Did You Know?

Up to the year 1940, tongue ties were routinely cut to help with feeding.

When this changed – because of a fear of excessive/unnecessary surgery and a reduction in the practice of breastfeeding – the belief that tongue tie was not a “real” medical problem but an idea held by overzealous parents became widespread.

DID YOU KNOW THAT TONGUE TIES MAY CAUSE REFLUX?
Most tied infants have high and narrow palates and lack tongue function and mobility which both encourage improper suck function often leading to gulping excessive air. Many infants, and older, with lip ties physically cannot close their mouth leaving their top lip pinned high allowing excessive air.
 
The tongue is connected to the esophagus and a highly restricted tongue causes tension throughout the body. This tension can and often does mean that the esophagus is physically pulled upwards towards the mouth. This not only keeps the esophageal sphincter open but shortens the path from mouth to stomach making it very easy for things to come back up.
 
 
DID YOU KNOW THAT FOOD ALLERGIES, FOOD INTOLERANCES, AND HISTAMINE RESPONSES EVEN PRESENT AT BIRTH MAY BE A SIGN OF TIES?
DID YOU KNOW THAT BEING A PICKY EATER MAY BE A SIGN OF TIES?
DID YOU KNOW THAT SCOLIOSIS MAY BE A SIGN OF TIES?
DID YOU KNOW THAT TIES MAY CAUSE ADHD?
DID YOU KNOW THAT THE HARM TIES CAUSE MAY BEGIN IN UTERO?
DID YOU KNOW THAT TIES MAY BE THE CAUSE OF SUDDEN INFANT DEATH SYNDROME (SIDS)?

According to the article, Dr. Jones said research is now showing SIDS is a form of obstructed sleep apnea, which leaves infants vulnerable. “Research is showing that tongue restriction may be linked with sleep apnea in older children and adults, so it’s possible there is a link in infants presenting with Annabelle’s symptoms. It’s an emerging theme we need to learn more about. Stanford University is showing that ties have an effect on airways and growth of the jaws and face. It is trailblazing research,” she said

DID YOU KNOW THAT IF THE TONGUE IS RESTRICTED IN FUNCTION THEN YOU’RE LIKELY NOT PRODUCING ENOUGH SALIVA?

Our saliva contains digestive enzymes and it is the first process of breaking down our food. Without adequate breakdown in the mouth, we produce extra acid to break down the proteins in the stomach. This acid often leads to GERD. Many infants are often placed on special formulas due to food sensitivities/acid reflux and unaware that the underlying root cause may be tongue, lip, or buccal ties. See the articles below:

DID YOU KNOW THAT WHEN THE TONGUE IS NOT RESTING AT THE ROOF OF THE MOUTH THE VAGUS NERVE IS LIKELY NOT BEING STIMULATED?
DID YOU KNOW WHEN THE VAGUS NERVE IS NOT BEING STIMULATED MANY CHILDREN MAY SUCK THEIR THUMBS/FINGERS OR USE A PACIFIER TO STIMULATE THAT NERVE IN ORDER TO PROVIDE THE RELEASE OF ENDORPHINS (CHEMICALS PRODUCED BY THE BODY TO RELIEVE STRESS AND PAIN)?

A part of the vagus nerve is found at the roof of the mouth behind your front teeth. When we put our tongue there, usually by instinct, it stimulates our vagus nerve and calms tension. That is the correct position our tongue should be in. But, if there is a tongue tie or someone is a mouth breather their tongue cannot reach this spot. This can cause tension, anxiety, and chronic stress.

DID YOU KNOW THE TONGUE’S JOB IS TO SHAPE AND WIDEN THE PALATE (TOP OF YOUR MOUTH)?
DID YOU KNOW THAT BEDWETTING MAY BE A SIGN OF TIES?

Chronic bedwetting is often related to sleep apnea because there is not enough oxygen for all systems so the body diverts oxygen from non-essential functions to the brain. Therefore, urine control becomes a low priority.

