7 Health Impacts, and Effective Solutions
What Are a Lip and Tongue Tie?
Lip and tongue ties are common conditions that affect many people, often without their knowledge. Sometimes these ties are referred to as tethered oral tissues or TOTs.
Though they can occur alone, there is a high incidence of them occurring together.
Because most research is based on younger patients we look here at these two published works. The authors in both studies demonstrated the occurrence of tongue tie along with a lip tie and the benefits of intervention for both.
https://pubmed.ncbi.nlm.nih.gov/27497378
Benoiton L, Morgan M, Baguley K. Management of posterior ankyloglossia and upper lip ties in a tertiary otolaryngology outpatient clinic. Int J Pediatr Otorhinolaryngol. 2016 Sep;88:13-6. doi: 10.1016/j.ijporl.2016.06.037. Epub 2016 Jun 18. PMID: 27497378.
and
https://pubmed.ncbi.nlm.nih.gov/27641715
Ghaheri BA, Cole M, Fausel SC, Chuop M, Mace JC. Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. Laryngoscope. 2017 May;127(5):1217-1223. doi: 10.1002/lary.26306. Epub 2016 Sep 19. PMID: 27641715; PMCID: PMC5516187.
Lip and Tongue ties in an adult can cause a range of problems, from dental issues to chronic pain, sleep problems, and even digestive issues.
Despite their prevalence, lip, and tongue ties are frequently overlooked or misdiagnosed, particularly in adults.
The term “lip and tongue tie” refers to a restriction in the tissue (known as a frenulum) connecting the tongue to the floor of the mouth and the upper lip to the gums. When this tissue is too tight or thick, it restricts movement, creating a cascade of issues.
In this blog, we’ll explore what lip and tongue ties are, their hidden health impacts, and the best solutions available for both conditions.
What Is a Tongue Tie?
Let’s start with a tongue tie, or “ankyloglossia,” which occurs when the frenulum connecting the tongue to the floor of the mouth is too tight or short, restricting the tongue’s movement.
Tongue ties can range in severity and are classified as either anterior or posterior. Some practitioners will grade them 1-4 in severity following the Kotlow scale https://www.kiddsteeth.com/assets/uploads/pdfs/websitettlnbew.pdf
Anterior tongue tie: This type of tie is easier to spot because it occurs at the front or tip of the tongue, causing noticeable restrictions. These are identified earlier in life and are typically associated with infants and breastfeeding issues.
Posterior tongue tie: This tie is more hidden, occurring at the mid-back of the tongue, and is often misdiagnosed or completely overlooked due to its subtlety.
If an anterior tie has been treated as an infant, then the problem is considered handled and often not thought of again. When if fact there may be a lingering posterior tie continuing to cause trouble.
As issues develop in toddlers and older years with speech or feeding concerns, ruling out a posterior tie is neglected due to a lack of knowledge as to the two distinct variations in tongue ties.
In both cases, the tongue’s ability to move freely is hampered, which can lead to several issues, including difficulty with speech, eating, breathing, and posture.
Adults with lip and tongue ties will lack harmonious oral motor movements and have developed compensatory movements to accomplish speech and feeding tasks.
What Is a Lip Tie?
A lip tie, or a restricted maxillary labial frenulum, occurs when the tissue that connects the upper lip to the gums is too tight.
Lip ties are often associated with infants, particularly in breastfeeding difficulties, but they can persist into adulthood with significant impacts.
There can be a range of severity, rating on a scale of 1-4 as in the tongue tie rating scale. Sadly, even a lip tie rated at 4 will often not be addressed as a child. A typical response to concerned caregivers is to wait until the child falls and hits their lip, it will burst open.
Is it any wonder so many adults have lip ties? It’s all due to not falling on your face or splitting your lip wide open as a kid!
Even if speech or feeding issues arise later in toddler or school-aged years, connecting it to a lip tie is rarely seen. Largely due to parents thinking it was a non-issue from the earlier in life dismissal.
