At TMJ Plus, the guiding principle of everything we do is the belief that your oral health and your overall well-being are deeply connected. We see it everyday with our patients and it’s one of the reasons we’ve added an osteopathic physician, Dr. Matt Barker, to our team. One of the services we’re offering in conjunction with Dr. Barker is frenuloplasty for tongue tie.
What Is Tongue Tie?
If you’ve heard of tongue tie before, it’s likely in the context of babies and young children with speech and feeding difficulties. Tongue tie is often first identified when babies cannot latch while breastfeeding. Other cases of tongue tie are uncovered as toddlers begin to talk—they may have trouble with certain sounds and words and their pediatrician diagnoses them with tongue tie.
The medical term for tongue tie is ankyloglossia. We all have a frenulum that connects the bottom of the tongue to the mouth; in patients with tongue tie, this membrane is short and thick, which restricts movement of the tongue, causing breastfeeding difficulties and speech disorders.
Some pediatricians choose not to treat tongue tie, believing that the frenulum will stretch on its own over time. Other children are undiagnosed because their tongue tie causes no obvious symptoms and they grow up to be adults with tongue tie. Mainstream medicine used to hold that tongue tie that didn’t cause issues with speech or eating did not need to be treated, but we now understand the connection between tongue tie and other health issues.
How Tongue Tie Impacts Your Health
Many of the patients we see for TMJ disorder, teeth grinding, chronic headaches, and sore neck and shoulder muscles are surprised to learn that the underlying cause of their pain is tongue tie. What they once believed was simply a quirk of their anatomy that made it hard to stick out their tongue or eat an ice cream cone is actually impacting their quality of life!
In addition to the feeding and speech issues seen in young children, tongue tie can cause:
- Bruxism (teeth grinding)
- TMJ disorder/pain
- Orthodontic issues
- Poor posture
- Muscle pain in the neck, jaw, and shoulders
- Uneven shoulder heights
- Toe walking
While it’s easy to see how issues with the tongue could cause teeth grinding and orthodontic issues, let’s talk more about those last three symptoms—poor posture, muscle pain, and toe walking. How can a tongue tie cause these?
The answer is simple: your tongue is part of a continuous band of fascia that starts at the tongue and ends at the toes. This is why a tongue that is restricted by a frenulum that is too tight can also cause you to hunch over instead of stand tall, make your muscles feel tense, and even make walking on your toes more comfortable than walking on flat feet.
Options for Treating Tongue Tie: Functional Frenuloplasty vs. Frenectomy
Knowing how important tongue tie treatment is, let’s discuss the two main options for treatment: frenuloplasty and frenectomy.
A frenectomy completely releases the tongue tie—the frenulum is removed using a soft tissue laser. This is the traditional treatment used for tongue tie and it’s commonly used for babies and toddlers with speech and feeding problems.
A guided functional frenuloplasty is a very different approach. Instead of fully releasing the frenulum, our goal in a frenuloplasty is to release just enough of the frenulum to relieve symptoms throughout the body. We are one of the few practices to offer frenuloplasty in Dallas—while it is a cutting-edge treatment, it is backed up by clinical research and patient outcomes.
During a frenuloplasty, Dr. Coats and Dr. Barker work together to determine the precise muscle fibers in the frenulum that are causing pain elsewhere in the body. As these are released, you’ll feel relief as your muscles relax. You’ll also work with a myofunctional therapist to optimize function of your tongue and muscles both before and after the procedure.