Cat Got Your Tongue?

As you no doubt know, the aforementioned expression is common idiom referring to one’s loss for words. But have you ever wondered how such a phrase came to be? This expression may have its roots during the seafaring days of the old British Navy when painful flogging with a whip called “Cat-o-nine-tails” rendered the victim of such abuse speechless.

Or perhaps this feline phraseology had its origin during ancient Egyptian times when the tongues of liars and blasphemers were cut out and fed to the cats. (yuck)

Tongue-Tie is a physical condition.

It is present at birth and is an inherited trait. In medical terminology, tongue-tie is referred to as ankyloglossia. It is when the tongue is bound to the floor of the mouth by a band of tissue called the lingual frenulum.

Now, most of us have a frenulum. Just look in the mirror, lift your tongue, and you’ll likely see a thin piece of “skin” that bisects the tongue. That’s your frenulum.

People with normal frenulums can lift their tongue up to the roof of their mouth and stick it out freely. But in people who have ankyloglossia, the lingual frenulum is thick and short. The Mayo Clinic describes it this way:

“With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth, so it may interfere with breast-feeding.”

The tongues of people with anklylossia have a more limited range of motion than what’s normal. Sometimes their frenulum extends all the way to the tip, severely restricting tongue movement.

About 4-11% of the general population has ankyloglossia. It is present at birth, occurs most commonly in boys, and runs in families.

What Does Tongue-Tie Have To Do With Breastfeeding?

In order to breastfeed properly, the baby must latch-on to his mother’s breast tissue and nipple. And, the baby’s tongue must extend over his lower gum. A tongue-tied infant is unable to suck properly – and thus can’t get enough milk to thrive. 

Tongue Tie can result in malnutrition, failure to gain weight, and irritability.

(Bottle-fed babies are not impacted by tongue-tie in their ability to take in adequate nourishment.

Interestingly enough, in the past few weeks, I have treated two patients who are both new parents. Each has a baby born with tongue-tie. One newborn “inflicted” great discomfort on her mom during feedings. The other was unable to breastfeed at all.

Both children had frenotomies which remedied the situation without incident. After a frenotomy, most babies can begin to feed normally within a very short period of time.

Tongue-Tie Can Affect A Child’s Speech

Babies who have mild ankyloglossia are usually able to breastfeed normally.  But when they begin to talk, it can be difficult, if not impossible, to produce certain sounds. Words that contain sounds such as tee, dee, ess, th, ar, and el are particularly troublesome. For example, lemonade will sound like wemonade. It’s cute when they’re little. Not so much as they get older.

Tongue-Tie Can Also Cause Misalignment of Teeth

Because the tongue is unable to rest against and support a maturing upper jaw, misalignment of the upper teeth can develop in children with moderate to severe tongue-tie. Additionally, due to the tongue’s limited range of motion, it can’t press against the anterior palate (the roof of the mouth behind the front teeth) which can lead to an adverse swallowing pattern which in turn can contribute to anterior open bite (a gap between the upper and lower front teeth when the back teeth are brought together). Tongue-tie can also create a space between the lower front teeth.

Furthermore, as a child matures into adulthood, maintaining good oral hygiene can be a challenge. The tongue just can’t sweep away food debris from the teeth as in a normal mouth.

Tongue-Tie Can Interfere With Simple Pleasures Of Life

Oh the simple pleasures in life! Licking an ice cream cone, kissing, sticking your tongue out at someone who is annoying you, playing a wind instrument (okay, maybe not so simple) can be a real challenge, if not impossible for people with ankyloglossia.

Here’s The Good News

A procedure called a frenotomy usually solves these problems. During a frenotomy, the frenulum is simply snipped with surgical scissors. In a baby, there are very few blood vessels and nerves in the area, so anesthetic is rarely required – and there is little (or no) bleeding.

For children experiencing speech problems due to tongue-tie, speech therapy can help, but a frenotomy is often the solution. It frees up the tongue to allow for proper elocution. The doctor will use a surgical scissor or laser to snip the frenulum. Local anesthesia and a few stitches are usually required. And, usually there is minimal discomfort during and after the procedure.

Over the years, I’ve performed numerous frenotomies in my office. The procedure is simple, recovery is easy, and it results in a better quality of life for my patient.

What To Do If You Think Your Child Has Tongue-Tie

If you’re breastfeeding and your baby is having a difficult time latching-on. Or, if you’ve noticed your older child having difficulty producing the sounds mentioned above, you should talk to your child’s doctor or dentist now. An ounce of prevention is worth a pound of cure, so they say.

Tongue-Tie Truly Does Run In Families

Interestingly, my wife, Ann, was tongue-tied as a child. A wise pediatrician detected the problem and treated her when she was around four years old. And it turns out that my daughter, Ashley, has a mild case of tongue-tie, too. Happily, she never experienced any of the difficulties mentioned above. 

Instead of sticking her tongue out at me, she just gives me the finger. 

Only kidding!

Michael Sinkin is a dentist in New York City. He loves being a dentist. He is known throughout the city for the wonderful care he gives his patients. And, for his wicked sense of humor. To contact Dr. Sinkin, click here.