Tongue Tie in Adult may be the silent root cause of many health issues that you associate with aging. But what if Aging was not the only reason for your troubles?
Tongue tie, medically known as ankyloglossia, is a condition that has long been associated with infants and breastfeeding challenges.
However, many adults continue to live with undiagnosed or untreated tongue ties, leading to a myriad of health issues that often go unrecognized.
In this comprehensive exploration, we delve into the nuances of tongue tie in adult, shedding light on its symptoms, impacts, and the transformative benefits of treatment.
Understanding Tongue Tie in Adult
A tongue tie occurs when the lingual frenulum—a small band of tissue connecting the tongue’s underside to the mouth’s floor—is unusually short, thick, or tight.
This anatomical variation restricts the tongue’s range of motion, potentially leading to functional impairments.
While many cases are identified and addressed in infancy, numerous individuals reach adulthood. Never realizing that a tongue tie is the root cause of their chronic issues.
The Controversy in Tongue Tie in Adult
Well, actually, this controversy spans the age ranges. Tongue tie, as a medical condition, has been known for hundreds of years, it’s not new and it’s not a fad.
The problem lies in education and experience. Every professional body has specialty areas especially when looking at medical fields. Just as we would seek an expert for our knee replacement surgery, so should we seek an expert for a tongue tie.
But non-specialty professionals stick to a mantra that tongue-tie treatment is a fad and is not necessary to treat. Sadly, they have no real evidence to support that thinking. Further, they are ignoring the patient in front of them, presenting them with the signs and symptoms.
With differing professional opinions on tongue ties, it’s no wonder that adults are walking around tied. Here are a few reasons to consider why you made it this far undiagnosed.
Disregarded by Professionals
Possibly the most frustrating reason to reach adulthood tied is due to medical professionals disregarding your ties completely.
When an orthodontist is placing braces, should they not have noticed a tongue tie?
When your dentist remarks on how the molars are prone to cavities, should they consider a restricted tongue that cannot clean debris?
We think of our dentists and doctors as all-knowing, that they would be the ones to point it out and identify it for us.
But usually, it’s you the patient analyzing and searching that identifies and links symptoms to tongue ties. If your local doctors and dentists are not specialists they will never consider a tie an issue.
Gradual symptom onset
Because the symptoms of tongue tie tend to worsen over time, many adults chalk up their discomfort to stress, aging, or unrelated medical conditions.
We accept things like snoring and sleep apnea as normal, something everybody experiences. Most won’t seek help until a loved one steps in and points out that in fact, this is not normal.
Adaptive behaviors
Over time, many people unknowingly compensate for their restricted tongue movement by adjusting their posture, speech, or breathing patterns.
It is this very compensation that eventually breaks down.
These compensations can mask the symptoms of the tie, making it harder to pinpoint as the cause of persistent issues.
This is when more painful red flags such as TMJ/TMD issues flare up or neck and back pain are just a daily thing to live with.
If you have regular headaches, it may be from the jaw strain after years of sliding and gliding to assist tongue movements.
Common Symptoms of Tongue Tie in Adult
The manifestations of a tongue tie in adults are diverse, often affecting multiple aspects of daily life. Common symptoms include:
Speech Difficulties:
Challenges in articulating certain sounds, fatigue with lengthy speaking, strain on facial muscles, or the sense of being slushy or slurring speech.
Vocal fry or laryngitis may be present due to the strain placed on the hyoid from lingual restrictions.
Eating and Swallowing Issues:
Difficulty in chewing or swallowing food, which can result in prolonged mealtimes or avoidance of certain foods. The feeling of food being stuck in the throat or floating up to the nasal cavity may occur.
Digestive Problems:
Chewing is the first step in the digestive process so it’s no wonder that if your chewing is insufficient, it would impact stomach digestion.
One factor could be that the food is not masticated into a cohesive bolus and bigger pieces are reaching the stomach.
Another problem could be the act of swallowing too much air due to open-mouth chewing. This extra air can cause an increase in belching, gas, and bloating.
Oral Hygiene Complications:
Restricted tongue movement can hinder the ability to clear food debris. This increases the risk of tooth decay and gum disease. Additionally, a low resting tongue can allow saliva to pool and collect around the bottom teeth increasing bad breath.
Dental/Orthodontic:
Many adults find that they are not happy with their smile. Even after years in braces as kids, the teeth still moved out of alignment and bites are off.
Adults with ties often find themselves in a second or third round of braces. Some even settling into a permanent fixed retainer.
