Let’s clear something up right away: posterior tongue ties are real — and they’re often missed. Posterior tongue tie release in adults can positively affect health, body dynamics, speech, and feeding skills.
If you’ve landed on this blog, chances are you’ve been told everything looks “normal,” yet you’re still dealing with symptoms like jaw tension, speech issues, sleep troubles, or trouble keeping your tongue on the roof of your mouth.
You might have even been told your tongue tie “wasn’t that bad,” or worse — that it doesn’t exist because you can stick the tongue out.
As a speech-language pathologist specializing in tethered oral tissues (TOTs), I’m here to set the record straight: posterior tongue tie release can be a transformative procedure for adults — but it must be done right, with a team-based, function-first approach.
In this article, we’re diving deep into the what, why, and how of posterior tongue tie release, and why it’s often the missing piece in your oral health puzzle.
What Is a Posterior Tongue Tie?
A posterior tongue tie is a restriction of the mid-back portion of the tongue — the part that sits deeper in the floor of the mouth, near the base.
Unlike anterior tongue ties (which are visible and easy to spot), posterior ties are subtler. The frenulum may be hidden in a mouth that has difficulty opening wide.
Because the tip is not tied, one may be able to stick it out or even touch one’s nose!
But make no mistake, these ties are no less impactful. In fact, they can cause even more insidious compensation patterns because they often go untreated for years.
The best way to check for a posterior tie is to perform a tongue click. Now do it again, keeping the tongue suctioned up into the palate—don’t click it down. In this view, you can better visualize the frenulum.
Does it look white, or does it remain pink while stretched out? A white band indicates strain and tension.
Is the back part of your tongue sucked up? Or is it unable to lift up and connect into the palate? A low tongue posture indicates poor range of motion.
If you have a white band, low posture, and feel strain and tension when elevating and moving your tongue, you may have a posterior tongue tie.
What Makes Posterior Tongue Ties So Sneaky?
The tricky part about posterior ties is that untrained eyes often miss them. A standard oral exam rarely involves lifting the tongue properly or measuring functional movement. And yet, a posterior restriction can significantly limit:
- Tongue elevation
- Posterior tongue suction, and palatal seal
- Proper swallowing patterns
- Rest posture
- Nasal breathing
- Sleep quality
- Speech clarity
- Facial and cervical muscle balance
Unlike the dramatic anterior tie (the one that can make the tongue heart-shaped), a posterior tie might look “normal” on the surface — but function tells the truth.
After examining how your posterior frenulum looks, one must consider its functional impact on the oral facial structures and the body.
Possible Signs of Posterior Tongue Tie
Here are some telltale signs I see in my clients (many of whom have been missed for decades). Consider how many boxes you would check off this list.
In Adults:
- Forward head posture
- Chronic jaw tension or TMJ issues
- Trouble sleeping, snoring, or sleep apnea
- Mouth breathing
- Difficulty with certain speech sounds (like /r/, /s/, or fast speech)
- Fatigue while speaking or chewing
- Reflux or digestive issues
- Persistent tongue thrust
- “Clumsy” or inefficient swallowing
- Can’t keep the tongue on the palate at rest
- Speech delays or distortions as a child
- Messy eating or difficulty chewing
- Heightened anxiety
- Hyperactivity or ADHD
- Struggles with nasal breathing
- Orthodontic relapse
- Narrow palate or dental crowding
If you see a combination of these signs, it may be time to explore posterior tongue tie release as an option — but not before preparing the body for success.
Why Posterior Tongue Tie Release Alone Isn’t Enough
Let’s get something straight: releasing the tie surgically is only part of the puzzle.
Without pre- and post-release therapy, you’re likely to experience:
- Minimal functional gains
- Reattachment of the tissue
- New compensatory patterns
- Ongoing tension in the jaw and neck
- Lack of carryover into speech, breathing, or sleep improvements
That’s why at Lynn’s Tied Together Hub, I emphasize a team-based approach:
A speech-language pathologist or myofunctional therapist for muscle retraining. Preparing the oral muscles to move appropriately after the surgical release ensures optimal function. A speech therapist has the education and know-how to address speech and feeding problems in conjunction with a myofunctional therapy plan.
