What You Need to Know
Welcome to Lynn’s Tied Together Hub, your trusted source for expert insights on tethered oral tissues, including tongue ties, lip ties, and cheek ties. Today, we’re diving deep into a topic often surrounded by mystery and questions: tongue-tie surgery adults.
For many, addressing a tongue tie later in life may seem daunting, but this procedure can be transformative, improving everything from swallowing to speech to overall body health.
Surgery is not the first step, well, at least it shouldn’t be! The best outcome for adult tongue tie surgery is to first participate in a course of oral motor exercises or myofunctional therapy.
Many different reasons can lead an adult to consider tongue tie surgery. Those reasons will be explored here and will help illustrate the need for a team approach with surgery sandwiched in the middle!
Why Consider Tongue Tie Surgery in Adulthood?
Many adults live with a tongue tie—a condition where the lingual frenulum (the tissue connecting the tongue to the floor of the mouth) restricts movement.
Most have adapted their oral movements for speech and feeding needs over time, utilizing compensatory patterns to accomplish these tasks. The problem is that these compensations usually break down as you age.
How this breakdown shows itself can differ from person to person. Some common complaints are headaches, jaw pain (TMJ), neck pain, dental decay, snoring, disruptive sleep, braces, daytime drowsiness/moodiness, pelvic floor pain, or digestive issues.
If you’ve been dealing with persistent issues that just don’t seem to fully improve and resolve, then you may indeed be dealing with a tethered oral tissue. The term tethered oral tissue refers to lip, tongue, and cheek ties that may hinder harmonious oral movements.
For those wondering if it is too late to address a tongue tie, the good news is that it’s never too late to improve your quality of life. Many adults have successfully released their tongue ties.
The adult tongue tie surgery, or frenectomy, is a procedure that releases this restriction, often followed by improvements in symptoms.
Signs You Might Benefit from Tongue Tie Surgery Adult
Common signs that could indicate a restricted tongue function include:
Difficulty Swallowing or Feeling Like You’re “Gulping” Air
Honestly, you may not even know that you are eating incorrectly. Adults are often surprised when myofunctional therapists evaluate their swallow and identify hiccups in the mechanism.
Open-mouth chewing can be subtle and connected to one or more tethered oral tissues such as lip and tongue ties. Because of a tie, the tongue is not fully ranging to accomplish the varying movements required for chewing food. As compensation the mouth grades open.
The tongue is dynamic and moves in a coordinated manner. The tongue should dip in the middle and curve its lateral edges up to create a tongue bowl shape. This bowl shape allows food and drink to enter the mouth and be lateralized or elevated.
Then the tongue can elevate in the mid to back portion and strongly propel food down to the throat. That range from dipping for a bowl and elevating for propelling food is integral to eliminating trapped air, and easily keeping lips sealed.
Picky eating can be another red flag that this system isn’t working in harmony. As described above if tongue movements are limited then over time an adult will develop a list of foods they don’t like. Never connecting that this is compensation for an oral tie.
Speech issues such as unclear pronunciation or a lisp
Articulation of sounds requires more dynamic movements than swallowing. The R sound is most often mispronounced due to poor elevation and side spread of the posterior tongue.
The S SH CH and J sounds may be produced with too much air escaping into the cheeks, a lisp. This is due to the tongue being limited in tongue tip and posterior tongue moving in sequential patterns required to direct airflow.
A speech therapist with myofunctional training would be the most qualified to evaluate your oral motor movements and their impact on speech and swallowing skills.
TMJ discomfort or jaw pain
The jaw is the base of support for the oral muscles. When those oral muscles do not move in harmony due to ties, the jaw tries to compensate. The jaw may glide left-right, jut forward, or lock in place to allow the speech or swallowing muscles to complete their action.
This excess jaw movement will break down the joint of the jaw, resulting in TMJ pain.
Reflux or Digestive Issues
Digestion starts in the mouth. If oral ties are present and the range of motion is limited for chewing and swallowing, then the next phase of digestion is compromised.
Too much air may be swallowed due to open-mouth chewing. This excess air will cause gas, bloating, reflux, and burping.
Sleep and Breathing Difficulties
The tongue should rest on the roof of the mouth or palate. When it is tied it rests lower on the floor of the mouth.
This low resting posture when sleeping can allow for the tongue to fall back blocking the airway. This can be the root cause of snoring and sleep apnea.
Understanding that these areas may be impacted by tongue tie as an adult can have you considering surgery to release the tie.
What to Expect from Tongue Tie Surgery for Adults
Initial Evaluation Before Surgery
It is crucial to work with a qualified speech-language pathologist (SLP) trained in myofunctional therapy. This assessment should be done before seeking a surgical release or frenectomy.
They will assess your symptoms, discuss your goals, and, if surgery is recommended, guide you in preparing your muscles and improving tongue strength.
One of the most important things is to ready the muscles for newfound movement. A course of at least 6-8 weeks of myofunctional therapy often improves surgical outcomes.
A major reason for this is the tension that exists through the fascia system. Fascia is intertwined in the muscles and skin throughout your body. When myofascial is introduced into the mouth to relieve and release the fascia we find increased muscle function and less pain.
Pain is an indication of tightness and restriction, especially under the tongue. Utilizing myofascial releases to lower pain is crucial before a surgical release.
