Tongue-Tie Assessment & Treatment in Sandgate
A tongue-tie is more than simply a piece of tissue that looks short or tight.
The term ankyloglossia is used when the lingual frenum underneath the tongue restricts tongue movement and causes a genuine functional limitation.
Many children and adults have a prominent or tight-looking frenum without experiencing any problem at all.
At Dental Seasons, assessment focuses on function first.
Treatment is only considered when there is a clear structural restriction associated with a meaningful functional concern and when the expected benefit justifies intervention.
Children and adults welcome.
A visible or tight-looking frenum does not automatically mean treatment is required.
Tongue-tie surgery carries risks and does not guarantee improvement in feeding, speech or another functional concern. Assessment and treatment should be based on the individual patient’s current function rather than concerns about possible future problems.
What is a tongue-tie?
A band of tissue called the lingual frenum connects the underside of the tongue to the floor of the mouth.
Everyone has this tissue.
A tongue-tie, also known as ankyloglossia, is present when the frenum restricts tongue movement enough to cause a functional limitation.
This distinction matters.
A frenum can look prominent, short or tight while the tongue still functions normally.
In that situation, its appearance alone is not considered sufficient reason for surgical treatment.
Assessment therefore looks at what the tongue can and cannot do, not simply what the tissue looks like.
When might a tongue-tie assessment be useful?
Feeding concerns in babies
A restrictive lingual frenum can occur alongside breastfeeding difficulties in some babies.
However, feeding problems have many possible causes and need a broader feeding assessment rather than diagnosis based on appearance alone.
Speech concerns in children
Some tongue movements are involved in speech production.
If a child has speech difficulties, assessment by a speech pathologist is important because tongue-tie is not the only possible explanation and the relationship between tongue-tie and speech problems is not always clear.
Restricted tongue movement
An older child or adult may notice difficulty with particular tongue movements or functions.
The restriction should be assessed objectively rather than judged solely by how the frenum appears.
Oral or dental concerns
In selected patients, tongue or frenum anatomy may be relevant to dental, periodontal or orthodontic care.
The significance depends on the individual clinical findings.
A visible tongue-tie does not automatically need treatment
This is one of the most important things to understand about tongue-tie. The appearance of the lingual frenum alone does not determine whether someone has a problem requiring treatment.
If tongue movement is functionally normal and there are no relevant symptoms, surgical release is generally not recommended simply to prevent hypothetical problems later in life.
Assessment should establish whether there is a genuine restriction, what function is affected, whether another condition could explain the problem, whether non-surgical management has been considered, and whether treatment is likely to provide a meaningful benefit.
Sometimes the appropriate result of an assessment is no treatment at all.
How is tongue-tie assessed?
A tongue-tie assessment should include more than looking underneath the tongue.
Depending on age and the reason for assessment, we consider:
Medical and dental history
We ask what prompted the concern and whether there are current feeding, speech, oral or dental difficulties.
Tongue movement and function
The tongue is assessed for movement and relevant functional limitations.
Appearance is considered together with function rather than in isolation.
The problem being attributed to the tongue-tie
If the concern involves feeding, speech or another area outside routine dental assessment, input from the appropriate healthcare professional is important.
Alternative explanations
Symptoms should not automatically be attributed to the lingual frenum.
Other dental, medical, developmental or functional causes may need to be considered before treatment is recommended.
Tongue-tie and breastfeeding
Tongue-tie can be associated with breastfeeding difficulties in some babies, but not every feeding problem is caused by a tongue-tie.
Concerns may include difficulty attaching to the breast, repeatedly losing attachment, clicking during feeding, poor milk transfer or maternal nipple pain.
Before surgical treatment is considered, feeding should be properly assessed.
This may involve support from a midwife, child health professional or International Board Certified Lactation Consultant.
Strategies involving positioning, attachment, feeding technique and milk supply may resolve the difficulty without surgery.
