Tongue-Tie Definition, Reason, Symptoms, Treatment & Prevention
Definition
Tongue-tie or ankyloglossia is a medical term used to describe a congenital abnormality of the mouth area. The disorder in question is due to the abnormal characteristics of the frenulum of the tongue (fold under the tongue) which limits the movement of the tip of the tongue. The tongue plays an important role in the functions of speech and swallowing. Therefore, this condition can interfere with the function of the tongue.
According to several studies, the incidence rate of this condition varies quite a bit, which is between 0.02% and 5%. In children with various congenital anomalies, such as Opitz Syndrome, orofaciodigital syndrome, Beckwith-Wiedemann Syndrome, Simpson-Golabi-Behmel syndrome, and X-linked cleft palate, there is an increased frequency of ankyloglossia. However, this condition is more common in people without congenital abnormalities or diseases.
Tongue-Tie Symptoms
There are several signs or symptoms of tongue-tie that commonly occur, namely:
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Breastfeeding difficulties
Tongue-tie can make it difficult for the baby to breastfeed. These difficulties include ineffective or ineffective latching (the position of the baby when attached to the mother’s breast for breastfeeding), inadequate milk transfer, and pain in the mother’s nipples. Difficulty in breastfeeding can cause babies with ankyloglossia to experience delays in weight gain.
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Speech difficulties
In toddlers with ankyloglossia, articulation difficulties can be found. This is often noticed when children are around three years old, especially for the pronunciation of words that contain the letters l, r, t, d, n, th, sh, and z. Evaluation should be done if a three-year-old child, more than half of his speech cannot be understood by people outside the family environment.
The presence of ankyloglossia can also cause social problems in children, for example difficulty expressing themselves so that children tend to close themselves off, ridiculed because of difficulty speaking, and the like. In addition, this situation can cause problems with oral hygiene.
Tongue-Tie Reason
The condition of tongue-tie is caused by an abnormality during the formation of the fetus in the womb (a congenital abnormality). The frenulum of the tongue will separate before the fetus is born and result in free movement of the tongue.
In someone with a tongue tie, this does not happen because the frenulum remains attached to the base of the tongue. However, the exact cause of this disorder is not known.
Diagnosis
To confirm the diagnosis of tongue-tie, a direct examination by a doctor is needed. The presence of some specific symptoms, such as difficulty feeding or difficulty speaking, may raise the suspicion of ankyloglossia.
Some of the characteristics of the tongue that has normal movement are that the tip of the tongue can protrude from the mouth, without indenting and the tip of the tongue can sweep the upper and lower lip area easily. Meanwhile, the following characteristics describe abnormal tongue movements that have the potential to cause speech disorders:
- V-shaped indentation at the tip of the tongue
- inability to protrude the tongue past the upper gums
- inability of the tongue to touch the roof of the mouth
- difficulty moving the tongue to the right and left
The term free-tongue is used to describe the length of the tongue from the insertion of the frenulum of the tongue at the base of the tongue to the tip of the tongue. The normal and clinically accepted size for free-tongue length is more than 16 millimeters.
Ankyloglossia can be divided into four categories, namely:
- class I – mild ankyloglossia; 12– 16 millimeters
- class II – moderate ankyloglossia; 8– 10 millimeters
- class III – severe ankyloglossia; 3– 7 millimeters
- class IV – complete ankyloglossia; less than 3 millimeters
Tongue-Tie Treatment
In babies without breastfeeding difficulties, treatment of tongue-tie or ankyloglossia can be delayed while observing the baby. During the growth period, at the age of 6 months to 6 years, the frenulum of the tongue can shrink so that it can improve symptoms without special treatment.
However, if there are breastfeeding or feeding problems, speech problems, or social problems, surgical treatment should be considered. Action options that can be taken are:
- Frenotomy: cutting of the frenulum
- Frenectomy: cutting and removal of the entire frenulum
- Frenuloplasty: several methods to remove the tongue tie and correct the anatomical condition
There has not been sufficient evidence in the literature as to which procedure is the best of the three.
