Lip and Tongue Tie

Have you ever had a hard time getting the words out that you want to speak? Have you ever felt that your tongue won’t make the words and sounds that you want?

Some may joke that they get tongue tied when this happens….. Well they may not be completely wrong!

Unfortunately, the condition of lip and tongue tie is often not properly diagnosed and treated due to lack of education and information. Even Dr. Funke didn’t know what he didn’t know until he learned more! If you want to learn more about lip and tongue ties than this is the blog for you!

What is a Lip and Tongue Tie?

Lip and tongue tie, also known as tethered oral tissues, occurs when muscle attachments of the lip and tongue prevent proper movement and function. These attachments are normal anatomy. The problem occurs when it prevents proper movement and function of the tongue and lip leading to common, but not normal, symptoms. Lip and tongue tie disfunction is relatively common and as many as one in five people have a lip or tongue tie that could benefit from treatment! The condition often runs in families and has been shown to have a genetic component.

How are lip and tongue ties diagnosed?

Most healthcare providers are not adequately trained and educated to not only diagnose but also treat lip and tongue ties. Often, we will hear families state that they were told by their other providers that “there is no lip or tongue tie”. The other provider believes that diagnosis is based only on appearance and weight gain. If the tongue tie is not to the tip or the tongue or baby is gaining weight then there is no need for treatment. Posterior tongue ties often go undiagnosed because they are not easily seen, yet they can cause many of the same symptoms of anterior and “to the tip” ties.

Lip and tongue tie disfunction can present as a number of symptoms. Although many of these are common, they are not normal! These symptoms can often lead to a challenging relationship with the mother-infant bond, eating challenges, speech challenges, breathing challenges, sleep challenges, growth challenges (orthodontic and skeletal problems), and social struggles. Disfunction of the lip and tongue can lead to long lasting complications.

What early developmental problems can lip and tongue ties cause?

Lip and tongue tie problems can often present as early as in utero! Frequent fetal hiccupping is often one of the first symptoms associated with a tongue tie issue!

Some other early development symptoms of an infant may include:

• Shallow/painful latch
• Falls asleep while eating
• Colic symptoms/cries a lot
  Reflux symptoms (it is not normal to have a child on acid reflux medications)
• Clicking or smacking noises while eating
• Spits up often leading to nasal congestion and breathing difficulty
• Hiccups often
• Gassy
• Lip curls under when nursing or bottle feeding
• Snoring/noisy sleeping
• Head, neck, body tension
• Blisters on lips

New mothers may also have struggles with nursing their babies. You may hear the old wife’s tale of needing to “toughen up” or that “pain is normal”. This is NOT TRUE!! It should not hurt to nurse your baby! That makes no sense in our development and ability to carrying on our species!

Some other common and NOT normal symptoms for mothers may include:

• Creased, flattened or blanched nipples
• Blistered, cut, bleeding nipples
• Poor or incomplete breast drainage
• Need for nipple shield while nursing
• Baby prefers one side over the other (likely caused by torticollis with baby)

Mothers may be told to supplement with formula for some of these symptoms or to give medication to mask some of the other symptoms. Again, this makes no sense in the development of our species! There was no such thing as formula as early as one hundred years ago and the thought of passing pills to an infant is absurd!

We made it past the infant stage. Are we in the clear as far as lip and tongue tie problems?

The easy and short answer is NO.

Lip and tongue tie problems can cause later developmental problems and issues in children that can last into adulthood. Some symptoms in children may include:

• Speech difficulties (mumbling, stuttering, hard to understand, difficulty speaking quickly, in speech therapy, etc.)
• Feeding difficulties (grazes, packing food in cheeks, choking or gagging, spits out food, slow eater, etc.)
• Sleep issues (sleeps in strange positions, wakes easily, grinds teeth, sleeps with mouth open, snores, etc.)
• Neck or shoulder pain/tension
• TMJ pain/headaches
• Reflux/GI issues
• Hyperactivity/inattention (ADHD)
• Orthodontic and growth problems

What are the lifelong effects of lip and tongue ties?

Lip and tongue ties can have lasting results into adulthood and beyond. The muscle restrictions can lead to growth and development problems leading to:

• head and neck tension
• TMJ and TMD problems
• sleep problems
• body tension
• GERD – tooth erosion
• GI issues
• Bite issues
• Clenching/grinding – broken teeth

How is lip and tongue tie treated?

After a proper diagnosis, there is a proper treatment. Dr. Funke treats things a little differently than a pediatrician or ENT would treat lip and tongue tie. Pediatricians and ENTs will often times use a scissors or scalpel to complete the release. The problems with this method is that there is often more bleeding and difficulty making sure that all of the offending tissues have been removed. If there are remaining tissues there will be remaining symptoms and the surgery will be unsuccessful.

In Rochester, MN Dr. Funke treats lip and tongue tie with a CO2 laser. The benefits of the laser are that it is efficient (shorter surgical time), does not penetrate deep into the tissue, and there is less bleeding allowing for better visualization and removal of offending tissues.

Does treatment of lip and tongue tie hurt?

In infants that area is numbed with topical anesthetic that is safe for babies. Adults are treated with topical anesthetic and a small amount of local anesthesia.

Pain and discomfort usually peeks around the second and third day after treatment. This can be managed with Tylenol and ibuprofen. It is often described as a pizza burn or getting hit in the face with a ball.

Are there things that need to be done before or after treatment for lip and tongue tie?

The biggest commitment with lip and tongue tie is the stretches and exercises involved. Stretching is extremely important and must be done 4-6 times per day for four weeks.

It is best to have chiropractic adjustments before and after treatment for musculoskeletal alignment. Myofunctional therapy is also recommended for adult lip and tongue tie treatment.

How soon can you expect results after treatment of lip and tongue tie?

Many times there are immediate relief of symptoms after treatment. Other times it may take some time. Typically any positive results are seen in the first six weeks after treatment has been completed.

Does insurance cover lip and tongue tie treatment?

Every insurance policy is going to be a little different. We have found that most dental insurance offer limited benefits. Our patients have had much better luck submitting to their health insurance. We are happy to provide the necessary paperwork and documentation to get the most out of your insurance benefits.

Is my child or am I candidate for lip and tongue tie treatment?

This is a great question! If you want to learn more please give our office a call to setup your consultation!

There is hope!