If significant feeding problems continue and a restrictive lingual frenum is confirmed as contributing to the functional problem, surgical treatment may then be considered by an appropriately trained health professional.
Dental Seasons does not assume that every baby with feeding difficulties needs a tongue-tie release.
Tongue-tie and speech
Parents sometimes worry that a tight-looking frenum will cause future speech problems.
Current evidence does not allow us to reliably predict future speech difficulties simply from the appearance of the lingual frenum.
If a child already has speech concerns, assessment by a speech pathologist can help identify which speech sounds or movements are affected and whether tongue restriction appears relevant.
Speech therapy may be appropriate regardless of whether a tongue-tie is present.
Surgical treatment should not be performed in a symptom-free young child solely because of concern that speech problems might develop later.
Tongue-tie in older children and adults
Older children and adults may sometimes seek assessment because they feel that tongue movement is restricted or because another healthcare professional has raised the possibility of ankyloglossia.
Assessment focuses on the actual functional limitation.
Surgical treatment in adults is elective.
Where treatment is considered, the potential benefit needs to be weighed against the risks and alternatives.
The presence of a tight frenum on its own is not enough reason to recommend surgery.
How is tongue-tie treated?
Treatment depends on what function is affected.
For many patients, non-surgical management or simply monitoring is appropriate.
Where there is a confirmed structural restriction causing a meaningful functional problem and conservative management has not adequately addressed it, surgical release may be considered.
Procedures may be described as:
- Frenotomy
- Frenectomy
- Frenuloplasty
The terminology and technique vary according to the amount of tissue involved, age of the patient and clinical circumstances.
The objective is to improve function, not simply to make the frenum look different.
Laser tongue-tie treatment
Tongue-tie procedures can be performed using different surgical techniques.
For suitable older children or adults, a dental laser may be one option.
Dental Seasons has a Fotona LightWalker laser available at our Sandgate clinic.
Using a laser does not mean treatment is automatically necessary or that the outcome will be better than another surgical technique.
The decision to perform surgery comes first.
The surgical method is then selected according to the patient’s age, anatomy, clinical requirements and the treating practitioner’s judgement.
Tongue-tie care can involve more than one health professional
The problem that brings someone for a tongue-tie assessment may involve feeding, speech, dentistry or another area of health.
Depending on the concern, appropriate care may involve professionals such as:
- A GP or paediatrician
- A lactation consultant
- A child and family health professional
- A speech pathologist
- A dentist
- An ENT specialist
- Another appropriately trained medical or dental practitioner
Working with the relevant professional helps ensure that treatment addresses the actual functional problem rather than assuming the lingual frenum is responsible for every symptom.
What tongue-tie treatment cannot promise
Tongue-tie treatment should not be presented as a solution for a wide range of unrelated health concerns.
Current evidence does not support claiming that release of a tongue-tie will reliably prevent or treat conditions such as:
- Sleep-disordered breathing
- Obstructive sleep apnoea
- Reflux
- Colic
- Future orthodontic problems
- Future speech difficulties in a child with normal current function
- Difficulty transitioning to solid food
These concerns require their own appropriate assessment.
Surgery should be recommended for an established functional problem, not because of speculative future benefits.
What about a lip-tie?
The labial frenum is the tissue connecting the inside of the lip to the gum.
Like the lingual frenum, its appearance varies considerably between people.
A prominent upper lip frenum in a baby or young child does not automatically indicate disease or require surgical treatment.
Current evidence does not support routine release of the lip or cheek frena in infants to improve breastfeeding, prevent speech problems or prevent future orthodontic concerns.
If there is a specific dental or periodontal reason to assess a labial frenum, treatment can be considered according to the individual clinical findings.
What are the risks of tongue-tie surgery?
Although tongue-tie release can appear to be a small procedure, it is still surgery.