The Frenectomy provider (dentist, ENT, or oral surgeon) trained in functional releases must be a preferred provider with experience in oral ties.
Those not specializing often tell you it’s a fad and steer you away from releasing the tie. The skill of a preferred provider is preferred!
A bodyworker or myofascial therapist is needed for tissue prep and recovery in the jaw, neck, back, diaphragm, and pelvic floor regions.
This may be a chiropractor, occupational therapist, physical therapist, or massage therapist.
They may have specialized training in myofascial releases, deep tissue massage, cranio-sacral therapy, and an understanding of the fascia connection with oral ties.
Airway-centric dentist if orthodontic support is needed. The airway-centric distinction narrows the search from your standard everyday dentist/orthodontist to one who considers oral ties and their impact on the oral muscles that support the entire airway system.
Posterior tongue tie release is not a one-size-fits-all fix. It’s an individualized process that prioritizes function.
You may need one or all of these team members, but the best place to start is with a trained speech therapist. After a thorough assessment, the speech therapist can then direct you to any required services.
The Role of Myofunctional Therapy in Posterior Tongue Tie Release
Myofunctional therapy is a structured program of exercises designed to retrain the muscles of the face, tongue, and throat. Think of it as physical therapy for your mouth.
In the case of a posterior tongue tie, the tongue often compensates by:
- Overusing the front (tip) while the back stays low and restricted
- Recruiting the neck and jaw muscles to help with movement
- Developing poor swallowing patterns like tongue thrusts or reverse swallows
- Demonstrating tongue thrust on speech sounds such as S, SH, CH, J, N, L
Pre-Release Therapy Helps
Improve proprioception (knowing where your tongue is in space)- Most have lived a lifetime with the tongue resting low on the floor of the mouth. Increasing awareness and training the tongue to rest on the palate is a cornerstone of myofascial therapy.
Increase strength and coordination—To raise the tongue where it belongs, exercises are implemented to improve the strength and coordination of the tongue, lips, and cheeks. These oral muscles should work in harmony to support the correct rest position of the tongue. Years of compensations mean we need to unlearn patterns while training new, correct patterns.
Reduce compensation and tension- Any oral muscle, but especially the jaw, can be involved in compensation or recruitment. TMJ/TMD discomfort may be directly connected to a compensation pattern established to help a weak tongue.
Teach correct tongue posture and resting position—as mentioned above, this is the cornerstone of myofunctional therapy. As much as we need harmonious movements for speech and feeding tasks, we also need an appropriate resting posture.
In fact, one could argue that this is where the tongue spends most of its time: at rest. It is elevated and toned while in this position, easily holding the placement. This allows one to sleep with closed mouth, reducing snoring and sleep apnea.
This position takes the load of the jaw, which now does not need to clench and fix firmly to keep the mouth closed.
Myofunctional therapy helps prepare for healing and recovery. As adults become educated on how their muscles move and rest, they gain knowledge to ensure optimal recovery from the surgical posterior tongue tie release.
Post-Release Therapy Helps
- Prevent reattachment – knowing where your tongue is resting and keeping it elevated off the floor of the mouth.
- Reinforce new, healthy movement patterns—continue with myofascial and myofunctional therapy to fully resolve old compensations now that the tongue is free from restriction.
- Restore proper swallow and rest posture – with ease now that the tongue moves freely
- Optimize speech and breathing mechanics – refining movements for a lifetime of ease as the last of the tension dissipates in recovery.
So yes, posterior tongue tie release is important — but therapy is what makes it functional and long-lasting.
What Happens During a Posterior Tongue Tie Release?