Temporomandibular Joint (TMJ) Disorders:
Chronic jaw pain or clicking sounds due to compensatory movements stemming from restricted tongue mobility.
Too often patients relapse into pain after a course of therapy for their jaw.
Once this relapse occurs their doctor or dentist will likely move to more aggressive treatments involving surgery.
Sleep Apnea and Snoring:
A tongue tie may impede airflow during sleep, contributing to snoring and obstructive sleep apnea.
Our tongues should rest comfortably up in our palate. When it is tied it rests low on the floor of the mouth. This position allows it to fall back into the throat blocking the airway.
Also, a low resting tongue promotes open-mouth breathing at night which reduces nasal breathing. When this occurs, optimal restorative rest is not achieved.
Neck and Shoulder Tension:
Persistent muscle tension and headaches result from overcompensation of surrounding muscles. This is largely driven by the jaw pulling out of alignment to compensate for the tongue.
Forward head posture or tilted chin can occur from low resting and forward tongue posture. Where the tongue goes the head and neck follow!
Dowager’s hump is a postural red flag. It’s that area where the back of the neck and mid-shoulders meet. The forming of the hump is due to forward posture and misalignment of the neck.
Pelvic Floor discomfort:
Pelvic pain and dysfunction: Chronic pelvic floor issues that persist despite physical therapy or other interventions may be linked to poor tongue function.
Misalignment in the head, neck, and jaw caused by tongue restrictions can lead to compensations in posture, which directly impact the pelvis.
The Silent Impact: How Tongue Tie Affects Daily Life
Dealing with just one of these common symptoms can directly impact the quality of your life. Realizing that many adults with tongue ties will check several symptoms off this above list allows one to see how impactful a tie can be.
Are you drowsy and irritable in the late afternoon? This can be due to poor sleep. When sleep is non-restorative mood and energy are directly affected.
It can feel weary to live day to day in a body that is not functioning optimally. This may lead to increased anxiety and depression in the adult with a tongue tie.
Fascia is the silent system that we are still learning much about. It turns out that fascia is woven throughout our body in muscles, skin, and organs. Tethered oral tissues such as tongue ties in adults place a hiccup in this system.
This little band of tissue has been silently disrupting harmonious oral and bodily functions your entire life.
Diagnosis: Identifying Tongue Tie in Adult
Recognizing a tongue tie in adulthood requires a thorough assessment that involves visual inspection, tactile inspection, range of motion measurements, and functional impact considerations.
If this is the first time you are puzzling through if you have a tie, you may find our self-assessment check helpful. Click this link to grab your FREE TONGUE TIE SELF-ASSESSMENT.
Self-evaluation may be easier for some than others. This is due to varying degrees of ties. Some ties are located anteriorly, making them more obvious to identify visually. While others are located posteriorly, making them a bit harder to identify visually.
The best way to visualize is by clicking your tongue. Click a few times while looking in the mirror. Look under the tongue as you click, does a band appear white while moving the tongue up? Now hold the click up tight into the roof of the mouth. Is the band popping out? Is it white and strained?
However, be aware that you may not actually be clicking correctly. Be sure to use the whole of your tongue and suck the back portion up equally with the front portion of your tongue.
If you’re having difficulty coordinating the click, then this is a functional impairment and a sign of a tie.
Professional Consultation
A comprehensive evaluation by a speech-language pathologist or dentist specializing in orofacial disorders is essential for an accurate diagnosis. We recommend finding a preferred provider to ensure appropriate assessment.
A preferred providers list arranged by state can be found here, Tongue Tie Life. If you are not finding anyone local to you, make a plan to drive the distance to the closest one. It will be worth the consultation!
Your assessment will involve a direct inspection of your tie. It will also check for lip and cheek ties as these sometimes occur together. Oral range of motion will be examined and a history of speech and feeding issues will be taken.
A determination will be made if a surgical release is needed and a plan to initiate myofunctional therapy will be made. Then referrals to other providers as necessary such as a pelvic floor PT or craniosacral therapists to address connected body issues.
Treatment Options for Tongue Tie in Adult
Now let’s look at a typical treatment plan an adult would walk through to address, treat, and heal from a tongue tie.
Myofunctional Intervention Tongue Tie in Adult
Strengthening and range of motion exercises are utilized to gain harmonious movement throughout the oral facial complex.
Tongue ties can be classified into four grades based on their appearance and the degree of restriction they cause. Tongue range of motion ratio (TRMR) provides a percentage of movement observed, or lack of movement, and helps to assess tongue tie restrictions.
