect the development of proper chewing and swallowing habits. The inability to move the tongue freely can cause difficulties in managing food, potentially leading to orthodontic issues or bad habits in the future.

Speech Development Challenges

Tongue tie can interfere with the correct pronunciation of certain sounds, such as “s” and “x.” While not all speech problems are linked to ankyloglossia, compromised tongue movement can lead to articulation issues as the child learns to speak. In severe cases, a child may require speech therapy or surgical correction to improve their speech.

Solutions for Tongue Tie

Historically, the primary method for addressing tongue tie was through a surgical procedure called frenotomy or frenectomy, which involved cutting the frenulum with scissors or a scalpel. While this approach is effective, it can be associated with more discomfort, longer recovery times, and a higher risk of complications like infection and excessive bleeding.

Laser frenectomy, on the other hand, is a cutting-edge alternative that has revolutionized the treatment of tongue tie. It employs a highly focused laser beam to precisely and painlessly release the tight lingual frenulum. 

When Should Surgery Be Considered?

The decision to operate on a baby with tongue tie is not straightforward, and it’s essential to approach it thoughtfully with the help of a multidisciplinary team of health professionals. Many factors influence the decision, and parents often wonder if early surgery is truly necessary. Below are some important considerations:

Breastfeeding Difficulties

If your baby is persistently struggling to latch, not gaining weight, or causing significant pain during breastfeeding, surgery may be recommended. However, it’s important to first explore non-invasive measures, such as working with a lactation consultant or trying alternative breastfeeding techniques. Surgery is typically considered when these measures do not provide sufficient improvement.

Speech Impairment

For older babies or toddlers, if tongue tie is leading to notable speech delays or difficulty pronouncing certain sounds, surgery may be necessary. However, speech development varies, and some children with tongue tie may not have any speech problems at all. This is where a pediatric dentist or speech therapist can offer valuable insights into whether surgery is appropriate based on the severity of the condition.

The Importance of a Multidisciplinary Approach

Deciding whether to opt for surgery should never be made based solely on initial screening (such as the neonatal “tongue test”). Instead, it’s critical to have close follow-up with a team of professionals that may include a pediatrician, lactation consultant, pediatric dentist, and other specialists. This team can provide valuable insights into your baby’s oral and overall health and help determine the best course of action.

Pediatric Dentist: A pediatric dentist can assess the oral anatomy and determine if the tongue tie is likely to cause future dental or speech issues.

Lactation Consultant: They can help identify breastfeeding challenges and work on improving latch and feeding without surgery, when possible.

Speech Therapist: For older children, a speech therapist can assess if tongue tie is contributing to speech development delays and whether surgery may benefit the child.

What If Surgery Isn’t the Right Option?

If surgery isn’t recommended or if parents prefer to wait, there are still ways to manage the effects of tongue tie. Non-invasive approaches, such as using different breastfeeding techniques, regular monitoring by health professionals, and speech therapy for older children, can all help mitigate some of the challenges caused by tongue tie.

In many cases, a baby’s feeding, speech, and development can improve with the proper suppor. However, close follow-up and regular check-ups are crucial to ensure that the tongue tie doesn’t cause future problems.

Making the Right Decision for Your Baby

Ultimately, deciding whether to operate on a baby with tongue tie is a deeply personal decision that requires careful consideration. 

At the Tongue Tie Institute, we believe that every baby is unique, and the decision to proceed with surgery should be made after a comprehensive evaluation by a team of professionals. Whether you opt for surgery or prefer to wait, we are here to support you and your baby every step of the way, ensuring that you have the information and guidance needed to make the best decision for your child’s health and well-being.

If you suspect your baby has tongue tie and would like to discuss treatment options, contact our team for a consultation. Together, we’ll create a personalized plan to support your baby’s healthy growth and development.