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oral restrictions

Learn more about tongue, lip and buccal ties from trusted circle providers

 

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Dive right in and explore these common oral restriction FAQs to help guide you in the right direction.

What is an oral restriction?

Tongue tie, lip tie, and buccal tie are oral restrictions present at birth that hamper the normal movement and function of the tongue and mouth.


Research shows that up to 10 percent of babies are born with an oral restriction and up to 25 percent of nursing infants can be affected by shallow latch caused by this condition. The most common types of oral restrictions are tongue tie, lip tie, and buccal tie.

  • A tongue tie is when the band of tissue connecting the tongue to the bottom of the mouth is too short, too thick, or too tight, restricting the tongue’s normal range of motion. Ankyloglossia is the medical term that refers to a restrictive lingual frenum. This is the most common form of oral restriction.
  • A lip tie is when the tissue connecting the upper lip to the gum is too stiff or too thick, preventing the upper lip from moving freely. This condition is less common than tongue tie, yet more prevalent than a buccal tie.
  • A buccal tie refers to tissues that attach the inside of the cheeks to the gums, restricting normal movement. This condition is less common than a tongue or lip tie.

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What causes tongue tie?

Although more research is needed to better understand the causes of oral restrictions, a lot can be learned about how the tissues of the mouth and tongue develop in a fetus during pregnancy. During the normal development of a fetus in utero, tissue forms to anchor the tongue to the base of the mouth.

In most cases, this tissue naturally dissolves to a small, flexible tether around the 12th week of pregnancy. In some fetuses, this tissue does not dissolve, leaving a “leftover” tie that is especially short, tight or thick, which can restrict normal tongue movement.

Evidence points to a genetic mutation known as MTHFR (methylenetetrahydrofolate reductase). Tongue tie is hereditary and is often passed down from one generation to the next. It is more common in boys than in girls and is often present in babies who are born with birthmarks known as “stork bites.”

Learn more about the possible causes of tongue tie here.

 

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What are the signs & symptoms of tongue tie?

The symptoms of oral restrictions are varied and can differ depending on the person and their age.

 

You may notice that your baby is:
  • acting irritable or fussy during or after feeding
  • having difficulty creating a secure latch during nursing
  • losing weight or having poor weight gain
  • falling off the breast frequently during nursing
  • forming blisters or cracks on their lips

If you are nursing your baby, you may notice:
  • breast pain
  • plugged milk ducts (which can lead to mastitis)
  • engorgement
  • cracked or blistered nipples
  • a feeling that your baby is chewing or biting on the breast
  • recurrent thrush or infections

You might notice that your toddler is having:
  • difficulty chewing food
  • difficulty swallowing
  • sleep issues
  • difficulty making sounds such as d, l, n t, th, s and z
  • trouble cleaning bits of food off of the teeth with the tongue
  • chronic sinus infection or ear infection
  • open-mouth breathing
  • snoring
  • oral hygiene issues

If you are a teen or adult you may notice:
  • speech issues
  • tension
  • severe grinding
  • neck pain
  • migraine
  • sleep issues


Find more information on signs and symptoms of oral restrictions here
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Issues related to tongue tie

Oral restrictions can lead to several long-term issues in babies, teens and adults. 

Symptoms usually begin in newborns who have trouble feeding, then progress with age into chronic problems dealing with sleep, speech, behavioral issues — and more — if the oral restriction is left untreated.

tongue-tie-breastfeeding

How does tongue tie affect breastfeeding?

In babies, an oral restriction can lead to complications with breastfeeding. The lack of tongue mobility can impair their ability to properly latch, suck, and swallow. This is why many oral restrictions are discovered and diagnosed due to difficulties with breastfeeding.

It's a great idea to check for oral restrictions in a baby if its breastfeeding mother has mastitis symptoms, decreasing milk supply, or clogged ducts.
 

Can tongue tie cause long-term problems?

If an oral restriction is not diagnosed or treated at an early stage, it can influence a range of health problems over the course of a lifetime. If ignored or never diagnosed, it can lead to a cascade of developmental issues in the mouth and even in the rest of the body.

Many specialists in this field suspect that oral restrictions are related to serious, chronic conditions such as sleep apnea, asthma, heart issues and mental health problems.

Functional effects of not treating an oral restriction:
  • mouth breathing
  • eating issues
  • sleep problems (that can impact mental health and learning)
  • lisp or speech problem
  • frustrations with communication
  • poor oral hygiene

Structural effects
of not treating an oral restriction:
  • crowded teeth
  • blocked-out teeth
  • need for extraction of multiple baby and permanent teeth
  • high palate (collapse of the upper jaw)
  • blocked nasal passages
  • poor head and neck posture
Behavioral effects have been linked to:
  • acid reflux
  • chronic ear infections
  • large inflamed tonsils leading to removal of adenoids (adenoidectomy)
  • ADHD symptoms
  • bruxism (teeth grinding)


Read more about long-term problems related to oral restrictions.

