Tongue Ties – to release or not? By: Dr. Nishita Ondhia

There are four functions of the tongue:

• Suck/Swallow (mastication)
• Speech (phonetic articulation)
• Structure (growth and development)
• Sleep (breathing and proper oral posture

 

Correct Oral Rest Posture has 3 criteria:

• Tongue is Up (against the palate, the roof of the mouth)
• Lips are together and Sealed
• Nasal Breathing (air in and out via the nose)

If the tongue is not functioning properly, it will results in problems with eating, chewing, frequent ear infections, throat infections and different speech mis-articulations.  These effects are more commonly known and understood.

Improper tongue function will also affect growth and development of the muscles and bones of the face; this is less well known.  The tongue is your lifelong orthodontist and  your lifelong retainer.  It is the constant and consistent pressure from the tongue that guides craniofacial growth.

With respect to nasal breathing, the tongue stimulates nasal breathing, it is an air filter, a humidifier, it produces nitric oxide and allows for deep diaphragmatic breathing.  Incorrect tongue function will affect all of the above.

A tongue will not function properly for many reasons.  One reason could be a tongue tie.

There is no such thing as a mild, moderate or severe tongue tie – only mild, moderate and severe symptoms.  Many variables must be considered.

Clinical considerations for a tongue tie release includes development stage, behaviour, functional issues, need for myofunctional therapy, type of procedure needed, level of co-operation needed and compliance for aftercare.

Ideally, with respect to treatment, the maxilla is expanded, myofunctional therapy is started, a release is done, myofunctional therapy is continued and further palatal expansion may be needed.  The ultimate goal of the tongue release is always nasal breathing.

Dr. Nishita Ondhia