Braces for adults have become increasingly popular as more people seek to improve their smiles and oral health later in life.
However, many adults pursuing orthodontic treatment might be surprised to learn that underlying factors like tongue and lip ties could significantly impact their progress and results.
As a speech-language pathologist specializing in oral motor myofunctional therapy, I’ve seen firsthand how tongue ties and other oral ties can influence dental alignment and overall oral health.
This article dives deep into the connection between tongue ties and braces for adults, explaining why addressing oral ties is critical for achieving optimal orthodontic outcomes.
What Is a Tongue Tie?
A tongue tie, or ankyloglossia, occurs when the lingual frenulum (the small band of tissue connecting the tongue to the floor of the mouth) is too short, tight, or thick.
This restricts the tongue’s range of motion, affecting its ability to perform essential functions like speaking, swallowing, and maintaining proper oral posture.
In adults, tongue ties often go undiagnosed, as their effects may manifest subtly over time.
Tongue ties can influence more than just speech. They play a significant role in oral and facial development, including the alignment of teeth and the structure of the jaw.
When left untreated, tongue ties can contribute to crowding, misalignment, and relapse after orthodontic treatment.
Wondering how to check your tongue for a tongue tie? Check out our self-assessment of tongue tie HERE.
What Is a Lip Tie?
An adult lip tie occurs when the frenulum, the tissue that connects your upper lip to your gums, is too tight or restrictive. You may also have heard it called a tethered oral tissue.
It may reach all the way down to your tooth line and or invert under the gum. Thus, creating a space between your two front teeth. Tethers can appear very wide and fat or be long, thin, and restrictive.
When smiling, the red part of your lip appears thin and is often pulled up towards the nose. This exposes the teeth and gum ridge in an exaggerated way.
This can cause a variety of both functional and cosmetic concerns.
While we often think of lip ties as a childhood issue, many adults unknowingly live with this condition. Facing long-term repercussions, from difficulties with basic functions like chewing and swallowing to self-esteem issues related to their appearance.
If you think lip tie may be affecting you, grab our free self-assessment of lip tie HERE.
How Tongue Ties Affect Dental Alignment in Braces for Adults
The tongue exerts constant pressure on the teeth and palate, which helps shape the dental arches and maintain proper alignment.
In individuals with tongue ties, the tongue’s restricted movement prevents it from resting in its natural position against the roof of the mouth. Instead, the tongue may rest lower in the mouth, leading to several issues:
- Narrowed Dental Arches: Without proper upward pressure from the tongue, the palate may remain high and narrow. This can result in crowding of the teeth and improper bite alignment.
- Forward Head Posture: A restricted tongue often leads to compensatory postural changes, such as forward head posture. This can affect the alignment of the jaw and teeth over time.
- Mouth Breathing: Adults with tongue ties are more likely to breathe through their mouths due to difficulty achieving nasal breathing. Chronic mouth breathing contributes to changes in oral and facial structure, including a longer face and a recessed jaw.
- Relapse After Braces: For adults undergoing orthodontic treatment, unresolved tongue ties can cause teeth to shift back to their original positions after braces are removed. This occurs because the tongue is unable to provide the necessary stability to maintain the new alignment.
Oral Muscle Balance to Shape Tooth Alignment
The lips and the tongue work in harmony to balance the oral system with pressure and stability. Think of it like a mold. The teeth fit into this perfect mold.
When the lip is moving freely, and not bound, it applies gentle pressure into the maxillary arch, where your upper teeth live.
The tongue when it moves freely, lives up in the palate applying gentle pressure to the palate and maxillary arch. The teeth are snugly held and molded into this shape between the tongue and lips.
When there is a hiccup in this harmony, an oral tie, the pressure is off, therefore the dental alignments are also off.
One or more ties are all it takes for a relapse into more orthodontic work. Addressing ties, and the needed restoring of muscle balance, is necessary for optimal orthodontic success.
The Role of Myofunctional Therapy When Considering Braces for Adults
Myofunctional therapy focuses on retraining the muscles of the face, tongue, and lips to function correctly. For adults with tongue ties, myofunctional therapy can play a vital role before, during, and after orthodontic treatment. Here’s how:
- Pre-Braces Preparation: Myofunctional therapy helps identify and address dysfunctional oral habits, such as tongue thrusting or improper swallowing patterns, that can interfere with orthodontic progress. Retraining the tongue to move up and back rather than out against the teeth is a key goal.
- During Braces: Exercises prescribed during myofunctional therapy ensure that the tongue and other oral structures are functioning optimally, supporting the work of braces. As shifting occurs, myofascial release can lessen tension and pain as you adjust to the new placements being achieved through the braces.
- Post-Braces Retention: After braces are removed, myofunctional therapy helps maintain proper tongue posture and oral habits to prevent relapse.
To learn more about the role of myofunctional therapy please see our other articles on the subject:
Myofunctional Treatment for Adults: Breaking Free from Tongue, Lip, and Cheek Ties
Orofacial Myofunctional Therapy Exercises
Myofunctional Therapy Exercises
The Connection Between Tongue and Lip Tie Releases and Braces for Adults
Surgical Release
For adults with significant tongue and lip tie restrictions, a frenectomy—a minor surgical procedure to release the tongue tie—may be recommended.
