Watching television has forever been changed. Even walking down a busy street or through a mall is bothersome. The woman on the bench finally resting while her baby sleeps with an open mouth in the stroller next to her prompts an uninvited internal assessment. Sleep disorder breathing, airway centered disorders, and tongue ties are everywhere since I joined the airway focused healthcare community.
It’s so common that you can easily identify someone in your life who “suffers” from an airway disorder. Suffers, sits inside quotes because while there are many people who could use treatment, there are many more who don’t know they do and frankly don’t experience enough symptoms to even bother. Hence, my frustration as my wandering eye scans every mouth for proper function.
It’s growing at an alarmingly high rate in notoriety as dental associations are often hosting and offering continuing education courses in airway centered disorders. The fastest growing portion of the airway focused healthcare community to grow, without a doubt, are the amount of tongue tie release providers. More babies, children and adults are being treated than ever before. Dental offices are incorporating tongue frenum assessments into their evaluations and subsequently treating the ties with a minor surgery in office.
Almost as fast as the “trend” or “fad” of diagnosing and releasing tethered oral tissues has grown, the counter articles and denials of necessity have grown too. It’s incredibly confusing for a frustrated person who may have been told that either they or their child are tied having to navigate through the conflicting views and get to the truth of the diagnosis.
As a myofunctional therapist, who has experienced many ends of the airway community, released the tie of my own child, and spent thousands to educate myself in many facets of addressing the issue, allow me to end the confusion.
Where is the research for necessity?
The biggest burden to overcome is the lack of cohesive classification, education, and research. Tongue ties, in and of themselves, are not new. Releases have been done for decades and can be dated well back into the 17th century.
There are assessment tools and classifications that were created by leaders in the field. However, clinical accuracy in classification varies widely. Interpretation is a tricky thing. Until awareness and research has mounted to a point that warrants definitive assessment criteria and professional collegiate training, make your personal decisions based on the available research.
- Lingual and Maxillary Labial Frenuloplasty as Treatment for Mouth Breathing and Snoring
- Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases
- Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn
- Ankyloglossia (tongue-tie): A diagnostic and treatment quandary
- More on Google Scholar
Why are so many babies getting tongue tie releases?
Breastfeeding issues are often very complex. There’s nothing that people love more than a quick fix. PERIOD. Blaming the issue solely on a tie, subsequently releasing that tie, and hoping it all ends well is the usual approach.
Sadly, that is wrong for numerous reasons. Primarily that the human body is complex. While having a tethered tongue or lip can impact the ability to latch correctly, it may not always.
Birth is a traumatic event. There are strains and traumas that stay with the body and may need to be treated by a bodyworker. This includes, but is not limited to: osteopaths, craniosacral therapists, pediatric physical therapist, pediatric chiropractors, and occupational therapists.
“Osteopathic treatment does not alter the underlying…birth injury factors, but it can be very effective in enhancing the child’s functional capabilities as well as improving general health and quality of life for the child and family.”
Margaret Sorrel, DO, FCA
In addition to possible birth traumas, there is also the possibility of infant reflex, feeding, positional, and developmental issues. Many of these can mimic tongue tie symptoms during breastfeeding. It is important to have the baby assessed for function. AGAIN, for those in the back who may not have read that correctly, It is important to have the baby assessed for function.
Not all lactation consultants, pediatric feeding therapists, or myofunctional specialists have training in tethered oral tissue identification. So simplify your process by asking those questions in advance, or reference my stress-free baby tongue tie plan blog.
Why does my pediatrician say the tongue tie does not exist?
A well worded answer to this complex question is in another blog post that you can access by clicking here. Short version is that they are not trained on oral function, development, or tethered oral tissues in medical school. If they spent 8 years working towards their medical degree, and more after in residency and never encountered a tongue tie, then it simply doesn’t exist.
Also, there are two types of ties, anterior (a.k.a. the obvious you can’t lift or stick out your tongue type) and posterior (a.k.a. the black sheep of ties). Obvious ties are easy to see when you are paying attention. The tongue is attached usually right at the tip very tightly to the floor of the mouth or to the gums behind the lower front teeth. Believe it or not, when the doctor asks the child to say “ah” they are looking at the throat and bypass the oral cavity altogether.
Dentistry is a specialty. There are specialists that your pediatric doctor would refer you to when they do not have enough experience or education to treat or diagnose (i.e. cardiologist, urologist, gynecologist, etc). Likewise, ideally a referral should be given to an oral function specialist such as a dental provider or feeding therapist; opposed to stating it’s a fad or doesn’t exist.
Why would I release a tongue tie when there are no speech problems?
Prevention. Similarly to why you vaccinate or get cleanings at a dental office. Tongue ties prevent proper function of the tongue. The tongue has 8 muscles that innervate it and several cranial nerves attached to it’s function. When that fails, the body compensates and finds ways to function in spite of the restriction.
These compensations are responsible for strains, pains, development problems, and dysfunction. So the speech may not be directly impacted, but feeding, sleep, and breathing might.
Why are dentist releasing, shouldn’t I see an ENT or Oral Surgeon?
A small sect of the laser releasing dentists are in it for the money. You can easily identify them because they will release your tie with no thoughts about whether you have proper function or functional ability. Trust me, as a hygienist it is common to temp or work in multiple practices. I have been around central New Jersey and know it is happening in an unethical manner in some offices.
There are dental providers that have been releasing ties for years and are at the forefront or the industry in skill, research, and knowledge. They are identified by an out-of-date preferred provider list on social media, or word of mouth. They all have a team of people they refer to, and have criteria that must be in place prior to releasing.
Outside of personal wishes to have a release performed under general anesthesia or sedation, you can trust a dentist to perform your surgery. I always recommend interviewing providers prior to choosing.
What happens if I don’t release my tongue tie?
Should you be informed that you have a tongue tie by a healthcare professional, hopefully it was accompanied by assessment and screening for associated symptoms. If not, then do as much research as possible about links between ties and health problems.
Worst case scenario, you are aware of the possibilities, risk and accept the consequences that may come. Best case scenario, you face little to no noticeable repercussions of not releasing.
Best further reading:
Tongue Tied by Dr. Richard Baxter
Airway Matters 
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