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Newborns and Tongue Ties – Your Questions Answered

Tongue ties can hinder your newborn’s ability to breastfeed, gain weight and possibly to develop proper speech. During your initial appointment with a pediatric dentist, they will examine your newborn’s tongue for any signs of a tongue tie and discuss your options if one is found. In this post, we will cover some of the basics of tongue ties and also talk about the important role that a pediatric dentist plays in your newborn’s first dental appointment.

What are tongue ties?

Under the tongue is tissue that connects your tongue to the bottom of the mouth. Easily visible when looking in the mirror, this tissue is known as the frenum or lingual frenum and it can pose problems if it is too thick or too short. In these scenarios, the lingual frenum starts to restrict the tongue’s movement and a full range of motion is not possible. This is known as a tongue tie, or ankyloglossia, and it occurs in 4% to 10% of newborn babies. The exact causes of tongue ties in newborns are unknown.

The American Academy of Pediatric Dentistry® classifies ankyloglossia as a ‘developmental anomaly’ of the tongue. If a tongue tie is present, it can restrict the airway, impact the growth of the face and the support of the upper jaw and also may cause teeth to come in crooked. As such, tongue ties must be taken seriously and if you notice any signs that your baby may have a tongue tie, action must be taken to determine the severity of the case.

Diagnosing a tongue tie in your child

Detecting tongue ties early on is important because of the way the tongue impacts overall oral and facial growth for children. Difficulty with speech, breathing, eating and sleeping can all possibly arise if children do not have their tongue ties addressed properly.

It is also important to know that not all tongue ties are easy to spot visually without trained inspection, especially since tongue ties can vary in severity.

A pediatric dentist can assess newborns for tongue ties during their first dentist appointment. This is part of the reason it is important to bring children in for their first checkup before their first birthday. During this initial appointment, the pediatric dentist will assess the child for tongue ties and interview the mother or father about certain signs that the child may have a tongue tie. Some indicators include:

  • Lisp
  • Jaw pain
  • Breathing from the mouth
  • Snoring or sleep apnea
  • The child’s resting face usually has an open mouth
  • Difficulty breastfeeding or latching
  • Difficulty gaining weight
  • Speech problems or slurred words

Tongue ties and breastfeeding

Tongue ties can impact a newborn’s ability to form a proper latch during breastfeeding. Tongue ties also pose problems for new mothers as an ineffective latch can cause nipple pain and general frustration during nursing.

If your baby is fussy around feeding time, cannot seem to hold a latch, and is experiencing weight gain issues, an appointment should be made to ensure that tongue ties are not the cause. While newborns can have trouble nursing for a variety of reasons, tongue ties are important to diagnose because they possibly can be fixed with a simple procedure.

Tongue ties and speech problems

While tongue ties restrict the ability of the tongue to reach its full range of movement, clinical evidence is unclear as to whether speech is always impacted. Many children have tongue ties and do not display signs of a speech issue at all. As such, children who are suspected of having a tongue tie should see a speech therapist for an examination to see if they are impacted negatively by it. Signs of a speech problem include difficulty articulating certain sounds, such as rolling ‘r’ sounds or ‘sh’ and ‘z’ sounds.

It must be emphasized that it is always possible that children can have a tongue tie and also a speech problem at the same time, but no causal relationship exists between the two. Clinical research has been inconclusive on the link between the two and therefore it should be handled on a case by case basis.

What is a frenectomy?

With age, the lingual frenum (the tissue connecting the tongue to the floor of the mouth) may become looser and the tongue tie can correct itself. During the first 4-5 years of a child’s life, there is so much growth in the size and shape of the face and oral cavity that the lingual frenum may change enough to reduce the seriousness of the tongue tie.

However, in some cases, tongue ties will require a direct procedure to correct. A pediatric dentist can evaluate the severity of the tongue tie and provide an opinion on what to do next. Speech pathologists can also diagnose tongue ties by analyzing your child’s speech patterns. Lactation consultants can also provide advice if your child has trouble breastfeeding and a tongue tie is suspected as the cause.

It is possible that these professionals will recommend a frenectomy. This is a simple procedure whereby the lingual frenum is reduced in size by using a scalpel or a laser. This corrective procedure results in little pain, little bleeding and little to no negative post-operative effects such as infection. As such, it is a simple procedure that yields great results for children who may be suffering the effects of a tongue tie. It also has been shown to increase milk intake and generally improve breastfeeding for mother and baby.

The importance of your child’s first dentist appointment

Most parents believe that their child’s first dental appointment is important for examining the teeth, the gums and to look for tooth decay or cavities. However, diagnosing tongue ties is also an important part of this appointment. With so many areas of a newborn’s life and development dependent on breastfeeding, parents should have their baby examined for tongue ties if they notice any common signs during the early months of their child’s life.

Written by: Dr. Dylan Bordonaro, DMD

As a dentist at Junior Smiles Children’s Dentistry®, Dr. Dylan enjoys developing friendly and long-lasting relationships with his patients and with their parents.

Categories: Infants

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