Health Impacts of Lip and Tongue Tie
While lip and tongue ties are most commonly associated with breastfeeding problems in infants, they can also affect adults, leading to chronic health issues. Here are 7 main health problems linked to untreated lip and tongue ties:
1. Airway Obstruction, Snoring, and Sleep Apnea in Lip and Tongue-Tie Adults
One of the most serious consequences of tethered oral tissues is its impact on your airway, particularly during sleep.
A restricted tongue may block the airway, leading to snoring or, in severe cases, obstructive sleep apnea (OSA).
Sleep apnea, if left untreated, can result in serious health problems, including high blood pressure, heart disease, and stroke.
The tongue should naturally rest in the roof of the mouth. Take note while you’re reading here, is your tongue resting up in your palate, or mid-way by your teeth, or lower in the bottom of your mouth?
A low resting tongue is common in lip and tongue-tied adults. It is compensation for the restriction of the frenulum. This low resting posture is the heart of sleep issues.
Lips that are unable to seal tightly, as in those that are lip-tied, result in open-mouth postures. An open mouth posture combined with a low resting tongue has a huge impact on your nighttime breathing.
To reach REM sleep and get optimal deeper rest, the mouth should be sealed tight at the lips and the tongue should rest up in the roof of the mouth. Allowing for easy breathing through the nose while asleep.
If you notice you’re waking and feeling unrested, if your partner has said you are snoring, if you’re exhausted at three in the afternoon with inattentiveness increasing, you may be suffering from lip and tongue ties.
2. Orthodontic Problems in Lip and Tongue-Tie Adults
The tongue plays a crucial role in shaping the palate during development. When its movement is restricted, the upper jaw may become narrow, leading to crowded teeth.
Without that tongue resting posture being up and creating force into the palate, the teeth have no boundary or mold in which to form around.
Having no natural suction created by the tongue in the roof of the mouth, the palate vaults upward. This narrowing growth leaves less room for teeth to align properly.
Thus begins years of palate expanders and braces to create the expected shape and alignment of the palate and teeth.
The lips also play a role in applying pressure to the teeth for a healthy alignment. If a lip is restricted there are two major impacts on the teeth.
One, the frenulum or tethered tissue may reach down between the two middle teeth, creating a part or space. Braces will close the gap, but there can be a recurrence of the space due to the frenulum’s position.
Two, the tethered tissue holds the lip up and away from the teeth, closer to the gum ridge. Here it presses into the gum line and the lip presents as thin and anchored. The teeth have no boundary to butt up against and help with alignment.
Essentially, the lip and tongue provide the structure or mold for the teeth to form around.
Adults undergoing multiple rounds of orthodontic work without success may have an undiagnosed lip and tongue tie.
By addressing the tongue’s mobility, and the lips positioning you can prevent further shifting of teeth after braces or other dental work.
3. Lip and Tongue Tie – Impact on TMJ (Temporomandibular Joint Dysfunction)
Another often overlooked consequence of lip and tongue ties is their significant impact on the temporomandibular joint (TMJ).
The restricted movement caused by tight oral tissues forces the jaw to compensate for the lack of tongue or lip mobility.
This compensatory strain can lead to TMJ dysfunction, characterized by pain in the jaw joint, difficulty chewing, headaches, and even ear pain.
When the tongue cannot rest against the palate or move freely for speech, it can pull the jaw into improper alignment, placing stress on the muscles and joints around the TMJ.
Over time, this stress may contribute to clicking or locking of the jaw, chronic jaw pain, and even migraines.
Addressing the root cause of the restriction—whether through myofunctional therapy, frenectomy, or a combination of both—can alleviate TMJ symptoms and promote proper jaw function, offering relief from years of discomfort.
4. Pelvic Floor Dysfunction in Lip and Tongue Tie Adults
Surprisingly, tongue ties can affect more than just the mouth. The tongue is part of a larger network of fascia (connective tissue) that runs from the head down to the diaphragm, and pelvis, all the way to your toes.
