You may have heard about the trend in tongue-tie releases in newborns. The term tongue-tie has only recently reached widespread awareness. It’s important due to the tongue’s crucial role in newborns to breastfeed properly.
Many parents have questions about tongue tie in newborns and healthy teeth.
Are tongue-ties fact or fallacy? Do your kids have a tongue-tie? If they do, will they affect my kid’s teeth? Most of the information about tongue-tie is conflicting so it can be a confusing topic.
The number of children born with a tongue tie or short lingual frenum isn’t agreed on. Numbers are variable because the condition doesn’t have a precise definition. The prevalence ranges between 1/10 to 1/100 births. Wide variation in numbers may be due to a lack of standard diagnoses procedure.
Many tongue-ties may also go unnoticed. Checking under the tongue is part of any dental exam. Until recently, however, many health professionals are still unaware of tongue-ties.
In the US tongue-ties may occur at between 4%-10% of newborns.
In 2013, 15,000 babies were born in the UK with tongue-tie. And across Europe numbers are estimated at 10% of births.
Should you be worried about tongue-tie in your kids? Is tongue tie a birth defect?
In this article, I’ll outline the current understanding of tongue-tie.
What does it mean when a baby is tongue-tied?
There are a few different names for oral restrictions which can be confusing:
- Tongue-tie
- Short lingual frenum
- Short lingual frenulum
- Ankyloglossia
The lingual frenum is the name for the tag of skin under the tongue. It’s generally classed as part of the normal anatomy of the mouth. A short lingual frenum is one which extends up closer to the tip of the tongue. It’s referred to as a tongue-tie.
A tongue-tie is considered an oral restriction due to the restraint of normal movement of the tongue. Oral restrictions can also occur on the inside of the upper and lower lips (labial frenum). Tongue ties are classed on the severity and are graded by a variety of systems.
What causes a baby to be tongue tied?
The cause of tongue tie is currently considered as ‘unknown.’ In the next article in this series I’ll outline why, in my opinion, tongue tie is a problem with prenatal nutrition.
Tongue tie shows some very similar traits to spina bifida and cleft palate. We will use research in these areas to understand why nutrients play a role in tongue tie in newborns.
Is a tongue tie genetic or hereditary?
There is evidence to suggest that certain gene mutations can increase the risk of tongue tie.
But the condition is dictated by more factors than simply one gene.
Is tongue tie known as a birth defect?
The American Academy of Pediatric Dentistry defines tongue tie it a ‘congenital anomaly.’ The common term is birth defect.
Tongue tie is more often referred to a ‘condition’ present at birth, rather than a birth defect.
It should be clear that a short lingual frenum isn’t the normal anatomy of the jaw and mouth.
Most birth defects occur in the first three months of pregnancy. The lingual frenum should disappear about at the 12-13th week in-utero, but earlier factors may influence its persistence.
How the tongue develops in-utero
To understand tongue-tie let’s look at how a baby’s tongue develops in the womb.
A growing human embryo uses different ‘core’ tissues that form the many parts of the body.
The tongue has a unique development process. It’s the only part of the body that forms from five different core tissues – called embryonic arches.
Different parts of the tongue form from several arches of embryonic tissues. In the first four weeks of a newborn’s life, the oral cavity begins to grow. The infant’s head, jawbones, throat, and airways are all mapped out from a tiny lump of cells.
By the fourth week of pregnancy, three parts of tissue appear in the middle of the tiny embryo. They will eventually form the tongue. The first branchial arch forms the front (two-thirds) of the tongue. Two different arches then become the back (one-third) of the tongue.
Between the 5th-10th weeks, these two parts of the tongue continue to grow.
By the 10th-11th week, the front and back of the tongue then fuse together. The fetus now has what resembles a fully grown ‘tongue.’
Creating a moveable functional tongue
The separate front and the back origins of the tongue is important. It allows us to understand the true anatomy and function of the tongue. The back third of the tongue is ‘fixed’ to the throat, while the tip and front two-thirds is free to move.
As the front and back of the tongue fuse, a fibrous flap of skin that connects the front two-thirds to the floor of the mouth remains. It’s left-over from the development process.
For proper movement of the tongue for swallowing and speech, the flap of skin must be released.
By week 13, the final step of tongue development is the removal of the frenulum. Cell death begins at the tip and continues to the base of the tongue. It’s called programmed cell death (apoptosis). It should completely remove the flap of skin under the tongue. The cell death then ‘frees’ the front two-thirds of the tongue from the lower jaw.
If cell death or apoptosis isn’t complete, the frenum or frenulum is left ‘anchored’ to the lower jaw. The flap of skin, depending on how close it is to the tip of the tongue, will restrict movement. It may impact swallowing, speech, feeding, and movement.
That flap of skin is what is known as a tongue-tie or short lingual frenum.
Have your child checked for tongue-tie
If you suspect a short lingual frenum or tongue-tie, you should have them examined. It can signal incomplete ‘release’ of the front portion of the tongue.
As we’ll explore in this series, there are many symptoms of tongue-tie. Some newborns with tongue-tie, don’t display any problems. But many experience significant health issues. The biggest concern is the child not being able to achieve natural tongue posture.
Proper tongue growth and movement are critical to dental function throughout life. It may also prevent braces in kids.
Tongue-tie should be assessed in both kids and adults.
Continue to Part III of this series to explore the cause of tongue-tie – Tongue-tie and Vitamin A Deficiency.
Do you or your kids show the signs of tongue-tie? Share your concerns and experiences below in the comment section.
For more information on Dr. Lin’s clinical protocol that highlights the steps parents can take to prevent dental problems in their children: Click here.
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One Response
My daughter had a tongue-tie when she was born. She couldn’t poke her tongue out as it went into a heart shape. Luckily she had sorted after being admitted into hospital with feeding problems. However she also still has a lip-tie. It goes all the way from her lip and between her top teeth into her palate. As a result, she has a gap between her top front teeth. She is almost 6 and hasn’t lost any teeth yet. I am concerned that this will cause a problem when her next set of teeth grow in. I enquired about getting this cut when she was younger (I’m in the UK so have the National Health Service) but was informed that they wouldn’t do anything unless it significantly affected her speech, which it hasn’t. Should I be looking to get this sorted privately? Thanks.