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Dr. Feder - Official Website - On Being Tongue-Tied

On Being Tongue-Tied:
by Lauren Feder, M.D.

If you are tongue tied, have breathing problems or sleep apnea,  Now Hear This!

When my son, Etienne, was born in 1993, he was tongue tied.  At the time I did not think much of it, as I was able to successfully breastfeed, and all seemed fine.  So I thought. 

Now my son is a young adult, and his dentist noted that his teeth were crowded and his palate (the arch of the mouth) narrow.   He was referred to Joy Moeller, an orofacial myologist who explained to us that If he did not receive any treatment he would need braces, develop breathing and snoring problems (sleep apnea), and this would all lead to poor posture resulting in neck and back pain as he got older.  That was a lot of information in one visit!  Within a short amount of time, he began to work with Joy and her colleague Samantha, and also underwent a procedure. Thanks to their efforts and expertise, he is on the road to improved health.  

Being tongue tied means  the  motion of the tongue is restricted due to a shortening or tightening of the band of tissue (frenulum) that connects the bottom of the tongue to the floor of the mouth.  In the olden days, midwives kept their nails sharpened to easily clip this at birth.  

Known as ankyloglossia, it can lead to difficulties breastfeeding in the newborn, and  problems later on.    The normal resting position of the tongue is on the palate.  In addition, to being a source of comfort, the tongue on the palate begins to ‘shape’ and widen the mouth, jaw, and even facial features.  This allows for more room for the teeth (including wisdom teeth).  A tightened tongue which is not able to rest on the palate causes the arch to become narrow and collapse which leads to crowding of the teeth,  speech problems, breathing problems, such as sleep apnea in adults. In order to try to breathe easier, the body compensates by jutting out the chin, leading to poor posture and neck and back pain.  Conditions that lead to mouth breathing and sleep apnea can be due to other conditions as well, such as enlarged tonsils and adenoids.  Therapists like Joy Moeller, work with patients (both young and old) to give them exercises for the tongue, mouth, jaw and face.

For patients who are tongue-tied, clipping of the tongue is recommended.  For babies this is a simple (very simple)  procedure known as a frenotomy,  no medication is needed.  For older children and adults, the clipping is known as a frenulectomy (tongue-tie surgery). The latter is a procedure which requires local anesthesia, as well as oral exercises from a trained oral mycologist to help re-train the tongue and mouth. 

From this experience, I am recommending that all babies who are tongue-tied have the simple procedure  (frenotomy) to get on the right path for breastfeeding and beyond.   I refer many children and adults to oral myologists for evaluation and treatment of many conditions for breathing problems as well as thumb sucking, etc.  In addition, I am encouraging parents to avoid the overuse of pacifiers, bottles, or sippy cups.

To learn more, contact myofunctional therapist Joy Moeller, BS, RDH, COM, at (310) 454-4044 or Interrnational Association of Orofacial Myology to find a local practitioner.