DID YOU KNOW THAT ENLARGED OR INFECTED ADENOIDS AND TONSILS MAY BE A SIGN OF TIES?

Mouth breathing, which often accompanies tongue ties, causes inflammation in the adenoids and tonsils due to unfiltered, dry, cold air that enters the mouth.

DID YOU KNOW THAT WHEN THE TONGUE IS RESTING AT THE ROOF OF THE MOUTH IT CAN HELP CLEAR THE SINUSES AND EUSTACHIAN TUBES IN THE MIDDLE EAR?
DID YOU KNOW THAT A HIGH VAULT IN A PALATE NARROWS THE NASAL PASSAGES CAUSING OPEN MOUTH BREATHING WHICH MAY BE A SIGN OF TIES?
DID YOU KNOW THAT TIES MAY CAUSE OPEN-MOUTH BREATHING WHICH CAN LEAD TO CAVITIES?
DID YOU KNOW THAT MOUTH BREATHING MAY CONTRIBUTE TO POOR ABSORPTION OF NUTRIENTS DURING THE DIGESTION PROCESS? THOSE WHO BREATHE THROUGH THEIR MOUTHS TEND TO HAVE A STIMULATED SYMPATHETIC NERVOUS SYSTEM (“FIGHT OR FLIGHT” RESPONSE) WHICH ENCOURAGES SHALLOW BREATHING. NASAL BREATHING, ON THE OTHER HAND, STIMULATES THE PARASYMPATHETIC SYSTEM (“REST AND DIGEST”) AND ALLOWS FOR DEEPER, MORE EFFICIENT BREATHING.
DID YOU KNOW THAT A BABY SLEEPING IN A PARTICULAR POSITION MAY INDICATE TIES?

If your baby has their rear in the air while sleeping on their belly this may indicate they are trying to create space to breathe better.

DID YOU KNOW THAT A TONGUE TIE MAY CAUSE SUCH THINGS AS TORTICOLLIS, SCOOT CRAWLING, RECESSED CHINS, FORWARD HEAD POSTURE, DOWAGER’S HUMPS, AND SCOLIOSIS?

Tongue ties typically are accompanied by a lip tie, high palate, and recessed chin. While tongue tie, lip tie, high palate, and recessed chin are exclusive of one another, their combination of all of these can contribute to significant issues with breastfeeding.

High palates make it difficult for the tongue to properly elevate to the roof of the mouth to compress the nipple for breastfeeding (or bottle feeding) and thus can hinder the tongue’s ability in contributing to proper jaw development. A recessed chin makes it difficult to maintain and hold a latch, due to potential misalignment of the jaw. A lip tie (which is further discussed below) contributes to the increased air intake, resulting in reflux and colic.

DID YOU KNOW WITH AN ANTERIOR TONGUE TIE, THE FRENULUM IS ATTACHED CLOSER TO THE TIP OF THE TONGUE THAN THE BACK, SO IT IS SHORTER AND TIGHTER THAN USUAL, WHICH MAY RESTRICT THE TONGUE’S MOVEMENT?

When an infant tries to lift its tongue and the center stays tethered down, it creates the heart shape This shape may or may not go away once the tie is released. Cutting that band somewhere in the middle doesn’t remove the portion of the band inside the tongue. That can still change the shape of the tongue but typically doesn’t affect function.

DID YOU KNOW THAT AN ISOLATED LIP TIE IS VERY UNCOMMON AND MAY BE LIKELY ACCOMPANIED BY A TONGUE TIE?
DID YOU KNOW THAT WHEN YOU PROLONG AN “S” SOUND (SNAKE SOUND) YOUR TONGUE SHOULD BE AT THE TOP OF YOUR MOUTH WITH YOUR TONGUE TIP BEHIND YOUR TEETH (NOT TOUCHING THE FRONT TEETH) AND MAY BE INDICATIVE OF A TIE IF THERE IS A LISP?
DID YOU KNOW WHEN YOUR LIPS ARE CLOSED YOUR TONGUE SHOULD BE LIGHTLY SUCTIONED TO THE ROOF OF YOUR MOUTH WITH YOUR TONGUE TIP BEHIND THE FRONT TEETH; NOT TOUCHING THE FRONT TEETH? THIS IS CALLED “NORMAL TONGUE POSTURE.”
DID YOU KNOW THAT CHEWING WITH YOUR MOUTH OPEN MAY INDICATE A TIE?