Adults with lip and tongue ties are often found to have poor posture and misalignment, including pelvic floor dysfunction.
This can result in chronic pain or other pelvic issues, often overlooked as being connected to a tongue tie.
Physical therapists specializing in treating pelvic floor issues often note that their patients have TMJ. They will include goals in the program for treating TMJ with the rationale of the pelvic floor issues causing recruitment up to the jaw resulting in jaw pain.
However, the opposite may be true. The tethered oral tissues may be the core problem for which TMJ and pelvic pain are the red flags. In Treating the lip and tongue tie in adults there is often a welcome shift in jaw and pelvic floor pain symptoms.
5. Lip and Tongue Tie – Impact on Vocal Strain and Speech Impediments
Tethered oral tissues affect your ability to speak clearly and project your voice. Some adults with lip and tongue ties experience vocal fatigue, lisping, or difficulty pronouncing certain sounds.
Speech is a harmonious movement balanced between the lips and tongue. When tethered tissues impede these movements, difficulty is noticeable.
The L and R sounds are the most commonly mispronounced due to ties. Then there is the process of a lisp. A lisp is either frontal, with the tongue placed incorrectly between the teeth, or lateral with obvious excess air escaping into the cheeks.
Adults who find symptoms of lisping as they fatigue throughout the day report feelings of embarrassment and anxiousness.
Vocal fatigue and hoarseness are also directly related to lip and tongue tie restrictions. Reports from those in treatment for ties note that if they need to speak for even a few minutes they begin to feel a quiver, as if they are nervous or about to cry.
They do not emotionally feel this way, but their voice strength is weak and creates this misrepresentation. Experiencing breathlessness and vocal fry as well as loss of voice are commonly noted in addition to the quiver.
Speech and voice issues have a significant impact on one’s work and personal life. Addressing a lip and tongue tie can certainly improve your expressive communication while boosting your confidence.
6. Persistent Chapped Lips in Adults with Lip and Tongue tie
Another red flag of a lip and tongue tie is chronic chapped lips.
The restricted movement of the upper lip along with the low resting posture of the tongue makes it difficult to keep the lips closed, leading to open-mouth breathing, which dries out the lips.
This often results in a cycle of applying lip balm, only to continue dealing with dry, cracked lips. Sleeping at night with an open mouth leads to hours of drying out the lips. No amount of lip balm can cure dry cracked lips caused by open-mouth breathing!
7. Lip and Tongue Tie and Photo Anxiety
Those with a lip and tongue tie often display a “toothy” smile due to the restricted movement of their upper lip. Though they may have had braces teeth may be overlapped or crooked. Leading one to avoid showing their teeth.
A tethered lip frenulum will anchor the lip higher on the gum ridge resulting in excessive exposure of the gums or teeth when smiling. Tongue ties can pull the bottom row backward/inward or cause them to overlap.
Often this can cause anxiety during social interactions when smiling and laughing or during photos.
Many people with tethered oral tissues will avoid these social interactions leading to isolation and signs of depression.
Along With Concerns of Aesthetics and Speech, Lip and Tongue Tie Can Affect Basic Daily Functions.
1. Open Mouth Chewing and Air Swallowing
Lip and tongue ties can make it difficult to chew with your mouth closed.
When we note that lip ties prevent adequate lip closure, and tongue ties prevent adequate tongue elevation, then we have a disharmonious system relying heavily on compensations.
Compensation is an adjustment you make to get the job done. The problem is these compensations eventually fatigue and breakdown. The big breakdown here is without a tightly sealed mouth, air will be trapped in the food.
This can lead to air being swallowed along with food, contributing to digestive discomfort, including gas, bloating, and reflux.
2. Reflux and Digestive Discomfort
Many adults with lip and tongue ties experience acid reflux or GERD but fail to make the connection between their oral restriction and digestive issues.
