Issues Related to Lip & Tongue Tie Boulder

Ankyloglossia

Ankyloglossia, more commonly known as tongue tie, occurs when a patient has a shorter or thicker lingual frenulum connecting their tongue to the lower jaw, which impedes function. Everyone has a frenulum – however, not everyone has a tie that needs to be corrected since it depends on the degree of functional impact.

For comprehensive assessment and treatment options, feel free to contact Dr. Witkoff and our team – after a thorough examination, we can recommend your next steps.

Unsuccessful Breastfeeding/Bottle Feeding in Infants

Successful breastfeeding requires a baby to correctly latch onto the breast. But in some cases, infants with lip or tongue ties may be unable to do this. It's important to recognize various symptoms during nursing that might indicate a tongue tie, which includes things like:

• Difficulty latching or staying latched
• Shallow latch
• Excessive gas or burps due to swallowing air
• Gagging, choking, and excessive spitting up
• Milk dribbles out while feeding
• Colic (excessive crying)
• An arched back due to discomfort
• Falling asleep at the breast in the beginning or middle of feeding
• Long feeding times or continual feeding (cluster feeding)
• Lip calluses or blisters
• Chomping on the nipple
• Can only feed during letdown
• Tucking of the upper lip
• Upper lip blister on baby
• Tenseness while nursing
• Difficulty holding a pacifier

Difficult, Painful Breastfeeding for Nursing Mothers

Tongue ties don’t just impact infants; they also impact breastfeeding mothers, often manifesting as physical challenges during nursing. Some difficulties include:

• Painful Latch
• Shallow Latch
• Distorted nipples- flattened, creased, lipstick shaped sore, damaged, and/or bleeding nipples
• Sore, damaged, and/or bleeding nipples
• Plugged ducts
• Mastitis
• Feelings of failure
• Loss of milk supply (especially after 3 months)
• Nipple throbbing (vasospasms)

The tongue tie release procedures that we offer allow the tongue to lift to the palate, providing the latch and suction that is needed to draw out the milk from mom.

When diagnosing and treating these issues, we often find that a lip tie is present as well. This is equally important to release because if a baby cannot flare their upper lip, they will not be able to latch onto the breast properly, making breastfeeding difficult or even impossible.

We do everything we can to make tongue- and lip tie procedures speedy and comfortable for babies. With the cold CO2 laser that we use, the procedure takes less than 30 seconds on babies. The goal is to improve tongue mobility, potentially aiding in better latch and suction for breastfeeding, with as little alteration as possible. Additionally, addressing a concurrent lip tie may further facilitate effective nursing. Amazingly, in most cases, once the ties are released, the baby is able to nurse immediately after the procedure.

Trouble Eating Solid Food for Babies

Some issues related to tethered oral tissue persist after infancy – since the condition doesn’t resolve itself, the associated problems do not normally simply disappear. If symptoms suggestive of a tongue tie are observed, further evaluation might be necessary to explore the possibility of a less obvious posterior or “hidden” tongue tie. This can only be checked by a physical exam of the tongue, as the posterior tie cannot be seen, only felt. Some symptoms include:

• Very picky about food, especially textures
• Choking when transitioning to solid foods
• Gagging or spitting food out
• Pocketing food within their cheeks
• Slow eaters, may avoid chewy foods like steak
• Fast eaters that swallow without much chewing
• Refusing to wean
• Easily distracted during mealtimes
• Grazing on food throughout the day

Difficulties with Speech for Children

When left unaddressed, tongue ties can have serious implications for a child’s development. While many children grow up and end up compensating without too severe speech difficulties, some can experience challenges.

If you notice any of the following symptoms, you shouldn’t hesitate to contact us to set up an evaluation.

• Trouble articulating sounds (- l, r, s, sh, z, t, d, n, and th)
• V-shaped notch at the tip of the tongue
• Inability to stick out the tongue past the upper gums
• Inability to touch the roof of the mouth when fully open
• Difficulty moving the tongue from side to side

Breathing Issues

Tongue ties also carry the potential to negatively impact airway function. It’s incredibly important to be aware of the symptoms that indicate this, as it can affect both children and adults, and professional treatment is the only way to ensure that it’s not negatively impacting one’s life.

The treatment for tongue tie aims to restore tongue mobility, potentially assisting in more ideal resting positions and contributing to improved sleep quality by addressing airway obstruction issues. That said, seek expert advice if you notice any of the following:

• Mouth breathing, often indicated by heavy snoring
• Disproportionate growth of the lower jaw
• Deficits in midface development, forward to backward and side to side
• High, narrow palate
• Restricted movement of the tongue
• Chronic fatigue

Problems with Posture, Neck & Back Pain

It’s possible for tongue ties to negatively impact head posture, which in turn can affect the health and function of the jaw joints. As a result of jaw joint dysfunction, other muscles can also be impacted, such as the sternocleidomastoid muscle (SCM) that runs along the side of the neck, and the trapezius muscle, which covers the upper back, as well as lower back muscles and the sacroiliac joint in the pelvic region. Look for the following symptoms and call our office to see if a release could help relieve these issues:

• Head-forward posture
• Neck, shoulder and back pain
• Knee, ankle, and food pain
• Headaches and migraines

If you or someone you know is suffering from the symptoms listed above, it might be related to a tongue tie. Opting for tongue tie release treatment may help in aligning the head and spine, which can assist with alleviating symptoms. Various myofunctional and physical therapy exercises might also prove beneficial for adjusting posture and addressing discomfort.

Emotional Issues Linked to Tongue and Lip Ties

• MOTHERS: It’s not uncommon at all for there to be emotional consequences related to tongue ties, particularly in the context of postpartum experiences. Feelings of guilt, inadequacy, and stress may be felt in new mothers facing breastfeeding challenges that may be related to a tongue tie. Mothers in these situations should be consoled with understanding and support. These issues are not their fault and can often easily be resolved with a tongue tie release.
• CHILDREN: Children who struggle to speak and eat properly might struggle with self-confidence issues, not to mention that the ongoing discomfort in older patients could have an emotional impact. Tongue ties aren’t something that anyone should have to live with, especially if the issue is causing them grief. Our team is dedicated to providing education, support, and above all else, relief for these challenges.