The frenulum of the tongue is a thin band of mucosal tissue that connects the underside of the tongue to the floor of the mouth. The frenulum serves to anchor the tongue to the rest of the mouth and aids in the activities of speech, eating, and swallowing.
Sometimes, unfortunately, the frenulum can be abnormally attached. Ankyloglossia, more commonly known as a tongue-tie, is a benign, congenital medical condition that occurs when the frenulum is abnormally short or attaches near the tip of the tongue, severely limiting the movement of the tongue.
Examination of the mouth and frenulum is part of the newborn examination, since a tongue tie will most commonly present in newborns as difficulty feeding. Newborns with a tongue tie commonly experience difficulty with breastfeeding, since the restricted movement of the tongue cannot create the effective latch and suction needed for successfully breastfeeding. Ineffective breastfeeding can lead to poor weight gain and failure to thrive in severe cases. Other side effects of a tongue tie include potential speech issues and difficulty eating solid foods, among others.
Treatment for ankyloglossia
Treatment for a tongue tie depends on both the examination and symptoms that the patient is experiencing. Most commonly, patients with mild cases can be treated with observation and watchful waiting, since the condition will likely resolve as the newborn grows. In patients who experience more severe symptoms, mainly difficulty with breastfeeding or failure to thrive, a procedure may be necessary to increase the movement of the tongue. This is called a frenulotomy, frenuloplasty, or frenulectomy and can be performed in the clinic most of the time.