Potential complications can include:
- Pain or discomfort
- Bleeding
- Swelling
- Infection
- Ulceration
- Scar tissue
- Restricted movement during healing
- Damage to nearby tissues or salivary ducts
- Changes in sensation
- Oral aversion in some children
- Recurrence or continued restriction
- No improvement in the original functional concern
Rarely, more serious bleeding or airway complications can occur.
The risks differ according to age, anatomy and surgical technique.
These should be discussed before consent is given.
Will tongue-tie surgery definitely improve function?
No.
Surgical release does not guarantee that the original problem will resolve.
The likelihood of benefit depends partly on whether the restrictive frenum is genuinely responsible for the functional difficulty in the first place.
That is why diagnosis, appropriate non-surgical care and input from other relevant health professionals are so important.
If another factor is contributing to the problem, releasing the frenum may not address it.
Does tongue-tie cause sleep or airway problems?
There is currently insufficient evidence to conclude that tongue-tie itself causes sleep-disordered breathing or obstructive sleep apnoea.
Snoring, breathing difficulties during sleep and suspected sleep apnoea should be assessed independently rather than attributed to a tongue-tie.
If there are concerning sleep-related symptoms, medical or sleep assessment may be appropriate.
Tongue-tie assessment in Sandgate
Dental Seasons is located at 119A Brighton Road, Sandgate QLD 4017.
Dr Andrew Bachour has undertaken further education in the assessment and management of oral frena and can assess selected tongue-tie concerns in children and adults.
We do not describe tongue-tie care as a dental specialty.
Where the concern is primarily related to infant feeding, speech, ENT issues or another area outside dental care, input from the appropriate healthcare professional may be recommended before treatment.
Tongue-tie questions
What is a tongue-tie?
Tongue-tie, or ankyloglossia, occurs when the lingual frenum underneath the tongue restricts tongue movement and causes a functional limitation. It is not diagnosed from appearance alone.
Does every tight-looking tongue need treatment?
No. If tongue function is normal and there is no relevant functional problem, surgical treatment is generally not recommended.
Can tongue-tie affect breastfeeding?
Tongue-tie can contribute to feeding difficulties in some babies. However, feeding problems have many possible causes and should be assessed comprehensively before surgery is considered.
Should my baby see a lactation consultant first?
When breastfeeding is the main concern, assessment and feeding support from an appropriately qualified professional such as an International Board Certified Lactation Consultant can be an important part of determining what is causing the difficulty.
Does tongue-tie cause speech delay?
The relationship is not straightforward. There is insufficient evidence to predict speech problems from a tight-looking frenum alone. A child with an existing speech concern should be assessed by an appropriate speech professional.
Should a tongue-tie be released early to prevent future problems?
Not simply as a preventive measure. Surgery should be considered because of a current functional limitation, not because a problem might develop in the future.
Can adults have tongue-tie treatment?
Yes, selected adults with an established functional restriction may consider surgical treatment. Treatment in adults is elective and should follow appropriate assessment.
Can a laser be used for a tongue-tie procedure?
Laser surgery is one technique that may be suitable for selected patients. The decision to treat should be made independently of which instrument is used. Read about laser dentistry.
Is laser treatment better than scissors?
The fact that a laser is available does not make surgical treatment more necessary or guarantee a better outcome. Technique should be selected according to the patient’s age, anatomy and clinical requirements.
Can tongue-tie treatment cure snoring or sleep apnoea?
Current evidence is insufficient to conclude that tongue-tie causes sleep-disordered breathing or that releasing it treats obstructive sleep apnoea. Sleep-related breathing concerns require appropriate medical assessment.
Concerned about a possible tongue-tie?
If you or your child has been told there may be a tongue-tie, the first step is determining whether there is an actual restriction in function. Book an assessment at Dental Seasons and we can examine the oral structures, discuss the concern and explain whether monitoring, input from another health professional or treatment may be appropriate.
Function first, treatment second
Tongue-tie care should begin with understanding the problem the patient is actually experiencing.
Our approach is to assess function, consider non-surgical options and involve other healthcare professionals where appropriate before recommending surgical treatment.