Chasing cures with over-the-counter and prescription medications to improve acid reflux and GERD, and avoiding foods and events due to digestive discomfort can be a thing of the past once the underlying cause is addressed.
Imagine that a natural cure exists. Releasing your tethered oral tissues may bring great relief of reflux and digestive discomfort.
Why Lip and Tongue Ties Go Unnoticed
Many adults live with lip and tongue ties without realizing it, largely because the symptoms develop gradually over time.
Some people develop compensatory behaviors, making them harder to diagnose. Additionally, healthcare providers may overlook or dismiss the signs of a tie, especially if they’re not familiar with oral restrictions.
The almost black and white, agree/disagree, it’s real/ it’s a fad that adults with lip and tongue tie face is a very real reason why they go undiagnosed.
Leaving adults with ties struggling unnecessarily with the unpleasant side effects of adult lip and tongue ties.
Effective Solutions for Lip and Tongue Ties
The good news is that there are effective treatment options available for both lip and tongue ties.
You can use a registry to find professionals more knowledgeable in tethered oral tissues to better address your concerns: https://www.tonguetielife.com/
Once you locate a team to work with you the first step is learning some exercises to help the muscles of the mouth work more harmoniously.
1. Myofunctional Therapy
One of the most effective non-surgical solutions for lip and tongue ties is myofunctional therapy.
This form of therapy focuses on retraining the muscles of the tongue, lips, and face to restore proper function. Laryngeal exercises, targeted at improving your voice, are also utilized if needed.
Myofunctional therapy exercises can strengthen the muscles around the mouth and reduce tension in the fascia and muscles to reduce pain.
Oral exercises can help improve breathing, reduce snoring, and alleviate other issues caused by oral restrictions.
Your therapist will lead you to the place where you’re ready for a surgical release of the restricted lip and tongue tie.
2. Frenectomy (Surgical Release)
In most cases, a frenectomy will be recommended. This simple surgical procedure involves cutting the frenulum to release the restriction and restore full mobility of the tongue or lip.
Frenectomies can be done using scissors or a laser, and the recovery time is typically short, with most people returning to normal activities within a day.
The procedure is quick in the office and typically only requires numbing at the site. You will likely be in and out faster than a typical dental appointment to clean your teeth.
The wound itself will require more direct attention for two weeks following the release.
This could mean an increase from 1x a day oral exercises to 4-5x a day to ensure the wound heals well and does not scar or reattach.
Following the plan laid out by your therapist will help with healing and muscle function. How long therapy lasts past the surgical release is case-by-case dependent.
Some feel immense changes immediately while still sitting in the dental chair. Others who’ve suffered from TMJ pain and more long-standing issues may benefit from longer plans of care to fully resolve their issues.
Real-Life Success Stories: Transforming Lives with Lip and Tongue Tie Treatment
Many adults have found significant relief from chronic symptoms after undergoing myofunctional therapy and a frenectomy.
One patient reported that after years of suffering from headaches during physical activities, she could finally enjoy outdoor activities without pain after her posterior tongue tie and lip tie were released.
Stating that she paddled with her son in the bay on kayaks for 2 hours, and though her arms were killing her, no headache or neck ache!
This real-life transformation highlights the profound impact that addressing a lip and tongue tie can have on overall health and quality of life.
Taking the Next Step: Is Lip and Tongue Tie Affecting You?
If you’ve been struggling with any of the symptoms mentioned in this blog—whether it’s snoring, reflux, speech difficulties, or aesthetic concerns—it might be worth exploring the possibility of a lip and/or tongue tie.
Myofunctional therapy and frenectomy offer effective solutions that can not only improve your appearance but also enhance your overall health and well-being.
If you suspect a lip or tongue tie, seek out a specialist familiar with tethered oral tissues. Treatment could be life-changing, helping you breathe easier, digest more comfortably, and feel more confident in your smile.
By addressing lip and tongue tie, you can unlock better health, function, and confidence.
Please check out our other blogs on lip and tongue ties here https://lynnstiedtogetherhub.com/blog/