This question can only be answered in the context of FUNCTION.  In other words, unless the presentation of the lingual frenulum is impacting oral function for speech or feeding/swallowing, it is not a "tie" and therefore may not need to be released via frenectomy.

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Occasionally, people send pictures of their child's or patient's mouths in the hopes that I will answer the question, "Is this a tongue tie?"  This question can rarely be answered without the opportunity to see the tongue actually functioning in speech and feeding/swallowing.  A picture or quick look without a functional assessment runs the risk of over or under-identifying ankyloglossia (tongue tie) and other ties.  A tongue tie determination often takes TIME.

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It is also important to know that no two ties are alike!  They do not all look like the picture above!  They differ in terms of their locations of attachment, elasticity, thickness, length, and of course functional impact; and can therefore be quite difficult to diagnose, requiring experience, skill, and sometimes even patience to be certain.  

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In addition to speech difficulties, a tongue tie can contribute to difficulties with oral resting posture and swallowing.  An open mouth and low tongue posture characterized by ankyloglossia can lead to undesirable mouth breathing, a less than optimal facial skeletal growth trajectory, feeding issues, "picky" eating, and various dental and orthodontic implications.  The ramifications for not surgically releasing a tie that is impacting function can be quite extensive.  On the other hand, nobody wants a child to have a procedure that is not warranted.  Therefore, I take this question very seriously and discuss any functional impacts with the parent, so that an informed decision can be made by the parent and release provider.

 

It is the release provider's skill, the timing of the release in the context of other factors, the quality of the personalized orofacial myology therapy or feeding therapy before and after the procedure, as well as the consistency of home practice that will determine the success of the frenectomy-- if needed.    

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To be clear, not all orofacial myology or feeding disorders involve tethered oral tissues!  Make your appointment today to get a functional tethered oral tissue assessment.