A. Grade 1: Tongue range of motion ratio (TRMR) is greater than 80%
B. Grade 2: TRMR is 50–80%
C. Grade 3: TRMR is less than 50%
D. Grade 4: TRMR is less than 25%
Improving the range of motion for tongue functions and optimally a tongue with the range to rest comfortably in the palate are consistent goals within a myofunctional plan.
The benefits of working with a speech therapist are that they are trained in speech and feeding techniques in addition to myofunctional exercises.
Addressing habit modification for the correction of chewing and swallowing or speech patterns is often a key element to ensure there is no relapse when treatment ends.
Typically, this period of treatment lasts 6-8 weeks and leads into the surgical release.
Surgical Interventions for Tongue Tie in Adult
To correct a tongue tie, two primary surgical procedures are available:
Frenectomy
A frenectomy involves cutting or releasing the frenulum to improve tongue mobility. This procedure can be performed using scissors or a laser. Laser frenectomy is often preferred due to minimal bleeding and faster healing. This is an in-office procedure.
The wound is typically left open to heal on its own over 10-14 days. The procedure itself is about 10 minutes long and the recovery period is typically untroubled. Pain is higher the first few days but easily managed with over-the-counter Tylenol or Arnica.
Normal activities are resumed quickly in most cases.
Frenuloplasty
A frenuloplasty is a more advanced procedure that may involve sutures to reshape or lengthen the frenulum. This option is typically recommended for severe cases or when additional functionality improvements are needed.
The wound is closed with stitches. However, the procedure is still short and completed in 10-15 minutes and managed with over-the-counter pain medications.
There may be a period of 1-2 days that an adult feels slurry or slushy in their speech. This can be due to swelling or getting used to the new range of movements that the tongue has. Though this can initially be worrisome it does resolve in a few days.
Healing of the wound itself takes between 7-10 days and by this time most of the pain has subsided. The wound, if left open to heal, will initially seem large and gaping. Within 1-2 days it is seen to have a white healing patch in a diamond shape.
This patch is present for about 5-7 days when it then starts to pink up in color and the wound is fully closed.
Throughout this healing period, you will continue with the myofunctional exercises and any other additional stretching the surgeon provides.
Dr. Soroush Zaghi, MD (ENT- Sleep Surgeon) one of the Founders of The Breathe Institute has several pictures and videos on his site if you’d like an in-depth look at surgical tongue tie release. https://www.zaghimd.com/frenuloplasty-how-we-do-it
Post-Surgical Myofunctional Intervention Tongue Tie in Adult
Now the fun really begins! You have made it through the surgical healing process and you’re beginning to feel improvements. The myofunctional plan will grow with you, adding in new exercises to increase your range of motion and strength.
With no restrictions present the muscles can find their new normal and compensations can be fully corrected.
Adults will often notice considerable improvement in body tension and state that anxiety levels are less. Finding improvements occurring daily keeps you motivated to continue with the plan.
Typically speaking the post-surgical plan is 2-3 months of direct therapy. This of course all depends on how many functional impacts were found on your assessment. Some adults feel completely healed and ready to go on their own in a month!
Everyone’s journey is their own, but no matter what your healing time is, improvements will be noted from the onset!
For more detailed information on myofunctional treatment programs see our other blog articles Myofunctional Treatment for Adults: Breaking Free from Tongue, Lip, and Cheek Ties and Myofunctional Therapy Exercises.
The Transformative Benefits of Treatment for Tongue Tie in Adult
Though the journey may seem daunting, undergoing treatment for a tongue tie can lead to:
- Improved Speech Articulation: Clearer pronunciation and enhanced communication skills.
- Enhanced Eating Experience: Ability to enjoy a wider variety of foods without discomfort.
- Better Oral Health: Reduced risk of cavities and gum disease.
- Alleviation of Chronic Pain: Reduction in jaw, neck, and shoulder tension.
- Improved Sleep Quality: Decreased snoring and lower risk of sleep apnea.
- Increased daytime energy and focus
- Reduced anxiety
Finding the right professionals to guide your journey of healing and sticking to a consistent home program can change your life in less than a year!
Conclusion Tongue Tie in Adult
Tongue tie in adults is a prevalent yet often overlooked condition that can significantly impact various facets of life. Awareness and appropriate intervention are key to alleviating many oral and bodily troubles.
At Lynn’s Tied Together Hub we’re here to make this process a little easier by providing you with resources and knowledge to empower your decision making!
A life lived tied is one of strain and tension, take a step today to untie these tethers and live in harmony within your body!