When the surgeon is surgically releasing the frenulum, it will be a better release if the tongue easily elevates, and the frenulum is not tightly embedded into the muscle. Myofascial allows the muscle surrounding the frenulum to relax and stretch out more easily. This provides the surgeon with an easy view and release of the frenulum.
Once your myofunctional therapist sees readiness in the oral muscles they will refer you to a preferred surgical release provider.
The Frenectomy Procedure – Tongue Tie Surgery Adults
Preferred Provider
Please do not just go to your neighborhood-friendly ENT or dentist. You may have a family doctor or dentist that you trust immeasurably. If they have no training in this field, they will likely tell you not to pursue release.
Unfortunately, many adults travel years-long paths in pursuit of answers having been dissuaded by non-preferred doctors. Preferred providers are the key to managing your tongue tie correctly.
www.tonguetielife.com is a preferred providers list can help you locate doctors and therapists near you. Traveling for a preferred provider is preferred over remaining locally for an inexperienced provider.
Now that you’ve found your preferred provider and arrived at the office one of two paths exists. The first is that the doctor will evaluate your tongue tie and release the tie on the same day. The second is they will evaluate and schedule you in a few weeks for the procedure.
Office Assessment
The tongue tie surgery adults evaluation will consist of the doctor looking at and probing the frenulum in his office. This is an office procedure and does not require a visit to the hospital.
They may use the TRMR tongue range of motion grading scale to help determine the necessity for surgical release. The grading system is as follows:
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%
Now you’re ready for surgery! The doctor may use scissors or laser, either one is fine in the hands of a skilled surgeon, but laser is more commonly used today. It is felt that because the laser seals as it cuts it lessens bleeding and improves healing time.
The surgery itself is often brief, lasting under ten minutes! The area will be numbed and prepped, and you will wear protective glasses if the laser is used. Discomfort is minimal with only the smell of burning under your nose as the release is completed. An experienced provider will ensure precision in releasing the tissue for optimal results.
You will often be moved to a side recovery room for monitoring over the next 20-25 minutes. During this time, an assistant will review with you the range of motion exercises recommended to encourage healing and reduce reattachment.
Typically, these exercises are recommended 4-5 times a day for the first 2 weeks following the surgical release.
Pain meds are used as needed for 1-3 days.
Post-Surgery Myofunctional Therapy
This phase is key to retraining the tongue and surrounding muscles. Your myofunctional therapist will guide you through exercises to build strength, improve tongue posture, and enhance overall function.
Reattachment of the frenulum is more likely if tongue range of motion and myofascial releases are not completed in a post-surgery plan.
Everyone is different, but the average post-surgical therapy time is 5 months.
Muscle function does not improve overnight, though many report feeling immediately better after being released. Feelings of reduced tightness and tension, ease of movement, and a sense of relaxation in the body are commonly noted.
This feeling should not be confused with long-term function which will require consistent therapy to achieve.
Then there can be a rebound effect around days 7-10 where tension is strongly noted again. Myofunctional therapy will assist you through this period, and in most cases keep it minimally impactful.
The journey of tongue tie surgery adults will average 7-10 months from starting your search through lifetime symptom relief.
So what’s stopping you? Let’s take a look at some common myths that keep adults from seeking surgical intervention.
Myths About Tongue Tie Surgery Adults
It’s Only for Children
Many adults benefit from surgery and report significant improvements in their daily comfort and quality of life. Due to a lack of provider knowledge, many parents are dissuaded from having their child’s tongue tie released.
This child is you! Yes, you certainly could have had it released as a child, but that does not negate the ability to release it as an adult. Many adults have had positive outcomes and improved their oral and overall health by having tongue tie surgery.
It’s Painful and Complicated
With modern techniques, the procedure is minimally invasive, and recovery is often swift, particularly with the support of myofunctional therapy. That’s not to say it will be pain-free. With a lifetime of tension, there can be pain in releasing/completing myofascial releases to improve function.
We find this pain to lessen within the first few weeks of treatment.
There will be discomfort following the surgical procedure, but usually akin to your average dental work and easily managed with over-the-counter pain meds.
Your myofunctional therapist will take the complication out of the process for you.
They will identify your needs, establish goals, and provide you with a home program. Making time for any self-improvement can seem overwhelming at first. But within a few weeks, it will be a genuine part of your wellness routine and day.
It Won’t Make a Difference
Many adults feel relief in areas they didn’t even realize were impacted. Improved sleep, better swallowing, and enhanced speech are just some of the potential benefits.
Your myofunctional therapist will listen to your concerns and target the areas that are most important to you. Ensuring that the intervention will indeed make a difference in your life!
Is Tongue Tie Surgery Adults Right for You?
Tongue tie surgery for adults can provide lasting, life-improving benefits when paired with comprehensive myofunctional therapy. If you experience any of the symptoms discussed above, consider reaching out to an experienced provider who specializes in tethered oral tissues.
Information is the first step to knowing if it is right for you. If you have more questions drop a note below or check out other articles on tethered oral tissues at www.lynnstiedtogethrhub.com/blog
For more insights and resources, explore Lynn’s Tied Together Hub where we cover everything from diagnosis to treatment for a range of oral myofunctional issues.