Tongue Tie Surgery

Tongue-tie is a congenital condition that causes impairment of the tongue’s ability to move. This muscular organ in the center of the mouth is connected to the floor of the mouth by a thin tissue called the frenulum, a type of membrane that helps hold the tongue in place. When this membrane is too thick, too thin or extends close to the tip of the tongue, it will limit the tongue’s movement, effectively ‘tying’ it to the floor of the mouth – hence the name of this condition.

Tongue-tie will not necessarily cause a problem: sometimes, the ‘tying’ is not significant, and it will not materially impair the freedom of the tongue; but in severe cases, it could cause breastfeeding problems, wounds, and pain of the mother’s nipples while breastfeeding. At later ages, it will also cause problems with speech, problems connected to cleaning the mouth and problems with licking and with other activities performed with the tongue (French kiss, for example). Also, when the tongue is poked out, it will be heart-shaped – because the frenulum will ‘pull’ its center inwards, and when it is elevated, its sides will be higher than its center.

Tongue-tie is a condition that can sometimes be treated without surgical intervention, with the help of a lactation consultant – but only in cases that are not severe. When the impairment to the tongue’s movement is significant, tongue tie surgery, a very brief surgical procedure, will be required, which can even be performed with no anesthesia.

General information about tongue-tie surgery

Tongue-tie surgery is a procedure that had been performed for hundreds of years already, and today is performed using special surgical scissors or using a laser. Since it is the thin membrane under the tongue that is being cut, there will be very little pain and only minor bleeding, rendering anesthesia superfluous, especially at young ages, when tissue is thinner and the rate of healing more rapid.

It is advisable to perform the tongue tie procedure at as early an age as possible, in order to enable the newborn to breastfeed properly and to learn how to use his tongue properly while he is still very young. Such procedures are therefore performed today even when the infant is only a few days old.

However, tongue-tie surgery is also done at older ages, including adolescence and even adulthood, although the procedure will then be slightly more painful and the bleeding more significant – because the tissue is much firmer and thicker. In such a case, the procedure will be performed under local anesthesia.

Preparing for the procedure

If the procedure is performed with no anesthesia, there is no need for any preparation. If it is performed under local anesthesia, all that needs to be done is to wait for the anesthetic to take effect – and then to perform the procedure in its entirety.

The course of tongue tie surgery

Tongue-tie surgery is a rapid and very simple procedure, during which the physician disconnects part of the frenulum that isn’t supposed to be connected to the floor of the mouth. The frenulum thus becomes ‘longer’, allowing the tongue to move freely, just like everyone else’s. The procedure takes a few minutes. As mentioned above, when the patient is a one-day-old baby, there is no need for any anesthesia: the cut should not cause him significant pain, and will also not cause massive bleeding, apart from a few isolated drops of blood.

Sometimes, other conditions, also connected to the function of the mouth and tongue, such as a short tongue or upper lip tie, will be treated during the procedure. These too will be treated on the same occasion, and in this case, also, should not cause strong pain.

In certain cases, you as parents will be asked to ensure that the tongue is lifted from time to time after the operation, in order to enable the part that was cut to close properly, and to prevent ‘adhesion’ of tissues at the location of the operation. Apart from this, guidance will quite often be provided by professionals (e.g. lactation consultants) in order to ensure that the infant is using his tongue correctly after it is freed.

side effects

In spite of the rapidity of the operation, there could be quite a few side effects following is – mainly because the patient needs to adapt to a new situation and to gain proficiency in controlling tongue movements. Therefore, in the initial days after the procedure, there could be such effects as increased posseting, a lot of drooling, swallowing air while breastfeeding, colic and others. These will pass rapidly after the infant learns how to use their tongue correctly. In certain cases, it will turn out that the procedure needs to be repeated for various reasons (e.g. imperfect healing of the cut in the frenulum) – but this possibility is considered to be quite rare.