This is typically completed by a preferred provider in office with a specialty in tethered oral tissues. The frustrating thing for adults is the misinformation that can occur among professionals.
You may feel that your current orthodontist or dentist should be able to handle your questions and provide intervention for your oral ties.
However, not all Dentists and orthodontists have specialty training in oral ties. All too often, rather than referring you to a preferred provider, they simply brush it off as a non-factor, leading you to believe that addressing your ties would be of no benefit.
In the past few years, it is as if a whole new field has emerged in dentistry. Airway-centric or airway-focused dentistry has arisen. Driven by dentists and orthodontists who have specialized in oral ties and understand the connectedness to your airway/breathing and oral posture.
Correcting it is multi-faceted involving a team of speech, myofascial, craniosacral, and PT/OT therapists. Along with a dentistry team.
Recommendations to surgically release the tethered oral tissues are made once these professionals agree the muscles are ready.
Benefits of Surgical Release and Myofunctional Therapy in Braces for Adults
When combined with myofunctional therapy, a surgical tongue and /or lip tie release can dramatically improve outcomes for those undergoing orthodontic treatment. Here’s why:
- Improved Tongue Mobility: After a release, the tongue can move freely, allowing it to rest naturally against the palate. This supports proper dental arch development and alignment. Retraining the tongue to rest in the palate can take time, but it is absolutely achievable as an adult.
- Improved Lip Mobility: Once released the lip can rest with proper placement and pressure against the maxillary arch. This will support proper dental alignment and development.
- Enhanced Breathing: A released tongue and lip can facilitate closed-mouth breathing. Nasal breathing becomes more dominant, reducing the negative effects of chronic mouth breathing on oral health.
- Optimal Orthodontic Results: When the tongue and lip can maintain proper posture, it helps stabilize the new alignment achieved through braces.
Identifying Tongue Ties in Adults
Many adults are unaware they have a tongue tie until they experience difficulties with braces or other oral health issues. Here are some signs that may indicate a tongue tie:
- Difficulty lifting the tongue to touch the roof of the mouth
- Speech issues, such as a lisp or difficulty enunciating certain sounds
- Persistent mouth breathing or snoring
- Trouble swallowing pills or certain foods
- A history of orthodontic relapse
If you suspect you have a tongue tie, consult with a qualified professional, such as a speech-language pathologist, dentist, or oral surgeon, who has experience in diagnosing and treating oral ties.
We like this website for its broad list of preferred providers, Tongue Tie Life, where you can locate providers by the state you live in.
Why Oral Ties Should Be Addressed Before Braces for Adults
Addressing tongue and lip ties before starting braces is crucial for several reasons:
- Prevents Complications: Resolving tongue and lip ties ensures that braces work more effectively, reducing the risk of complications during treatment.
- Enhances Stability: A functional tongue provides natural support for the new alignment, minimizing the risk of relapse.
- Improves Comfort: Many adults report improved comfort and ease of movement in their jaw and mouth after addressing their tongue ties.
Comprehensive Treatment: Braces, Myofunctional Therapy, and Tongue Tie Release
A multidisciplinary approach is often the most effective for adults with tongue ties pursuing braces. One provider will not be able to handle all your needs. This typically involves:
- Evaluation: A thorough assessment by a team of professionals, including an orthodontist, speech-language pathologist, and oral surgeon. This crucial first step depends on finding knowledgeable preferred providers. Typically, finding the first one will help you find the next as they will provide you with reliable names of those they have successfully worked with in the past.
- Myofunctional Therapy: A tailored therapy program to address oral habits and prepare the tongue and lips for optimal function. Oral motor therapy for at least two months is recommended before surgical release. Then at least two months following the surgical release. The length of treatment is dependent on how much tension is in the mouth and the degree of functional impact noted.
- Frenectomy: A tongue and/or lip tie release procedure to improve tongue mobility. Performed by a preferred surgical release provider. Typically done in an office setting with local numbing similar to when you have had a cavity filled. The entire procedure can take as little as 10 minutes to complete.
- Orthodontic Treatment: Braces or aligners to correct misalignment and improve dental function. You may need a palate expander before braces and your orthodontic team will fully assess for this. Expanders will increase the length of time to complete your smile transformation.
Final Thoughts: Braces for Adults and the Role of Tongue and Lip Ties
For adults considering braces, understanding the connection between tongue and lip ties and orthodontic treatment is essential. As an Adult, you are likely on round two or three for braces. Experiencing relapse into braces is concerning. Why did your teeth shift again?
Considering underlying causes can be the key to successful orthodontic treatment. And let’s face it, it’s an expensive treatment! We should get it right and make this the last time.
Which brings us to fixed retainers. If you’re living with a permanent fixed or bonded retainer, ask yourself what force exists in your mouth to continuously shift your teeth.
Addressing tongue and lip ties through a combination of myofunctional therapy and, if necessary, a frenectomy can significantly enhance the effectiveness and longevity of orthodontic results.
If you’re embarking on your orthodontic journey, don’t overlook the importance of evaluating and treating oral ties. By taking a comprehensive approach, you can achieve a healthier, more stable smile that lasts a lifetime. Allowing you to toss those retainers in the trash for good!
If you found this article helpful, explore more resources on oral ties and orthodontic care at Lynn’s Tied Together Hub Blog. Your journey to a confident smile starts with understanding and addressing the root causes of misalignment.