A tongue tie, medically known as ankyloglossia, is a condition where the lingual frenulum—the tissue connecting the underside of the tongue to the floor of the mouth—is unusually short, thick, or tight. Not knowing what a typical frenulum looks like vs a restricted frenulum leads one to ask, what does a tongue tie look like in adults?
How To Know If My Tongue Is Too Short, Thick, or Tight
A restriction of the frenulum can impede tongue movement, leading to various functional challenges. Let’s start with visual indicators of a tongue tie in adults.
In adults, a tongue tie may present with the following characteristics:
Limited Tongue Mobility
Difficulty lifting the tongue to the upper teeth. The tongue should be able to touch behind the top middle teeth while the mouth is open as wide as it can open.
Resting posture
The tongue should naturally rest on the roof of the mouth. With your mouth closed identify where your tongue is resting. Is it up in the palate? Is it lower next to the bottom teeth? Take a deep breath in through your nose then slowly open your mouth, did your tongue pop down from the roof, or was it already down on the bottom?
Narrow Opening of the Jaw
Generally speaking, you should be able to easily place three stacked fingers into the opening with a fourth causing a slight strain but still fitting. One or two finger widths indicate a narrow opening.
Heart-Shaped Tongue Tip
When attempting to lift the tongue, the tip may appear notched or heart-shaped due to tension. When pointing up, the tongue should appear rounded at the tip.
Tight Lingual Frenulum
A visibly short or thick band of tissue under the tongue that restricts movement will be blanched white. While lifting the tongue the frenulum should remain pink if it’s not restricted. It is likely restricted if you’re lifting and seeing a white band.
Feeling Strained
Click or pop the tongue. If the movement feels tight, strained, and even painful the frenulum is restricted.
Anterior Tongue Tie
A tie that is closer to the tongue tip is labeled as an anterior tie. These are more obvious and easily seen on visual inspection, cause greater strain in movement, and are blanched white even in a small range of motion.
Posterior Tongue Tie
This tie is located mid-back of the tongue and is often harder to visually identify. Adults typically have posterior ties and have difficulty elevating the back of the tongue.
Above we see four photos provided by Dr. Richard Baxter which demonstrate the various looks of tongue tie when visually examined. Images shared on the blog by The Alabama Tongue Tie Centers Dr. Richard Baxter, DMD, MS http://tonguetieal.com/do-tongue-ties-affect-adults-what-symptoms-do-they-have/
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Visual inspection of the frenulum and tongue is one step in the visual process. Next, we will examine dentition and facial structure as an identifier of what does a tongue tie look like in adults.
Long Narrow Faces Less Pronounced Jawlines – What Does a Tongue Tie Look Like in Adults
When posing the question of, what does a tongue tie look like in adults, you were likely only thinking of the tongue structure itself. But tongue ties may cause other visual concerns in adults.
Adults with tongue tie often exhibit facial structures that are distinctively different from those without the condition.
The restricted movement of the tongue due to ankyloglossia can impede proper jaw development. When the tongue is unable to rest comfortably against the roof of the mouth, as it should, the jaw does not expand to its full potential.
This limitation often results in a longer, narrower face, characterized by underdeveloped jaws.
Research
Research has shown that the tongue plays a crucial role in the expansion of the maxilla, the upper jawbone, during early development.
In cases of tongue tie, the lack of adequate tongue pressure on the palate can lead to insufficient growth of the maxilla, resulting in a narrow facial appearance.
Studies aimed at highlighting the importance of proper tongue function for normal facial development such as
Deregibus, A.; Parrini, S.; Domini, M.C.; Colombini, J.; Castroflorio, T. Analysis of Tongue Function from the Orthodontist’s Point of View: Not Only a Matter of Deglutition. Appl. Sci. 2021, 11, 2520. https://doi.org/10.3390/app11062520
Concluded
“On behalf of the complete diagnosis of the development of malocclusions, every aspect of the patient should be considered with caution.
Within the experimental limits, results obtained in this observational study showed that the tongue position in patients with Angle class III malocclusion, maxillary hypoplasia, and posterior crossbite seemed to influence malocclusion.
Therefore, the clinician (orthodontist or general dentist) should analyze not only the presence/absence of atypical swallowing but also anatomical aspects, such as ankyloglossia and the behavior of the tongue in the rest position, and functional aspects, such as the correct execution of certain logopedic exercises (i.e., “hold and pull” and “chuck”).”
For those not familiar the term “chuck” it is more commonly referred to as a tongue click and the “hold and pull” is sucking the tongue up into the palate and then opening the mouth wide while keeping the tongue up.
Moreover, the lack of proper jaw expansion due to a restricted tongue can lead to a less pronounced jawline.
This can contribute to several dental issues, including overcrowding of the teeth and misalignment, which further exacerbate the challenges faced by individuals with tongue ties.
Dentition – What Does a Tongue Tie Look Like In Adults
Teeth sit in the maxillary and mandibular arches, which we noted are directly impacted by tongue resting posture.
