Mewing with a tongue tie is the hottest topic doing circles in the Orthotropic community at the moment.
Today we’re going to discuss this condition that affects more than 10% percent of newborns. It is a condition that occurs by birth and restricts tongue movement while causing speech impediment in some cases.
Today, we’re going to learn about Tongue Tie also known as Ankyloglossia in medical terms and its effects on Mewing.
Table of Contents
What Is A Tongue Tie?
A tongue-tie is a fairly short and tight string of tissue (lingual frenulum) that ties the bottom of the tongue’s tip to the floor of the mouth.
Tongue tie also may interfere while breast-feeding as it restricts the ability of the baby to suck onto something.
Individuals with tongue-tie might have difficulty sticking out their tongue or pushing it up on the palate. Tongue-tie might also affect the way a person eats, speaks and swallows.
In some rare cases, tongue-tie may not cause problems, while some cases may require a simple surgical procedure to treat and correct the tie.
Types of Tongue Tie
Tongue ties are usually of two types, either anterior or posterior. Anterior tongue ties are comparatively easier to locate and identify as they are near the gums when the tongue is raised. A posterior tongue tie is located much deeper underneath the tongue.
There is a grading scale system called ‘Coryllos Ankyloglossia’ for identifying the type of tongue-tie an individual has.
Doctors often use this classification system when referring to tongue ties. Anterior tongue ties are referred to as type I and type II. Posterior tongue ties are referred to as type III and type IV.
- Type I: Here, the frenulum is usually thin and elastic, and connects the ridge behind the lower set of teeth to the tip of the tongue.
- Type II: Here too, the frenulum is fine and elastic, and the tongue is anchored 2 – 4 mm from the tip to the floor of the mouth close to the ridge behind the lower teeth.
- Type III: Here, the frenulum is usually thicker and stiff, and connects the tongue from the middle of underneath the tongue to the floor of the mouth.
- Type IV: Here, the frenulum is posterior or not visible, but when touching the area with the fingertips, the individual or examiner can feel tight fibers anchoring the tongue, i.e. with or without a thick, shiny surface on the floor of the mouth.
When a thorough evaluation is done, it not only considers the Coryllos grade, but also how well an individual’s tongue is able to move.
Another way to assess the tongue’s function and mobility is the Hazelbaker assessment tool for lingual frenulum function (HATLFF).
Tongue Tie Diagnosis | How to check if you have a Tongue Tie?
There are several ways to identify if you have a tongue tie and if there is a need to get it checked by a professional.
Below mentioned are some easy-to-do, at home tests that you can perform on yourself to check if there are any symptoms.
- Take a clean finger and swipe it across the base of your tongue. If it is a smooth transition then you do not have a tongue tie. You should not feel any piece of tissue restricting this movement.
- Stick your tongue straight out, now try to lift the tip independently without moving the rest of the tongue. You should be able to move just the tip without any distress.
- Another way is to open your mouth as wide as you can. Now without closing your mouth, try to touch the tip of your tongue behind your upper front teeth.
- Check if you can comfortably swipe across the outer side of your upper and lower molar teeth.
Tongue Tie in Adults
Adult tongue-ties are very less talked about. There is now a newly born awareness in terms of oral health in young adults. Adult tongue-tie release/treatment can be looked into by dentists, oral surgeons, and ENTs.
While the tongue tie in an adult is similar to that in babies, there are various other underlying conditions that accompany the tongue tie, making it more complex.
We are going to learn about one such case study involving an adult, who is a certified practicing speech pathologist trained in orofacial myofunctional therapy and her tongue tie journey to better understand tongue ties in adults.
Adult Tongue Tie Surgery Before and After
Let’s look into what symptoms Michelle faced before the tongue tie release:
“I had a debilitating lack of energy. It was difficult to get through the work week. It would mean afternoon naps, and craving sugar to give her energy. I was always a bad sleeper. This culminated in a diagnosis of snoring and obstructive sleep apnea. The sleep study showed an AHI (apnea-hypopnea index of 30).
I began CPAP treatment three years ago, of which brought my AHI down to 1-2. But it still didn’t make me feel rested. CPAP helped a little bit, but I was still so tired that I could not entertain the idea of socializing through the week out of fear of losing sleep.
For most of my life, I had chronic neck and back pain. It would focus at a point on the right scapula and spread through the shoulder and thoracic area.
The pain also included my jaw joint. I had TMD which meant my jaw would open to the left and would click on the right 3 times and left 2. I’d wake in the morning with a sore jaw joint and I had chronic migraines.
