Can a Tongue Tie Be the Reason for Your Symptoms?

Tongue ties have a cascade of symptoms that we reveal

General society has likely heard of tongue ties, especially parents, as a large focus of tongue tie information and research is geared toward newborns who have difficulty breastfeeding due to restrictions in the movement of their tongue. Less known, however, are the ramifications that a tongue tie can have on childhood and into adulthood, and that an adult can go their whole lives without realizing that they have a tongue tie at all. Many of the symptoms may seem unrelated to a tiny string of tissue that is usually out of sight and out of mind. Yet once a tongue tie is diagnosed and corrected, the connections among symptoms are made and the appropriate group of practitioners collaborate, even those who have suffered their whole lives with a tongue tie can find relief from the cascade of negative issues they dealt with.


Tongue Tied

Dr. Richard Baxter, along with a team of professionals who treat the negative effects of tethered oral tissues, provide detailed information about the negative effects of tongue ties.

Product: Nipple shields

Mothers of babies with tongue ties often abandon breastfeeding within days or weeks of giving birth, due to breastfeeding difficulties and the stress and pain that accompanies nursing sessions. While they aren’t guaranteed to work for all mothers and babies, nipple shields are a simple and cost-effective device that may improve breastfeeding sessions. It is not advisable to substitute these for assessment of tongue tie, however.

Tongue Ties: They Hold You Back

How tongue ties wreak havoc in many areas of daily function

We’ve all heard the idiom about feeling “tongue-tied” and you may have felt the sensation yourself when trying to speak while feeling shy or nervous. It doesn’t take much reflection on how this sensation was coined; it can really feel like your tongue is tied in a knot when you have difficulty verbally expressing yourself. For many children and adults, however, a tongue tie is a literal, physical restriction that can impact speech– as well as a number of other important functions.

Tongue-tie, also referred to as ankyloglossia, is a condition in which the lingual frenulum– the band of tissue that tethers the tongue to the floor of the mouth– is notably short, thick and/or tight, thus limiting the tongue’s range of movement. An official definition from the International Affiliation of Tongue-Tie Professionals (IATP) states that a tongue-tie is “an embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal tongue movement.”

While everyone has a frenulum (also called a frenum) on the underside of the tongue, it does not always cause limitations in the tongue’s range of motion and thus does not result in negative consequences to a person’s well-being. In order to meet the criteria for a tongue-tie, there must be both anatomical evidence as well as presence of a functional limitation. Let’s examine the functional limitations that can result from ankyloglossia…


A newborn baby’s difficulty with nursing is typically the earliest indication that a tongue tie may be the root of the problem. Some signs include:

  • Difficulties with latching
  • Acting particularly fussy during feedings
  • Exhibiting a clicking sound while feeding
  • Extended feedings that do not seem to satiate baby
  • Poor weight gain

Early identification is ideal for a myriad of reasons, the most important being that the earlier the tongue tie is corrected, the greater the chance that the breastfeeding relationship between mother and baby can be salvaged.

There are various professionals who can identify and correct a baby’s tongue tie, and it’s important to research the most appropriate practitioner that will suit your baby’s needs and your family’s budget. Consider requesting to follow the Illinois Tongue and Lip Tie Support Group on Facebook in order to connect with other concerned parents who can provide advice and support (but don’t let it replace professional advice and recommendations!)


In an ideal world, problematic tongue and/or lip ties would be identified in all babies shortly after birth. In actuality, many fly under the radar, often due to lack of nursing difficulties (since even babies with tongue ties that eventually become problematic can manage to nurse efficiently through compensations) or because babies with tongue ties may be bottle-fed (and drinking from a bottle is generally “easier” than breastfeeding, from an oral motor standpoint). When babies with tongue-ties go unidentified, they often become problematic eaters in childhood.

Feeding difficulties that may indicate a tongue tie include:

  • Inability to chew age-appropriate foods
  • Gagging, choking, and/or vomiting foods
  • “Picky” eating/food refusals
  • Pocketing foods (i.e., leaving pieces of food in crevices of the mouth for extended periods)
  • Dental hygiene concerns
  • Speech difficulties/decreased intelligibility (see next section)

Parents who are concerned about their child’s feeding difficulties are advised to seek an evaluation from an experienced speech-language pathologist, who can perform a comprehensive feeding evaluation and determine if an assessment by a pediatric dentist or ENT to rule out a tongue tie is warranted.


