Tongue Tie

Tongue tie is a congenital deformity, which means it exists at or before birth. It happens when the string-like tissue attaching the tongue to the mouth is very short, preventing the tongue from moving freely. This disorder may vary from being mild (a slight, unnoticeable deformity that does not interfere much with tongue movement) to severe, in which case the tongue may fuse to the bottom of the mouth. 

Babies born with tongue tie have difficulty latching on and feeding, and it also affects their speech later on. Difficulties in feeding prevents normal weight gain, while for toddlers and older children, misalignment of teeth besides speech problems could also be one of the consequences of tongue tie.

​Tongue tie may not be discovered at first in babies, especially in cases of a mild form of this disorder. The symptoms will vary depending on the age of your child. For instance, the following signs and symptoms will be exhibited by babies born with tongue tie:

  • Inability to latch properly.

  • Difficulty feeding.

  • Poor weight gain because of inability to feed.

  • Trouble sucking.

Toddlers and older children may exhibit the following symptoms:

  • V-shaped notch at the tip of the tongue.

  • Inability to move the tongue from side to side, stick it out or touch the roof of the mouth with it.

  • Problems reaching the back teeth with the tongue.

  • Speech problems, particularly the pronunciation of certain sounds.

  • Difficulty licking, for instance a lollipop or ice-cream.

  • Dental problems, such as a gap between the bottom two front teeth.

  • ​​Problems with speech and changes physical appearance due to tongue tie may also affect a child’s self-esteem.​

You must have your child evaluated if there are problems feeding and latching on and weight gain seems insufficient or lower than expected. A child who is having speech difficulties must also be assessed for the possibility of tongue tie. Any other complaints of the above-mentioned symptoms from your child must not be ignored and should be checked by a doctor.

At The Aga Khan University Hospital, the only internationally accredited hospital of Pakistan, you can discuss your child’s symptoms and any other concerns in complete confidence with an ENT specialist working for the Eye and ENT Service Line. Your doctor will prescribe the most suitable treatment option for your child, based on the symptoms exhibited and the severity of tongue tie. 

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​

​Diagnosis of tongue tie may be difficult, with a tongue tie not always obvious by looking under the tongue. Your doctor will ask questions about your child’s symptoms, such as noticeable difficulty in feeding or licking, speech problems, since when has your child been exhibiting the symptoms, etc. 

The doctor may use special tools to conduct a physical examination to assess the ability of the tongue to move and carefully check the tongue’s appearance. In babies, a tongue depressor may be used, while in older children, the physical examination will be focused on making the child move the tongue to the maximum range.​

The treatment for tongue tie will depend on the severity of your child’s disorder. In some cases, the doctor may recommend a wait-and-see approach whereby the disorder will not be treated right away and the doctor will assess your child’s symptoms regularly to see if they are worsening or improving. In other cases, the doctor may recommend a surgery to have it corrected earlier before the baby reaches the toddler stage. 

One of the procedures, called a Frenotomy is a simple procedure whereby the doctor snips off the string under the tongue with the help of surgical scissors. This method is quick and allows babies to start breastfeeding after the problem has been resolved.

Another procedure, called Frenuloplasty, is a more extensive procedure which is similar to frenotomy, but is used if the string under the tongue is too thick or additional repair is required in the area. Exercises to facilitate tongue movement may be recommended after surgery.  

​The team of otolaryngologists (ENT specialists) at The Aga Khan University Hospital are internationally trained in the diagnosis and treatment of ENT disorders. You must discuss your treatment options in detail with your doctor and ask questions to weigh the risks and benefits of surgery.​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage​​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage​​

​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​