Sidekick was born tongue-tied: the tissue attaching his tongue to his lower jaw was too short, constricting his tongue movement. He also had an upper lip frenulum tie: the tissue connecting his upper lip to his gums extended too far down his gumline, making it difficult for him to control his lip movement.
The doctors recognized his tongue tie when he stopped breathing several times in the hospital due to choking on his spit-up, as he was unable to move it out of the way with his tongue. His tongue tissue was cut/clipped in a very minor corrective surgery, which he was numbed and awake for.
His upper frenulum tie remains uncorrected, as it tends to be a controversial oral development subject. We’ve been volleyed between medical providers, and specialists in the field of oral development are torn on whether it should be left or be surgically addressed. Very few doctors in our area have experience performing the procedure to correct upper lip frenulum tie. We also spent much of Sidekick’s early months dealing with allergy concerns and lactose sensitivity (much of which he has now outgrown).
I went ahead and asked my friends at Bundoo to offer some clarification on oral development, since I’ve had a ton of questions from parents going through similar experiences. I shared a couple weeks ago how Bundoo has been a lifesaver for new parents. It is SO nice to have easy access to experts who truly care. They research and provide information to help parents can be advocates for their children.
Things You Should Know about Oral Development
What are some common indicators for tongue tie or lip tie?
Some babies with tongue tie are unable to protrude the tongue very far outside the mouth or are unable to touch the roof of the mouth with the tongue tip when the mouth is open. In extreme cases, the tongue appears “serpent- like” (W-shaped or forked tongue tip) when attempting to elevate the tongue. Difficulty latching, suckling and nursing sometimes occur and can be what leads to the diagnosis.
With lip tie, the tissue can be long and loose or low set and quite tight. There can be impairment of feeding or speech, and severe cases causes cosmetic issues.
What steps should a parent take to get a tongue tie or lip tie diagnosed?
In addition to pediatrician and/or dentist, a speech-language pathologist can assess the effects on speech and oral motor function. If a family decides to have the frenulum clipped, it can often be done easily as an office procedure. In newborns, the frenulum is clipped and the baby can immediately be placed onto the breast to nurse. In older infants and children, anesthesia may be necessary but the recovery is fast.
What is the outlook for children with tongue tie or lip tie if the family chooses not to have it clipped?
Severity and restrictions of tongue tie often decrease as a child ages and, if mild, children may be able to compensate on their own to function without any complications. However, in some more severe cases, tongue tie can potentially affect:
- Eating: difficulty moving food in the mouth and clearing teeth can cause chronic bad breath and dental problems such as cavities or gingivitis. Also, messy eating because of reduced ability to lick lips can pull lower gums away from teeth, impairing palatal growth
- Cosmetics: abnormal looking tongue. Possible embarrassment and self-esteem issues
- Personal interactions: inability to lick an ice cream cone or participate in oral play routines or “French” kiss when older
- No empirical evidence has proven that tongue tie causes speech delay. Some speech and language pathologists disagree, but their evidence is anecdotal
How should parents assess oral development throughout their child’s growth stages, beyond infanthood?
Parents should monitor their infant’s eating and feeding skills. Let your doctor know if you have difficulty nursing either with latch or with unexpected nipple soreness. As your child grows, notice if they are able to use their tongue for functional daily activities like licking lips. Have well child checks with your pediatrician and begin a relationship with a pediatric dentist within the first year of life.
Are there federal or state resources available to parents who are concerned about speech delays?
There are great resources that are free to parents who have concerns about speech and language development. In California, it’s called Early Start. Parents can self-refer their child to Early Start, meaning that you do not need a doctor’s prescription. If your child qualifies for services they are provided at no cost to you. Once a child reaches age 3, the public school system takes over the screening process.
As far as Sidekick’s own oral development, he has been a bit slow to talk (although that was also true of Some Boy who’s a real chatterbox now, so we’re not particularly concerned). We are also seeing a minor gap between his two front teeth which may be a result of his frenulum tie or could very well be genetic. We’re continuing to see experts in the field of oral development to determine next steps.
Is there anything else you’ve wondered about tongue ties or other oral development issues in children?