Very often individuals are compensating with their lips (using more gross motor movements) while chewing since their tongue’s fine motor movements are limited in their mobility due to being tethered from a tie.

DID YOU KNOW THAT HAVING A HEIGHTENED GAG REFLEX MAY BE A SIGN OF TIES?
DID YOU KNOW THAT WEAK ABDOMINAL MUSCLES (YOUR CORE) AND DIASTASIS RECTI MAY CONTRIBUTE TO JAW ISSUES AS WELL?
DID YOU KNOW THAT BEING TONGUE-TIED MAY LEAD TO SLEEP APNEA AND MAY CONTRIBUTE TO THE RISK OF HEART ATTACK OR STROKE?

Due to the tongue and/or lip impairment caused by ankyloglossia, the oral structures and airway tend to be smaller than normal. If the oral tissue begins to sag, Obstructive Sleep Apnea (OSA) may result.

This condition occurs when oral tissue blocks the airway entirely multiple times during the night, often for 10 seconds or more. OSA interferes with restful sleep, and can even contribute to the risk of a heart attack or stroke.

DID YOU KNOW THAT BRAZIL IS THE FIRST COUNTRY TO HAVE PASSED A FRENUM INSPECTION LAW, WHERE EVERY NEWBORN IS ASSESSED FOR TONGUE AND LIP TIES? SEVERAL OTHER COUNTRIES ARE NOW IN THIS PROCESS. THEIR VALIDATED PROTOCOLS FOR THE ASSESSMENT OF TONGUE AND LIP TIES ARE BEING PROMOTED AROUND THE WORLD TO GUIDE PROFESSIONALS TO KNOW WHEN TO INTERVENE.
DID YOU KNOW THAT MOST STANDARD SPEECH THERAPISTS ARE NOT TRAINED TO EVALUATE TIES? THE EXPERTS IN THE FIELD ARE MYOFUNCTIONAL THERAPISTS, OCCUPATIONAL THERAPISTS WITH A SPECIALTY CERTIFICATION IN FEEDING, EATING, AND SWALLOWING (SCFES OR SCFES -A), AND DOCTORS THAT PERFORM TONGUE TIE SURGERY?
DID YOU KNOW THAT PACIFIERS PUSH THE TONGUE DOWN? THE BULBOUS END OF THE PACIFIER WILL PUSH DOWN ON THE TONGUE AND NOT ALLOW FOR THE TONGUE TO MOVE, DEVELOP, OR PROPERLY FUNCTION. THE TONGUE IS VERY IMPORTANT IN THE EARLY DEVELOPMENT OF THE PALATE, DENTAL ARCHES, AND AIRWAY. IF THE TONGUE IS NOT ALLOWED TO INTERACT OR CONTACT THE PALATE AND DENTAL ARCHES, THE DEVELOPMENT OF THESE STRUCTURES CAN BE NEGATIVELY IMPACTED AND AFFECT A PATIENT FOR YEARS UNTIL INTERVENTION CAN OCCUR.
DO YOU KNOW THAT TONGUE TIE SURGERY MAY CAUSE FOOD AVERSIONS?
DID YOU KNOW A TONGUE TIE MAY AFFECT BOTTLE FEEDING?
DID YOU KNOW THAT TOE WALKING MAY BE A SIGN OF TIES?
DID YOU KNOW THAT OUR DEEPEST GROUP OF MUSCLES IS REFERRED TO AS THE DEEP FRONT LINE (DFL)? THE CONNECTIVE TISSUE, OR FASCIA, OF THESE MUSCLES, WEAVE DEEPLY TO FORM A DIRECT PATH FROM FOOT TO HEAD. (SEE PICTURE BELOW)
DID YOU KNOW THAT BUCCAL (CHEEK) TIES MAY INTERFERE WITH BREASTFEEDING?
DID YOU KNOW THAT A CUPPING SHAPE OR BOWL SHAPE OF A TONGUE MAY BE A SIGN OF TIES?

