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Tongue-tie treatment

Treatment for tongue-tie, a condition that occurs from birth

close up of surgeon performing surgery in patients mouth
Tongue-tie, or ankyloglossia, is a condition that is present when you are born. It occurs when a band of tissue inside your mouth, called your lingual frenulum, is unusually short, thick, or tight. This tethers the bottom of the tongue’s tip to the floor of the mouth and restricts movement of the tongue.

Tongue-tie is present in up to 10% of newborns.

In some cases, tongue-tie may not cause any problems, but it may make breastfeeding difficult and cause problems with speaking, eating, and swallowing in later life.

Tongue-tie can be treated with surgery, which we offer here at Circle Health Group.

Call or book online today to arrange a consultation to discuss private tongue tie treatment with a consultant of your choice at Circle Health Group.

This page explains what tongue-tie is, what the symptoms are, and how the condition is treated.

Symptoms of tongue-tie include:

  • Difficulty breastfeeding — this may include difficulty attaching or staying attached to the breast, frequent feeding for short periods, appearing unsettled and hungry, not gaining weight, and making a clicking sound while feeding
  • Difficulty sticking out the tongue
  • The tongue tip may appear notched, heart-shaped, flat, or square
  • Difficulty lifting the tongue to the roof of the mouth
  • Difficulty moving the tongue from side to side
  • Difficulty pronouncing certain sounds such as “t,” “d,” “l” and “th”

Normally, the frenulum separates from the floor of the mouth before birth, but in babies with tongue-tie it remains attached. Why this happens is unclear, but there may be genetic factors involved.

If tongue-tie isn’t causing any problems, the condition may not need to be treated. The frenulum may also loosen on its own as the child grows up. If tongue-tie is causing problems for you or your child, your consultant may recommend surgery.

There are two surgical procedures available to treat tongue-tie: frenotomy and frenuloplasty. These will be discussed in more detail later on this page.

At your first consultation, you will be seen by a consultant ear, nose and throat surgeon, or oral surgeon.

Your consultant will ask about you, or your child’s, symptoms and perform a physical examination of you, or your child’s tongue and frenulum. They will ask you to move your tongue to assess the level of restriction. They may also ask about any problems you, or your child have experienced, such as problems breastfeeding, speaking, or eating.

How is a diagnosis made?

A diagnosis of tongue-tie is made based on a physical examination of the tongue and frenulum.

Why is this first consultation so important?

At Circle Health Group, your first appointment is very important as it’s where you first meet your consultant, the doctor responsible for your care. Your first consultation is also where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your treatment, so please ask your consultant any questions you may have during your appointment.

After making a diagnosis, your consultant will discuss possible treatment options with you and decide on the best option based on you, or your child’s symptoms and diagnosis.

Your consultant will tell you everything you need to do to prepare you, or your child for surgery. If there’s anything you’re not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice.

Before your surgery, tell your consultant about any medical conditions or allergies you, or your child have, and any medication, including over the counter medicines, vitamins or supplements you, or they are taking.

Adults should stop smoking as soon as possible before surgery.

If the operation is to be performed under general anaesthetic, you, or your child will not be able to eat anything from midnight on the day of the procedure. You may be allowed clear fluids such as water or broth for up to 2 hours before the surgery, but check first with your healthcare team.

Frenotomy (tongue-tie division)

A frenotomy is a quick and simple procedure that involves cutting the frenulum free from the floor of the mouth with a laser or sterile scissors. It can be performed with or without anaesthesia as there are few nerve endings in the frenulum. Local anaesthetic gel may be applied to the inside of your baby’s mouth to numb the area and minimise any discomfort. Recovery from a frenotomy is usually quick, and feeding normally improves immediately after the procedure.

Frenuloplasty

This is a more complex procedure that may be performed if the frenulum is too thick for a frenotomy, or if further repairs are needed.

During a frenuloplasty, the frenulum is released, and the wound closed with dissolvable sutures. A frenuloplasty is performed under a general anaesthetic, which means you or your child will be asleep for the procedure and will not feel any pain.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether there are any complications during your surgery or recovery.

Your consultant will give you an estimated recovery timeline based on your individual circumstances.

If your baby has a frenotomy, you will be encouraged to breastfeed them straight after surgery. This will help to soothe your baby and encourages them to move their tongue.

If you had a general anaesthetic, you will be taken to the recovery room where your blood pressure, heart rate, breathing and oxygen levels will be monitored closely until the effects of the anaesthetic have worn off.

What to expect after tongue-tie surgery?

Within the first three days after surgery, a white patch (ulcer) will form over the area. This normally heals in around two to three days. Within a week, your stitches (if you had any) will dissolve, and any pain, bleeding and swelling will be reduced.

Your healthcare team can recommend an over-the-counter painkiller if you, or your child experiences pain after surgery.

You, or your child can eat and drink as normal straight after the procedure. If a numbing medication was used during the surgery, stick to soft foods, and avoid hot drinks until the medication has worn off completely.

Many babies show an immediate improvement in breastfeeding after tongue-tie surgery. If you continue to experience difficulty breastfeeding after surgery, contact your healthcare team or lactation consultant for advice.

Your consultant may recommend tongue exercises for the first 4 to 6 weeks after surgery. These exercises are important to strengthen your tongue muscle, improve your tongue’s range of motion and prevent the frenulum from reattaching or the development of excessive scar tissue. If your child or baby had surgery, you will need to help them with these exercises, or manipulate their tongue for them. Always wash your hands thoroughly with soap and water beforehand.

It’s important to keep the surgical site clean after tongue-tie surgery. For adults and older children, your consultant may recommend gargling with salty water a few times a day.

How many nights will I need to stay in hospital?

Tongue-tie surgery is performed as a day case, meaning you or your child will be able to go home later the same day.

When will I be back to normal?

Recovery from tongue-tie surgery is normally quick and complications are rare. Providing there are no complications, you can expect to be back to normal within 4 weeks of surgery.

Tongue-tie surgery is a relatively simple and straightforward procedure that has a low risk of complications. However, as with all types of surgery, complications may occur. Your consultant will explain all the potential risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision, so please ask any questions you may have.

Possible complications of any surgery include:

  • Bleeding
  • Infection
  • Blood clots
  • Adverse reactions to the anaesthetic

Possible complications specific to tongue-tie surgery include:

  • Bleeding
  • Infection
  • Damage to the tongue or salivary glands
  • Scarring

Call your healthcare provider immediately if you or your child has any of the following symptoms after surgery:

  • Excessive or uncontrolled bleeding
  • Fever (a temperature above 38C)
  • Refusal to feed (in babies)
  • Agitation or significant fussiness (in babies)

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care, including:

  • Flexible appointment times and locations that are convenient for you
  • The freedom to choose which hospital and consultant suit your needs
  • Personalised, consultant-led treatment plans tailored to your individual needs
  • Comfortable and safe private facilities maintained by expert multidisciplinary teams
  • Private ensuite rooms as standard
  • A range of delicious healthy meals
  • Affordable, fixed-price packages with aftercare included
  • Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about tongue-tie surgery, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in January 2024. Next review due January 2027.

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