Tongue tie and lip tie in older children can result in speech impediments, dental problems, jaw development issues and other complications that may require extensive therapy and/or orthodontic treatment to correct if left undetected. Due to a recent cultural shift toward breastfeeding, more infants are being diagnosed at an early age when painful nursing alerts the mother of the problem, which can then be quickly corrected with tongue tie and lip tie laser surgery (also called frenectomy). Still many cases of tongue tie and/or lip tie remain undiagnosed, however, until later in childhood, especially if the patients were not breastfed or no significant problems occurred until they began speaking.
While not all children with tongue tie or lip tie will have difficulties, knowing the possible complications can help achieve the proper diagnosis and treatment for those who do exhibit symptoms.
Speech Problems with Tongue Tie and Lip Tie in Older Children
One of the most common problems caused by tongue tie and lip tie in older children is speech difficulty. The position of the tongue and how it moves in the mouth are critical factors in forming sounds, and therefore words, correctly. When the tongue’s movement is restricted by a tight frenulum (the band of tissue that tethers the tongue to the mouth floor), certain sounds may be hard to achieve. A lip tie can cause discomfort moving the mouth into certain positions required to form specific sounds.
Speech problems due to tongue tie or lip tie can present as a lisp and/or trouble with articulating the sounds of the letters d, l, n, r, t, z, th, and sh. Because children are often hard to understand when they first begin to speak, most tongue tie/lip tie speech impediments do not become noticeable until after age 3. While there is no definitive way to know if a tongue tie or lip tie will affect speech, there are commonalities associated with those patients who later develop speech problems, including:
- Heart or V-shaped tip of the tongue
- Inability to extend the tongue past the lower lip or to the roof of the mouth
- Difficulty with side-to-side tongue movement
Speech therapy can be utilized to correct speech problems caused by tongue tie or lip tie, however, therapy is typically much more effective after laser frenectomy. Because the tongue is a muscle, it may take some time for the patient to learn to use the tongue without restriction, but as the body adapts and muscle memory is created, speech should improve dramatically.
Dental and Orthodontic Problems from Tongue Tie and Lip Tie in Older Children
Tongue tie and lip tie can have an adverse effect on dental health, as well as overall oral health. When the tongue is unable to rest against the palate, the result can be abnormal jaw growth and a high palate. An underdeveloped jaw can lead to major orthodontic problems that could require an extensive amount of correction.
A high, narrow palate (rather than a flat, wide palate which occurs when the tongue rests properly at the roof of the mouth) can result in inadequate space in the mouth for healthy permanent tooth eruption. When the teeth come in, they are often too crowded which can mean overlapping roots and very crooked teeth. High palates can also contribute to chronic sinus issues.
Some patients whose tongue tie prevents a proper seal between the tongue and palate develop a tongue thrust which can ultimately push the dental arch forward causing a misaligned or open bite. A tongue tie can also create a pulling force against the gum at the back of the lower teeth which can lead to tooth recession.
A lip tie can make brushing the teeth more difficult, as well as cause food to be trapped between the lip and gum, both of which can lead to dental caries (cavities). Diastemata, a gap between the upper central incisors, can also form when the frenum, or fibrous tissue connecting the lip to the gum, extends between the teeth creating a space. Jaw growth can be affected if an ineffective lip seal results in mouth breathing and an open mouth posture.
Other Potential Problems Related to Tongue Tie and Lip Tie in Older Children
The lips and tongue are comprised of complex muscles which work together to perform all oral functions. When a tongue tie or lip tie is present, the functionality of other bodily systems can be affected.
Other possible complications of tongue tie or lip tie in older children include:
- Chewing and swallowing difficulties: When the tongue is unable to move freely, food placement is uncontrolled making eating and swallowing harder to do.
- Food texture problems: Because food may be difficult to chew and swallow, children with tongue tie may seem like picky eaters, when often the aversion is created by the inability to move food around the mouth properly. Partially chewed food can also be harder to digest, and chronic indigestion may cause older children to simply avoid those foods which create it.
- Jaw, head, and neck pain: Because of the complexity of the oral musculature, a restricted tongue can manifest as migraine headaches, neck tightness, or chronic TMJ (temporomandibular disorder).
- Sleep apnea: If the jaw becomes misaligned from a tongue tie or lip tie, the airway may be affected resulting in snoring or sleep apnea.
Early detection of a tongue tie or lip tie can help prevent and/or correct speech, dental, and other problems when treated with tongue tie or lip tie laser surgery. Dr. Rubin is one of the few dental surgeons in the area to acquire a specialized laser capable of performing tongue tie and lip tie release quickly, safely and effectively. Even if symptoms have been present for years, a laser frenectomy can produce benefits that can be life-changing at any age.
If you are concerned that your child may have an undiagnosed tongue tie or lip tie, contact our office for a simple and painless evaluation. If your child is diagnosed with a tongue tie or lip tie, Dr. Rubin will be happy to discuss the benefits of tongue tie and lip tie laser surgery with you.
If you would like more information about the benefits of tongue tie and lip tie laser surgery, please contact our office if you would like to arrange a pediatric dental consultation with a pediatric dentist at Frisco Kid’s Dentistry, please submit an online appointment request or call our office at 214-618-5200.