Professionals assessing babies for tongue-ties should assess elevation, lateralization, and extension. Elevation can most easily be assessed when a baby cries. With the mouth wide open, the tongue tip should lift up to at least the mid-mouth. In tongue-tied babies, the tongue often stays quite flat on the floor of the mouth or the edges curl up to form a bowl shape or “V” shape. Babies should be able to poke their tongue tip out well over the bottom lip when the bottom lip is stimulated. When the assessor runs their finger along the top ridge of the bottom gum the tip of the baby’s tongue should follow the finger so the tongue sweeps side to side (lateralization).

Some assessors perform a suck assessment by placing their finger in the baby’s mouth (pad side up, nail side down) and feeling how the baby is cupping and using their tongue. Assessors sweep their fingers under the baby’s tongue so they can feel the extent of the tongue tie and the tongue will also be lifted to visualize the frenulum. The appearance of the frenulum is also documented including the shape of the tongue tip, where it attaches to the floor of the mouth and the underside of the tongue, and how long and stretchy it is.

DID YOU KNOW THAT TIES MAY CAUSE CROOKED TEETH?

Fascia is the connective tissue that holds your insides in! It is incredibly strong and important. All of the frena in the mouth are made of fascia, including the frenum under the tongue. Since muscles are responsible for moving the bones in our body, so does the tongue. Being a muscle, it moves bone (your teeth).

DID YOU KNOW THAT STUTTERING MAY BE A SIGN OF TIES?
DID YOU KNOW THAT THRUSH MAY BE A SIGN OF TIES?

Due to the low tongue position, often high palate, and the upper lip not flanging out completely over the nipple, bottle, or breast, your baby cannot make a good seal and loses suction, you can hear clicking sounds. Also, very loud drinking, gulping it down, and choking. Complaints of swallowing air. The swallowed air needs to go somewhere; it goes up or down. Burping, hiccough, spitting, windy, colic. GER or reflux with or without spitting (hidden reflux). In hidden reflux the baby tries to keep the milk down by swallowing again, sometimes forgetting to breathe momentarily. During feeding, it can be very uncomfortable for the baby and can become restless. It’s difficult to put the baby down to sleep. Parents walk with their baby until symptoms subside. The baby can experience pain from the stomach acid in the esophagus. GERD. Sometimes medication is given which lowers stomach acid. Thrush is often confused with tongue-tie problems. Although you can see it both at the same time. The tongue may have debris in the papilla (from the day of birth) due to the fact that the tongue hardly touches the palate so it doesn’t “rub clean”. Pinching and stabbing pain can be from thrush or compensating behavior from tongue and lip tie. With a tongue tie, you can see white debris on the posterior part of the tongue behind the tongue tie, the front of the tongue rubs clean against the inside of the upper maxilla. Thrush is a “pearl white” shine or white plaques on the inside of the lips and on the mucous membranes of the inside of the mouth.

*Note that not all symptoms have to be present at the same time.

DOES MY BABY HAVE THRUSH?

Sometimes restless drinking, when the baby lets go often and makes clicking sounds are attributed to having thrush (candida infection), and when feeding is painful for the mother. However, both tongue tie and thrush can be present. When there is thrush, there is sometimes little to see on the nipples and areola of the mother. On the baby, you see white plaques on the mucous membranes on the inside of the lips and cheeks in the mouth. Often a “two-tone” tongue is seen. Due to the tongue tie, the front part of the tongue wipes clean (against the inside of the upper jaw) and the back part of the tongue does not, because the tongue is “tied” low in the mouth. You see a white deposit in the taste buds which can be confused with thrush.

