Tongue Tie

Overview

Tongue tie (also called ankyloglossia) is when the thin fold of skin under the tongue (the frenulum) is shorter or tighter than usual. This anchors the tongue to the floor of the mouth, which can make it harder to move the tongue. It may affect feeding, speech, and mouth hygiene.

Yes, it is fairly common. Around 4 to 11 in every 100 babies are born with some degree of tongue tie.

Tongue tie can affect people at any age, but it is most often noticed in babies and young children. It is more common in males than females.

Symptoms

Common symptoms

• Difficulty lifting the tongue to the roof of the mouth
• Trouble moving the tongue side to side
• The tongue looks notched or heart-shaped when pushed forward
• A visible tight band of tissue under the tongue

Symptoms in children

• Breastfeeding problems such as trouble latching, clicking sounds, or a poor seal
• Poor weight gain or a baby who seems hungry after feeds
• Painful breastfeeding for the mother
• In older children: trouble sticking out the tongue, difficulty licking food, or speech sound issues

Symptoms in older adults

• Difficulty cleaning the mouth and teeth properly
• Gum irritation or receding gums in the lower front teeth
• Trouble eating certain foods, like ice cream cones or licking at food
• Problems with dentures staying in place

Causes

Main causes

• The exact cause is unknown.
• It happens before birth when the frenulum does not separate from the base of the tongue as it normally would.
• It is not caused by anything the mother did during pregnancy.

Risk factors

• Family history of tongue tie
• Being male
• Certain genetic conditions that affect the face and jaw

When to see a doctor

See a doctor urgently if:

• Your baby is not feeding enough to gain weight or is losing weight
• Feeding is extremely painful and you are developing damaged nipples
• Your child cannot swallow or is choking regularly during feeds

Book a routine appointment if:

• You or your child is having trouble with feeding, speech, or oral hygiene that you think could be linked to tongue tie
• Your baby seems to have a poor latch no matter how you position them
• You would like an opinion from a healthcare professional or a specialist feeding clinic

Diagnosis

A doctor, midwife, health visitor, or dentist can usually diagnose tongue tie by looking inside the mouth and observing how the tongue moves. They will also ask about feeding and other symptoms.

Tests that may be done

• A physical check to see how far the tongue can lift and move
• A review of your baby's feeding pattern and weight
• No imaging or blood tests are required

What to expect at your appointment

The assessment is quick and simple. For babies, the practitioner may watch a feed. For children and adults, they may ask you to make certain tongue movements or say certain sounds. You will have time to ask questions and discuss whether any support is needed.

Treatment

Treatment is only recommended when tongue tie is actually causing problems, such as feeding difficulties, speech issues, or dental health problems. Many cases need no intervention at all. When treatment is needed, the aim is to free the tongue so it can move normally.

Self-care at home

• For breastfeeding babies, try different feeding positions and seek help from a lactation consultant or feeding specialist
• For older children and adults, keep up good oral hygiene and see your dentist regularly
• If you notice difficulty speaking, ask about speech therapy

Medical treatments

If symptoms are significant, a doctor or specialist may offer a simple surgical procedure. In a frenotomy, the tight band of skin is quickly divided with sterile scissors or a laser. It is often done without or with just local anesthesia. Another option, called a frenuloplasty, may be used for more complex cases. Your healthcare team will explain the benefits and risks so you can decide together.

When is surgery considered?

Surgery is only considered when tongue tie is clearly causing problems that have not improved with conservative support, such as feeding help or speech therapy. It is generally a low-risk, short procedure, but your provider will discuss whether it is right for you or your child.

Living with this condition

For most people, tongue tie is a very manageable condition. If it causes feeding issues in a baby, specialist support can make a big difference. For older children and adults, the main day-to-day thing is taking care of your teeth and gums, and getting help early if you notice any difficulty eating, speaking, or cleaning your mouth.

Lifestyle tips

• If you are breastfeeding, allow time for your baby to latch and seek support early
• Maintain regular dental check-ups, especially if you struggle to clean your lower front teeth
• If speech is affected, a speech and language therapist can give targeted exercises

Diet and exercise

There are no special dietary needs for tongue tie. A healthy balanced diet is always recommended. If tongue tie makes it hard to eat certain foods, like licking or chewing, choose foods that are easier for you, and mention any difficulties to your healthcare provider.

Mental health and emotional wellbeing

Tongue tie can sometimes be stressful, especially for new parents who want to breastfeed but are struggling. It is normal to feel frustrated or anxious. Talking to a supportive professional, whether a midwife, health visitor, or counselor, can help. If you or your child are having a hard time, you are not alone.

Prevention

No, tongue tie cannot be prevented. It develops before birth, and there is no known way to avoid it.

Vaccines

There is no vaccine for tongue tie.

Screening programmes

There is no official national screening program for tongue tie. It is usually picked up during routine checks after birth or when feeding difficulties are noticed.

Complications

If left untreated

• Breastfeeding difficulties, which may lead to poor weight gain in a baby and painful nipples for the mother
• Difficulty with speech sounds, although research is not conclusive
• Poor dental hygiene and an increased risk of gum disease or tooth decay, especially around the lower front teeth
• In adults, trouble with dentures staying in place

Long-term outlook

The outlook is very good. Many tongue ties never cause problems, and even when they do, there are safe, simple ways to help. Babies who have treatment usually feed better quickly, and older children and adults often find daily activities like eating and cleaning teeth noticeably easier. With the right support, most people manage extremely well.

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