The morning jaw pain was probably due to my teeth grinding at night. The daily mouth breathing seemed to give me sensitive teeth. I would often have a rush of tooth pain when I would drink cold water. I would go through a stick of lip chap in two weeks, on bad weeks it would be one because my lips were so dry during the day to which I now realize was due to mouth breathing.
In general, my sleep was light. I would wake with acid reflux and the feeling of ‘pressure.’ It would always be a struggle to get back to sleep, and this made a horrible cycle of being scared about being tired, and unable to sleep.
I was seeing a psychologist for anxiety.”
Adult Tongue Tie Myofunctional Therapy
Michelle underwent an 8-week myofunctional therapy program surrounding her laser release.
Myofunctional therapy goals include:
- Nasal Breathing
- Correct Tongue Posture
- Sealed Lips Posture
This therapy includes applying sticky spots to help train the tongue to rest at the roof of the mouth.
After 4 weeks of myofunctional therapy, Michelle reported the following :
“I still found it uncomfortable to hold the correct tongue posture. I was wearing four spots (spot, central, upper, lateral) to encourage tongue posture on the roof of mouth but it was far too tight at the base of tongue and floor of the mouth.”
The following differences were reported:
- Improved nasal breathing while maintaining the correct tongue posture
- Improved sleeping patterns
- Sealed lips throughout the day
- Waking up with the correct tongue posture
Adult Tongue Tie Surgery
Michelle reported the following, 4 weeks after her tongue-tie surgery:
“My sleep length improved straight away. I can now sleep 7 ½ hours to 8 hours on CPAP. There are still waking periods but can get straight back to sleep. Before I could never get to sleep.
I notice I can keep my mouth closed through the day. I use less paw-paw ointment on my lips because I’m not mouth breathing during the day. There is no longer need for afternoon naps, and I have plenty more energy and feel alert in the evenings. I can socialize through the week which I had not done for years.
My gut issues decreased, reflux has settled which I think was contributing to my night time waking.
I feel the front part of the tongue fits into my palate. At the back it feels a bit crowded. My posture has improved; I can now get myself into straight posture before my neck begins to hurt. The back and neck pressure released almost immediately after the tie. My teeth clenching appears to have stopped (I need to confirm this) and my tooth sensitivity has ceased.
There have been no headaches or migraines, since the release. They have completely resolved. I’ve also lost 5 kg since the procedure.
I don’t feel the cravings and dependence on sugar for energy.I feel much calmer as a person. For instance, I burnt my hand, instead of panicking I put my tongue up and felt calm. I no longer feel anxious, and I have postponed my psychology sessions.
My life has changed significantly since having the release. I would recommend anyone who thinks they may have a tongue-tie to investigate further.
I am continuing working with an Orofacial Myofunctional Therapy program to achieve my goals. Most excitingly I can now produce /s/ and /z/ sounds with tongue in the correct position.”
To read the in depth article go to this website.
Tongue Tie and Mewing
One of the many symptoms of a Tongue Tie is restricted tongue movement. Hence, maintaining a correct tongue posture can be proven difficult.
Pushing the tongue on the roof of the mouth requires a lot of muscle strength and flexibility that individuals with a tongue tie lack. Therefore, it is important to address this condition and the best possible way to do so is by making an appointment with your nearest Orthodontist.
Tongue Tie Exercises
Tongue Exercises are a part of various Tongue tie treatments, it is also often included as an after care method post surgery. There are several tutorials on the internet that will help you increase the mobility of your tongue and help you with Mewing aka maintaining the correct tongue posture.
Tongue Tie Treatment
Treatment may be necessary in cases where tongue-tie is interfering with breastfeeding, speech, causing distress. There are two types of procedures when it comes to tongue tie release.
Frenotomy (also known as frenulotomy) is a surgical procedure to release the tongue tie so the tongue movement is no longer restricted. Most babies undergoing this procedure can continue feeding immediately.
Frenuloplasty, on the other hand, is more complex and is conducted in cases of tongue-tie where revision is required, and involves plastic surgery of the frenulum. The recovery process may include speech therapy and tongue exercises.
The risks associated with both the procedures include – severe bleeding, infection, injury to the salivary ducts, and worsening breathing.
There is a recent spike in the awareness of tongue ties in Infants and also young adults. With the rising popularity of Mewing, individuals are taking their oral health very seriously.
Tongue-tie has a huge impact on dental health, breathing, and sleep quality. The symptoms of an undiagnosed tongue tie include mouth breathing, sleep apnea, chronic neck pain, digestive issues, and anxiety.