The fraenulum under the tongue is called the lingual fraenum. Tongue-tie is a condition where tongue movement is restricted due to a short lingual fraenum. For example, some people have difficulty licking around their lips, or raising the tongue tip inside their mouth. This can mean that they have difficulties with eating and pronunciation of certain letters of the alphabet. The medical name for tongue-tie is ankyloglossia.

Tongue-tie can improve by the age of two or three years. Severe cases of tongue-tie can be treated by cutting the fraenum. This is called a fraenectomy . Two per cent of babies may be affected by tongue-tie. Tongue-tie can resolve in early childhood if the fraenum ‘loosens’ by itself, allowing the tongue to move freely for eating and speech. However, in some cases, the child may need to have a surgical procedure known as a fraenectomy to release the tongue.

Symptoms of tongue-tie

The symptoms of tongue-tie can include:

• The tongue can’t poke out past the lips
• The tongue tip can’t touch the roof of the mouth
• The tongue can’t be moved sideways to the corners of the mouth
• The tongue tip may look flat or square, instead of pointy when extended
• The tongue tip may look notched or heart-shaped
• A baby with tongue-tie may have difficulties breastfeeding or bottle-feeding
• The front teeth in the lower jaw may have a gap between them.

Causes of tongue-tie

There are two main causes of tongue-tie. Either the fraenum is too short and tight, or it failed to move back down the tongue during development and is still attached to the tongue tip. In the second case, a heart-shaped tongue tip is one of the obvious symptoms.

Tongue-tie and speech problems

Tongue-tie in toddlers seems to be less common than in babies, which suggests that a short fraenum can normalize itself as the child grows. In persistent cases of tongue-tie, the child may have certain speech problems.

Difficulties can include creating sounds that need the tongue or tongue tip to:

touch the roof of the mouth (to pronounce sounds such as t, d, n, l, s, z)

Arch off the floor of the mouth (to pronounce sounds such as r).