Being “tongue tied” isn’t always just a figure of speech. For children with a physical tongue-tie (called “ankyloglossia”), speaking, breastfeeding or dentition might be affected by a shortened frenulum inside the mouth. The frenulum is the small attachment between the floor of the lower jaw and the tongue. When you lift your tongue, it’s easy to see and feel. A shortened frenulum, in the case of akyloglossia, restricts the movement of the tongue and is considered a congential condition present at birth. Without the freedom to move it properly, difficulties with the normal function of the mouth for speaking or eating might arise, though the definitive connection between the two is hard to say. For that reason, it’s important for speech therapists, the experts in language and sometimes feeding, and parents to know about children who are tongue-tied.

A tongue-tie is not exactly rare. Between 0.2% and 2% of babies are born with tight frenulums (though some statistics report upwards of 5%). The degree to which the frenulum is attached can vary from child to child. The treatment for tongue-ties can include no intervention at all, or “clipping” to free the frenulum and increase it’s range of movement (called a “frenulectomy”).

Tongue-tie can sometimes cause problems such as speech difficulties and difficulty eating certain foods.

With a restricted range of motion, it has long been argued that the tongue might be unable to move into the correct position to make select speech sounds, include, lingual-alveolar sounds (particularly /l/) and interdental sounds (voiced and voiceless /th/).Tongue-tie can interfere with the ability to make certain sounds — such as “t,” “d,” “z,” “s,” “th,” “r” and “l.” If the child cannot produce these sounds, a frenctomy may be indicated.

A speech language pathologist might see a child for evaluation before or after a frenulectomy. Children should be assessed by a SLP prior to tongue-tie surgery. Some require pre-operative exercises, and most require post-operative exercises under a SLPs supervision. Postoperative exercises might help develop new muscle movements, increase awareness of movements and range of motion, and encourage using tongue movements to move food or debris within the mouth.