Tongue-Tie

Treatment Overview

Many children with tongue-tie do not need treatment, because the tissue underneath the tongue (lingual frenulum) stretches as the child grows and adapts to the tongue restriction. But some children with tongue-tie may need surgery to release the tissue.

What can be done?

If your child has been diagnosed with tongue-tie, you can choose to wait and see if the lingual frenulum stretches or if your child adapts to the tongue restriction. You can:

• Talk to a lactation consultant if you are having breast-feeding problems. The consultant can teach you techniques to help your baby latch on and suck effectively.
• Try speech therapy if your child is having difficulty making (articulating) the t, d, z, s, th, n, and l sounds. A speech therapist may help your child learn to make these sounds more clearly, but speech therapy will not correct tongue-tie.

When is surgery indicated?

Surgery is recommended if tongue-tie causes:¹

• Significant latching on and sucking problems in your breast-fed baby.
• Difficulty making (articulating) the t, d, z, s, th, n, and l sounds as your young child learns to speak.
• Personal or social difficulties, such as if your school-aged child is being ridiculed by other children or if an adult is having difficulty wearing dentures.

Two types of surgery can be done for tongue-tie. The surgeries are:

• A procedure called frenotomy to release the lingual frenulum. Frenotomy can be done without anesthesia or with local anesthesia. This is the preferred surgery for babies with tongue-tie.
• The complete release and repair of the attached tongue (frenuloplasty). Frenuloplasty requires local or general anesthesia. This procedure is preferred for children older than 1 to 2 years.

What To Think About

The appropriate age for a child to have surgery for tongue-tie is controversial.¹

• Some experts believe that surgery should be done before speech problems develop.
• Others believe that surgery should be delayed until the child is 4 years old and should be done only on children with speech difficulties. But delaying surgery may result in the child needing speech therapy after surgery to correct any altered speech patterns.

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Author:	Debby Golonka, MPH	Last Updated: August 20, 2009
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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