Tongue Tie
Tongue tie (ankyloglossia) is a condition present at birth that restricts tongue function and mobility, which can contribute to oral dysfunction.
What is Tongue Tie?
Tongue tie, medically known as ankyloglossia, is a condition present at birth in which the lingual frenulum (the band of tissue connecting the underside of the tongue to the floor of the mouth) is unusually short, thick, or tight. This restricts the tongue’s range of motion and can significantly impact feeding, breathing, swallowing, speech, and facial development.
Tongue ties exist on a spectrum—from anterior ties that are visible at the tip of the tongue to posterior or submucosal ties that are hidden beneath the tissue and harder to identify. The severity of restriction is determined not only by the appearance of the frenulum but by how it affects the tongue’s ability to function: Can the tongue elevate to the palate? Can it lateralize to move food? Can it create the suction needed for efficient swallowing and feeding?
Orofacial Myofunctional Therapy plays a critical role both before and after a tongue tie release (frenectomy). Pre-release therapy prepares the tongue muscles for their new range of motion, while post-release therapy ensures the tongue learns to use its full function and that the release site heals optimally without reattachment.
Signs & Symptoms
- Difficulty breastfeeding (poor latch, pain for mother, slow weight gain)
- Inability to lift the tongue to the roof of the mouth
- Heart-shaped or notched tongue tip when extended
- Limited tongue mobility—difficulty moving side to side
- Mouth breathing and open mouth rest posture
- Speech articulation issues (difficulty with L, R, T, D, N, S sounds)
- Difficulty clearing food from teeth and cheeks
- Jaw tension, clenching, or TMJ discomfort
- Snoring or sleep-disordered breathing
- Gagging or choking on certain food textures
How Orofacial Myofunctional Therapy Helps
Orofacial Myofunctional Therapy is an essential complement to tongue tie treatment. A frenectomy alone does not teach the tongue how to function correctly—it simply removes the physical restriction. Without therapy, patients often develop compensatory patterns or the release site may reattach due to insufficient movement and stretching.
Pre-release therapy focuses on building as much tongue strength and coordination as possible before the procedure. We work on tongue elevation, lateralization, and suction within the patient’s current range of motion. This gives the tongue a “head start” so it can take advantage of its new freedom immediately after release.
Post-release therapy guides the tongue into its full range of motion, establishes proper resting posture on the palate, retrains swallowing mechanics, and addresses any compensatory habits that developed over time. We also provide wound management guidance to support optimal healing and prevent reattachment.
Therapy Techniques
- Tongue elevation and stretch exercises (pre- and post-release)
- Tongue lateralization drills for improved food management
- Suction and palatal hold exercises
- Swallow retraining to eliminate compensatory patterns
- Lip and cheek strengthening for overall oral balance
- Wound care stretches and management protocol (post-release)
Expected Outcomes
- Improved tongue range of motion and function
- Proper tongue resting posture on the palate
- Better feeding efficiency (breastfeeding or eating)
- Clearer speech articulation
- Reduced mouth breathing and improved nasal airway use
- Optimal healing after frenectomy with reduced reattachment risk
- Resolution of compensatory swallowing and chewing patterns
Who is this for?
Infants with feeding difficulties, children and teens preparing for or recovering from a frenectomy, and adults with untreated tongue ties causing functional limitations. We coordinate closely with the provider performing the release.
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Has a tongue tie been identified? Let’s discuss how therapy supports the best outcome.