Identifying and Treating Tongue-Tie in Adults

Tongue-tie is a condition some people are born with that reduces the mobility of the tongue.  If you look in the mirror, open your mouth and lift your tongue, you’ll see a band of tissue connecting the bottom of your tongue to the floor of the mouth. This tissue is called the lingual frenulum.  In most people, the lingual frenulum is thin and pushed toward the middle of the bottom of your tongue. This is typical, and allows for a wide range of motion for your tongue.  But if you’re experiencing tongue-tie, the lingual frenulum may be short, thick, or tight. It may connect to the floor of the mouth at the tip of the tongue, restricting tongue movement.  In some cases, tongue-tie doesn’t cause too many problems, and a person may retain their tongue-tie into adulthood without correcting it. However, it’s possible tongue-tie can present problems over the course of one’s adult life.
 

Symptoms of tongue-tie in adults

If you’ve maintained a tongue-tie into adulthood, chances are you’ve adapted to living with it. You may not even be aware you have one, if you have a mild case.  Approximately 3.5 to 5 percent of all people are born with tongue-tie. Additionally, some doctors recommend parents hold off on tongue-tie surgery in infants, as the lingual frenulum tends to loosen over time.
Due to limited tongue mobility, adults with tongue-tie often have difficulty with:

• speaking
• eating
• drinking
• breathing
• kissing

Other common signs of tongue-tie in adults include:

• problems sticking your tongue out of your mouth past your lower front teeth
• trouble lifting your tongue up to touch your upper teeth, or moving your tongue from side to side
• your tongue looks notched or heart-shaped when you stick it out

Risks and side effects of tongue-tie in adults

A tongue-tie can significantly affect your health and wellbeing in adulthood. The most common side effects can impact everything from your oral and dental health to your ability to sleep.

Poor oral and dental health

A tongue-tie can diminish a person’s ability to brush food debris off their teeth, and to swallow completely. An inability to keep the mouth clean can result in tooth decay, gum inflammation (gingivitis), and other oral problems.

Tongue-thrust

Those with tongue-tie may also develop a space between the lower bottom teeth, or other alignment issues caused by tongue-thrust — an adaptation to tongue-tie.
This could possibly impact the health and alignment of other teeth in your mouth. Usually, people with tongue-tie tend to have smaller, more narrow mouths than other people.
 

TMJ disfunction

Those with tongue-tie often adapt their mouths and bodies to cope.  One of these adaptations includes an incorrect swallowing pattern. Normally, the tongue rises as you swallow to push food to the back of your mouth. People with tongue-tie may find it hard to keep food from moving around their mouth as they eat.  Incorrect swallowing can cause several issues, such as tooth misalignment. But it can also cause pain and disfunction in the temporo-mandibular joints (TMJ), where your jaw hinges near the base of your ears.
 

Sleep apnea

Adapting to a tongue-tie may also cause breathing difficulties, including those occurring during sleep.  Over time, people with tongue-tie tend to experience dental misalignment issues and a smaller-sized palate (roof of the mouth) than other people, reducing the overall size of their upper airway.  This puts people with tongue-tie at risk of their upper airway collapsing when they sleep, causing sleep apnea. Sleep apnea causes repeated breathing interruptions during sleep that can be dangerous if untreated.
 

Speech problems

Tongue-tie can make it more challenging to speak. The following sounds are usually tricky to create when your tongue has reduced mobility:

• “t”
• “d”
• “z”
• “s”
• “th”
• “r”
• “l”

Reduced overall quality of life

A tongue-tie, depending on its severity, can impact a person’s quality of life.  A person who grows up with a tongue-tie may create several different adaptations to better cope, like eating certain types of foods that are easy to eat, but aren’t necessarily healthy. This can affect a person’s weight and health.

A person with tongue-tie may also avoid having to do things with their tongues, like:

• licking an ice-cream cone
• licking lips
• kissing
• having oral sex
• playing a wind instrument
•  

Treating tongue-tie in adults

If you have tongue-tie as an adult, it’s not too late to seek treatment. In fact, many people might go through childhood to adulthood not realizing they have tongue-tie.  A doctor can help you diagnose the condition and find a treatment plan that works best for you. They’ll perform a physical exam and record your medical history while making a diagnosis.
 

Can tongue-tie exercises for adults ease symptoms?

Tongue-tie exercises are sometimes recommended for adults hoping to reduce their symptoms without surgery. Such exercises can improve control over the tongue, and correct maladaptive use of the tongue or mouth.
There’s no one-size-fits-all exercise for coping with tongue-tie. A therapist will be able to show you which specific exercises might be best for you.
Most recommended exercises fall into one of two categories:

Oral kinesthesia
Oral kinesthesia involves feeling the part of the tongue that you’re moving and how you’re moving it. This might include visually observing or physically touching your tongue.

Diadochokinesis (DKK)
DKK exercises involve performing rapid, alternating movements of your tongue. These repetitive exercises can increase your muscle memory and best retrain your tongue to cope with tongue-tie.
 

Tongue-tie surgery for adults

It’s usually never too late to get tongue-tie surgery. However, the sooner tongue-tie is corrected, the fewer possible side effects this condition will likely cause you. The surgery to correct tongue-tie is called a frenectomy. It involves cutting the lingual frenum.  The procedure is usually quick and simple. Complications are rare, but there are always some risks to surgery, including bleeding, infection, or scarring. There is also a possibility that the tongue or salivary glands could be damaged during surgery.  In cases where the lingual frenulum is very thick, a more extensive surgery called a frenuloplasty may be necessary. Unlike a frenectomy, this surgery is done under general anesthesia. It usually requires stitches and often leaves scarring.
 

How much does tongue-tie surgery for adults cost?

The costs of a frenectomy or frenuloplasty vary depending on your healthcare provider, and whether or not you have insurance. You can expect to pay up to almost $10,000 if your insurance does not cover the procedure.  Since these surgeries are fairly simple, you should be able to get right back to work or school the same day.
 

Takeaway

Tongue-tie is a common condition that, in some cases, causes few-to-no-side effects — or resolves itself over time. While some parents choose to correct their child’s tongue-tie in infancy or childhood, others do not.  People who have tongue-tie into adulthood usually adapt by using their tongue atypically. While this may provide some short-term relief from symptoms, it can cause various side effects, from dental issues to speech impairments, in the long run.  If tongue-tie is interfering with your health and quality of life, it’s possible to find relief in therapeutic exercises chosen by a speech pathologist or other doctor.  In other cases, you might opt for surgery to correct your tongue-tie. Surgery is usually simple and low-risk.