If the arches are shifted, then it follows that teeth will shift too. Dental crowding with the two front teeth overlapping is a consistent finding of adults with tongue ties.
Open bite and crossbite typically have been addressed in either childhood or adulthood through orthodontic measures. Many adults report two to three rounds of braces in their lives.
Visually, your teeth are a red flag waving at the tongue tie. Limited tongue range may also play a part in dental hygiene.
The lack of proper tongue movement can result in the buildup of plaque and tartar, leading to tooth decay and periodontal (gum) disease.
The health of your teeth, or lack of it, may be directly related to a tongue tie which causes limited range of motion to keep teeth clean.
The visual inspection is just one step in determining if the frenulum is restricted. Functional symptoms are just as valuable in identifying the adult tongue tie.
Functional Symptoms Associated with Tongue Tie – What Does a Tongue Tie Look Like In Adults
Beyond visual signs, adults with a tongue tie might experience functional issues in 4 key areas.
Speech Difficulties
Tongue ties are most associated with speech deficits in children but can persist into adulthood. It can be challenging to pronounce certain sounds when the tongue is restricted in movement.
The R sound is often seen as an affected sound. The posterior side-spread and mid-blade elevation movements required to fully create the sound can be hindered. The S, SH, CH and J sounds may be produced in error due to excess air creating a lisping quality.
For airflow sounds such as the S the tongue needs to retract and side spread where it holds onto the inner molars, creating a runway for the air to travel down. The tension in the tongue will create the force for the air to produce the S crisply.
If the tongue is tied, it struggles to create this runway and crispness. Hence a lisp exists, as too much air is escaping into the cheeks or out through the front teeth.
It can also make it difficult to speak for extended periods, meeting presentations as an example. The rapidly alternating patterns of speech can be fatiguing to a tied tongue that lacks the full range of motion and strength to perform longer sequences of speaking.
Eating and Swallowing Issues
Adults with tongue ties may find chewing and swallowing food uncomfortable, sometimes leading to reflux or even nutrient deficiencies from not fully breaking down food.
The tongue needs to create a tongue bowl shape to accept and move food. It lateralizes food side-side for efficient chewing.
When the tongue is tied it lacks the range of motion and strength to move food easily. This often leads to picky eating or limited diets.
The final oral stage of chewing food requires the tongue to squeeze up into the palate and then forcefully push the food down into the throat/pharynx. Poor propulsion of the food can lead to reflux, gas, and burping.
Posture and Musculoskeletal Health
Restricted tissues in the mouth can subtly affect posture, leading to issues with neck and back alignment. The tightness from oral ties often causes compensations that extend into the jaw and down to the shoulders and spine.
Fascia is known to travel the length of the body like a web interconnecting our muscles, organs, and skin.
These restrictions can cause the diaphragm to be held up higher than normal, creating breathing issues. It can similarly pull tension into the pelvic floor. This may make it difficult to have a vaginal delivery as a woman or to recover easily after birth.
Resolving oral ties may bring you ease in your neck, back, pelvic floor, and breathing allowing you to be as active as you need with your kids.
Breathing Challenges
Restricted tongue mobility can affect proper breathing patterns. The tongue should rest up in the palate. Lips would be sealed closed, and the tongue would be suctioned up into the palate (roof of the mouth).
When this is not achieved, mouth breathing is prevalent. Mouth breathing is generally considered unhealthy. The best air for your lungs and body comes through the nose where it has been filtered and warmed.
Mouth breathing, when one sleeps, can lead to increased occurrences of snoring and eventually develop into sleep apnea.
Having spent the night snoring or experiencing periods of sleep apnea an adult will suffer other issues. Possible daytime drowsiness, reduced attention, and a general feeling of moodiness.
Summary- What Does A Tongue Tie Look Like In Adults
In individuals without a tongue tie, the tongue can move freely, facilitating clear speech, effective chewing and swallowing, and proper oral hygiene.
A normal lingual frenulum allows the tongue to rest against the palate, promoting nasal breathing and reducing the risk of dental malformations.
When assessing what a tongue tie looks like in adults you should consider both appearances and functional abilities.
We find clues in appearance from the structure of the tongue and the frenulum to the maxillary and mandibular arches. Then the dentition sitting within them and the impact upon facial shape and bone structure.
All these features should be considered along with functional use for speech, eating and swallowing, posture, and breathing.
Recognizing the signs of a tongue tie in adults is crucial for addressing potential functional impairments. If you suspect a tongue tie, consult with a healthcare professional experienced in diagnosing and treating this condition. To explore appropriate interventions always consider second and third opinions to find the right provider for you.
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Next Steps – What Does a Tongue Tie Look Like In Adults
It may seem overwhelming as an adult to begin the journey of identifying and then treating adult ties. You should know there can be great improvement in your oral and overall health when you release your ties.
Please check out our article on The disadvantages of Clipping a Tongue Tie to help you decide if it is the right path for you.
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