Remember the sensation of feeling “tongue-tied” referred to earlier, when speaking becomes difficult? For those who experience this during nerve-wracking events, this challenge is temporary and situational. For those with tongue ties in the diagnostic sense, talking can be a chronic challenge, due to physical limitations of the tongue when producing various sounds in connected speech. For instance, it may be difficult for someone with a tongue tie to elevate the tip of their tongue or retract their tongue in order to produce sounds such as: /t, d, z, s, l, r, th/. If these sounds alone are difficult for someone with a tongue tie to produce, imagine how challenging speech must be at the conversational level!

Again, the recommendation here is to seek a skilled speech-language pathologist, who will assess speech sound production as well as any physiological limitations that may be impacting an individual’s ability to produce speech sounds.

Dentition/Jaw development

In typical craniofacial development, our tongue is aligned correctly in our mouths when it is resting in the roof of our mouth, without pushing against the back of our teeth. When a tongue is restricted by a short and tight frenulum, it cannot elevate to the roof of the mouth easily or comfortably. When this happens, the tongue will inevitably rest in a downward position, and may even push forward when swallowing (instead of up, in the roof of the mouth). These two occurrences will typically result in the following, in terms of dentition and jaw development: a narrow upper arch in dentition (teeth), an overjet of the front teeth, and an underdeveloped lower jaw. Tongue ties can and do change the shape of a person’s face during the course of their craniofacial development, which is why many people often learn the negative effects of a tongue tie when seeking cosmetic solutions to undesirable facial and/or dental features. This can include those who noticed a relapse in the alignment of their teeth/jaw following orthodontic treatment.

More important than cosmetics, detriments to jaw and dental development that result from tongue ties can include the following adverse symptoms:

  • Clicking jaw
  • TMJ pain
  • Difficulties biting into/chewing various foods
  • Migraines
  • Poor self-esteem

A Tongue and a Lip and a Cheek Tie.. Oh My!

Tongue ties may not be the only strings holding you back

Lip Ties

Another frenulum that may pose negative issues for feeding is the lip tie—the band of tissue on the underside of the upper lip, which attaches the lip to the gums. While it is typical to have a band of tissue in this area, it can have a negative impact when it restricts lip movements for nursing or feeding. It can also cause a gap between the two front teeth if left untreated.

Buccal (cheek) ties

A buccal (pronounced “buckle”) tie is an abnormally tight frenum in the cheeks. There is limited research on buccal ties and its negative impacts on feeding, speech or otherwise, but there has been some evidence to indicate that buccal ties can negatively impact nursing, can cause gum recession in adults and can lead to increased fascial tension around the mouth. There is even speculation that buccal ties cause dimples (although if that’s true, no one would ever want to release theirs!)

For those experiencing any of the above issues, it is important to seek assessment from an oral surgeon or oral myofunctional therapist (also called an orofacial myologist), who can assess these areas of concern and recommend or perform procedures that may be necessary for appropriate treatment.


Snoring and tongue ties – how could those possibly be related? Turns out, there’s quite a strong connection, although the etiology is not
always straightforward. For those with tongue ties who have experienced the deficits in jaw/dental development described above, an underdeveloped palate often causes a smaller airway, which leads to an increased likelihood that the airway will collapse and cause snoring and/or apnea during sleep. Poor jaw development and inappropriate tongue position often results in mouth breathing, which can also be a contributing or causative factor in snoring. Mouth breathing can also be associated with smaller nasal cavities or deviated septums, both of which can result from inadequate tongue pressure on the palate in utero and during infancy.* Mouth breathing leads to decreased quality of sleep, so many adults and children with tongue ties often experience chronic fatigue.


Mouth breathing, which often results from the presence of a tongue tie, invites more bacteria and environmental toxins from the air into the mouth, without it first being filtered through the nose. This, in addition to dry oral and pharyngeal tissues that mouth breathing can cause, increases the likelihood of having inflamed and infected tonsils, which cause a host of health complications.


Restrictions caused by a tight frenulum have been shown to cause tension and stiffness throughout the whole body, and can lead to headaches, neck tension, shoulder pain and poor posture.

Tongue-ties, in short (no pun intended), are anything but a simple string of tissue under your mouth. The complications that can result from limitations in lingual movement are vast and complex, and can have detrimental effects on an individual’s quality of life. Be sure to seek assessment and treatment if you suspect that you or your child experience the symptoms discussed in this article. We at CTC are here to help; discuss your concerns with your child’s therapist, and we can help you get on the right path!


Huang YS, Quo S, Berkowski JA, Guilleminault C. Short lingual frenulum and obstructive sleep apnea in children. Int J Pediatr Res [Internet] 2015;1(003).