Ankyloglossia

Ankyloglossia, commonly known as tongue-tie, is a congenital condition in which the lingual frenulum—the tissue connecting the underside of the tongue to the floor of the mouth—is unusually short, thick, or tight. This can limit tongue mobility to varying degrees, from mild restriction to nearly complete immobility of the tongue tip.

Prevalence estimates for ankyloglossia vary widely because of differing diagnostic criteria. In newborns, reported rates range from about 1% to 4%, with higher estimates in some studies that use broader definitions. The condition is typically categorized as anterior (vrij brief frenulum near the tip of the tongue) or posterior, which can be more difficult to detect clinically. The functional significance depends on the degree of restriction and the presence of compensatory movements.

Clinical significance ranges from asymptomatic to problems with breastfeeding, speech, or oral hygiene. In infancy, ankyloglossia may contribute to latch difficulties, nipple pain for the breastfeeding parent, or inadequate weight gain. In older children and adults, it may be associated with limited tongue elevation, articulation issues for certain sounds, or challenges with oral care. However, evidence regarding the impact on speech and long-term outcomes is mixed, and not all individuals require treatment.

Diagnosis is clinical, based on history and observation of tongue movement and tongue-tip function. Several classification systems exist to describe Frenulum characteristics, including its length, thickness, and insertion relative to the tongue tip.

Management ranges from observation to procedural intervention. Asymptomatic cases generally need no treatment. When functional impairment is present, a frenotomy (a simple cutting of the frenulum) or a more formal frenuloplasty may be performed by physicians, surgeons, or dentists. Post-procedure outcomes commonly include improved tongue movement and, in infancy, potential improvements in feeding; speech outcomes are variable and may require additional therapy.