DID YOU KNOW GOOD NUTRITION MAY WIDEN A CHILD’S PALATE?
DID YOU KNOW THAT WEARING HEADBANDS AND BOWS ON A BABY CAN AFFECT THEIR CRANIOFACIAL DEVELOPMENT?

It takes less than 5 grams of pressure to influence the cranial bones’ shape and motion. So placing a tight headband that constricts the cranium will not only change the shape of the head but will decrease the movement of the cranial bones and negatively impact the primary respiratory mechanism. Many parents who have little girls who are bald for a long time will want to always have a headband on their baby since they can not clip on bows to her hair. This will always constrict the movement of the cranial bones and work towards altering the shape of the cranium. Typically a headband will wrap around the occiput, temporal, sphenoid, and frontal bones. Even slight alterations in the shape or motion of the occiput can cause misalignments in any other cranial bone. This again will cause adhesions in the dura and affect the nutrient saturation of the nervous system. Keep the headband or bow in your bag and only slip it on for pictures and then take it right back off. Look for red marks and signs of the bow on the head after you take it off. The more marks and redness you see left behind after the bow is off, tells you there is more pressure being applied by the headband. Bows and headbands look cute but have a huge impact on the shape and motion of the cranium.

DID YOU KNOW THAT WEARING HEADBANDS AND BOWS ON A BABY CAN AFFECT THEIR CRANIOFACIAL DEVELOPMENT?

It takes less than 5 grams of pressure to influence the cranial bones’ shape and motion. So placing a tight headband that constricts the cranium will not only change the shape of the head but will decrease the movement of the cranial bones and negatively impact the primary respiratory mechanism. Many parents who have little girls who are bald for a long time will want to always have a headband on their baby since they can not clip on bows to her hair. This will always constrict the movement of the cranial bones and work towards altering the shape of the cranium. Typically a headband will wrap around the occiput, temporal, sphenoid, and frontal bones. Even slight alterations in the shape or motion of the occiput can cause misalignments in any other cranial bone. This again will cause adhesions in the dura and affect the nutrient saturation of the nervous system. Keep the headband or bow in your bag and only slip it on for pictures and then take it right back off. Look for red marks and signs of the bow on the head after you take it off. The more marks and redness you see left behind after the bow is off, tells you there is more pressure being applied by the headband. Bows and headbands look cute but have a huge impact on the shape and motion of the cranium.

DID YOU KNOW THAT THERE IS A SIMPLE WAY TO TELL IF YOUR BABY HAS NORMAL TONGUE POSTURE?

When your baby is sleeping, slowly pull down on their chin as the mouth starts to open. The tongue should be lightly suctioned to the roof of the mouth and make a clicking noise when you open it all the way as the tongue should release from the roof of the mouth.

DID YOU KNOW THAT GRINDING YOUR TEETH MAY BE A SIGN OF TIES?

A tongue tie can cause bruxism your jaw muscles tightens to compensate for the loss of the normal healthy support your tongue should provide. Grinding is usually sleep disorder related too. The brain signals grinding in order to stimulate breathing.

DID YOU KNOW TIES MAY CAUSE SENSORY ISSUES?
DID YOU KNOW THAT RESTLESS LEG SYNDROME MAY BE A SIGN OF TIES?
DID YOU KNOW THAT TIES MAY CAUSE GUM RECESSION?
DID YOU KNOW THAT TIES MAY CAUSE BUNIONS, FLAT FEET & PELVIC FLOOR ISSUES?
DID YOU KNOW THAT CHRONIC NECK PAIN, ISSUES WITH BREATHING, JAW, SWALLOWING, & UPPER BODY TIGHTNESS MAY BE SIGNS OF TIES?