What kind of healthcare professionals can help with tongue tie?

Professionals from various healthcare fields and specialties can help you or your child before, during and after a tongue tie release procedure.


They can be broken down into three basic categories:

  • Functionalists provide therapy and exercises to support the recovery of functions such as eating, speech, and sleep.
  • Proceduralists are trained and licensed to diagnose oral restrictions and perform the release procedure.
  • Structuralists provide treatment and therapy to support healthy structure of the teeth, bones, and body.
    functionalist-structuralist-proceduralist

Learn more about Functionalists, Proceduralists and Structuralists here.



What type of professional is best for me?

To set yourself up for success, you want a team that communicates with each other across disciplines for a full-health approach. At any age, a multi-provider, collaborative effort will help your family have the best possible outcome.

 
Here are important questions to ask as you create your circle of support:
  • What is the developmental stage of your infant or child?
  • How long has your child’s oral restriction gone untreated?
  • To what extent has your child compensated for the oral restriction?
  • Does your child have any other health or behavioral conditions that need to be considered?

 

Does it depend on age?

Yes! Your team of professionals will change depending on the age of your child, their functional and structural issues, and when they received their release procedure.

Infant (newborn to 3 months)

tongue-tie-age-newborn

Many oral restrictions are diagnosed in babies due to difficulties with breastfeeding. At this stage of development the main issue is the baby’s inability to properly suction, suck and swallow due to an oral restriction. This can lead to weight loss, low weight gain and a failure to thrive diagnosis for the baby, as well as clogged milk ducts, mastitis, infections, and nipple pain for the nursing mother.

The ideal time to have a release procedure is between 6-14 days after your baby is born. When an oral restriction is diagnosed and treated at this stage, you can prevent many other complications and conditions that can arise in a child with an untreated oral tie issue.

Baby (3 months to 1 year)

tongue-tie-age-baby

At this stage of development your baby may or may not be breastfeeding. Around six months your pediatrician will advise you about how to introduce foods other than breastmilk or formula. Your baby will start to make babbling sounds, crawl and develop motor skills. Sleep and feeding patterns are changing.

Many, if not all, of these developmental milestones and processes can be affected by an oral restriction. As a parent it is important to know the signs and symptoms of oral restrictions so you can communicate them to your healthcare provider who knows about tongue tie such as your pediatrician.

Child (1-12 years)

tongue-tie-age-child

At this stage your child is learning important skills and functions that will serve them for the rest of their life. As a parent you might notice issues such as problems sleeping, a lisp or difficulty pronouncing certain sounds, challenges with activities such as licking a popsicle or playing a wind instrument. Parents may also be concerned about add and adhd symptoms, which may be indirectly linked to sleep and brain function due to an oral restriction affecting their ability to breathe properly.

Teen (13-19 years)

tongue-tie-teen

At this stage, there are often structural problems or “collapse” related to an untreated oral restriction that need to be corrected.

Adult (19+ years)

tongue-tie-adult

At this stage it is common to see significant structural damage due to an untreated oral restriction. Because form follows function, the movement of the muscles actually changes the bone, leading to problems with posture,migraines, tension, and head and neck pain. Impaired breathing affects sleep, digestion, cardiovascular and mental health issues.

Learn more about the healthcare professionals who can help with your specific needs here.


 

What happens in a tongue tie release procedure?

A healthcare professional known as a proceduralist, such as a dentist, doctor, naturopath, or nurse practitioner will release the membrane causing the oral restriction.

It is an outpatient procedure that usually only takes a few minutes and heals within a matter of days.

The procedures to release oral restrictions have evolved over time. In the past, scissors or scalpel were the main options available. With the invention of lasers for medical treatment, the procedure can be even more precise and allow for faster healing.

 

What are the different types of tongue tie release procedures?

There are two types of tongue tie release procedures — a frenectomy and a frenotomy. As you explore your options, it's important that you know the difference between them.

Click here to learn the difference between a frenectomy and a frenotomy.


 

Build your personal circle of care

The health:latch circle was created to help parents, patients and caregivers connect with health professionals who can help them with all aspects of care for oral restrictions.

You can get answers from specialists and connect with Proceduralists, Functionalists, and Structuralists who understand oral restrictions and are committed to helping families thrive.

By bringing together healthcare professionals across a variety of fields, the health:latch circle helps parents and patients to assemble a personalized team to accompany and guide their journey towards better health.

 

Follow these 3 easy steps to receive the care you deserve:

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1. LEARN from articles, videos and research studies about oral restrictions.

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2. TRUST the circle to guide you and find the answers and care you're looking for.

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3. THRIVE by growing your unique circle of healthcare providers who can help.

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