Here’s what to expect if you go the route of releasing a posterior tongue tie
1. Functional Assessment
You’ll start with a thorough evaluation from someone trained to see what others missed, like a myofunctional therapist and airway dentist.
Functional assessments include tongue range of motion (TRMR), suction ability, oral rest posture, swallowing, and more. The best place to start is with a trained speech therapist who can refer you to the appropriate follow-ups.
A plan will be developed at the time of the assessment, and in most cases, training in exercises for home carryover will be provided.
2. Pre-Release Therapy & Bodywork
You’ll engage in exercises and gentle bodywork (like myofascial release or craniosacral therapy) to loosen the fascia and train your muscles for the upcoming changes.
3. The Frenectomy
The procedure itself is usually quick (5–15 minutes) and often done with laser or scissors, depending on the provider’s technique. Local anesthesia is used in an office setting. It is very similar to a dental visit to fill a cavity, only quicker!
4. Aftercare & Integration
You’ll be guided through wound care, movement protocols, and reintegration exercises.
This is where the magic happens — when the brain and body relearn how to use the tongue without restriction.
Posterior Tongue Tie Release: What the Research Says
Posterior ties were once controversial — not because they don’t exist, but because most providers weren’t trained to recognize them.
Now, studies and clinical experience support what many in the field have known for years:
- Posterior ties impact airway and sleep quality
- They affect oral rest posture and muscle compensation
- Release improves swallowing, tongue strength, and mobility
- Therapy + release yields far better outcomes than release alone
In other words, yes, this is real. And yes, it works.
Research has primarily focused on infants. Here is one article highlighting the benefits seen when posterior tongue tie release was completed:
Then here’s a research article involving adults you may find interesting:
As the research catches up with adults’ positive reports after their releases, we will hopefully have a greater consensus amongst professionals.
This professional agreement will allow for appropriate referrals to preferred providers who can help adults who have been tied together by oral ties for a lifetime find relief from their symptoms.
FAQs About Posterior Tongue Tie Release
Will it hurt?
Most adults report mild soreness, like after a dental procedure, managed by Tylenol or Arnica. The first three days are the worst, with a steady reduction in pain noted as the week progresses.
What if I had a tie released before, but still have symptoms?
You may have had an incomplete or superficial release, especially if it was done without therapy. Re-evaluation can help clarify.
How long does therapy last?
It varies, as many adults benefit from 8–12 weeks of therapy (pre- and post-surgical release). Your age, functional impacts identified and healing wil all play a part in length of treatment.
A safe plan is to expect three to six months from start to finish.
Can a posterior tie grow back?
Not exactly. What can happen is reattachment if the tissue isn’t properly maintained during healing. That’s why wound care and exercises are key.
Can this help with sleep or snoring?
Yes! Especially when nasal breathing and oral rest posture are restored after therapy and release.
What if I sound funny afterward?
Some adults experience slurring of the speech in the first week. This can be due to swelling and the tongue moving with newfound range. Scheduling the procedure when your work or home life load is slower can be helpful to alleviate worry about your speech. It will resolve and improve in a week’s time.
Final Thoughts: Posterior Tongue Tie Release Is Real, and It Works
If you’ve been told everything is “fine,” but your body says otherwise — trust your gut.
Posterior tongue ties may be hidden, but their impact is loud. From speech to sleep to swallowing, they can quietly shape your health and function over a lifetime.
But here’s the good news: with the right team, approach, and timing, posterior tongue tie release can change your life.
Not just by freeing the tongue — but by unlocking your ability to breathe, speak, eat, and move the way you were always meant to.
At www.lynnstiedtogetherhub.com, we offer support for every step of your release journey. Want to learn more?
Check out these related posts:
Tongue Tie in Adult: Unraveling the Silent Struggle
Myofunctional Therapy Exercises
Disadvantages of Clipping Tongue Tie in Adults
Your posterior tongue tie has tied you together for a lifetime, and each case is unique. Consulting with specialists in tongue-tie management can provide a personalized path forward, tailored to your needs and goals.