More than five things about a tongue-tie you didn’t know

Nov. 16, 2016
Shirley Gutkowski, RDH, advised dental hygienists to develop a "low tolerance" for a tongue-tie

By Shirley Gutkowski, RDH, BSDH

Are you of the mindset that if a person can talk and eat they don’t need their tongue-tie released? Read on to lower your tolerance for tongue-tie and improve your patient’s quality of life.

People with a tongue-tie are always having to watch their speech. It’s a job to keep their speech sounding right. They often have to move their tongues in unusual ways to be able to make the right sounds. Just because they learned how to doesn’t mean the tongue-tie is inert.
  • Clicking and pain in temporomandibular joints are common with ties. The tongue is attached to the hyoid bone, and the rest of it is supposed to be unattached. If it’s pinned to the floor of the mouth none of the muscles work right and compensations will add up! (And they add up weird.)
  • Posterior regions of the tongue can fall back, causing sleep disordered breathing, and the cascade of symptoms may include:
    • Bruxing to keep from sleeping deeply
    • Restless leg syndrome to keep from sleeping deeply
    • Type II diabetes from altered hormones during sleeping with mouth open
    • Snoring and behavior problems
    • Migraines
    • Prognathic profile
    • Sensitivity about personal appearance
    • Emotional factors resulting in rising levels of stress

    Do your patients a favor and lower your tolerance for tongue-tie. There’s more to the tongue than eating and speaking. What’s a tie? It’s not only ankyloglossia! Here are three little tests you can do for every patient and never add a minute to your evaluation time.

    • Ask them to stick out their tongue and look for a heart shape on the tip.
    • Ask them to open wide and reach with their tongue to the incisive papilla; they can close up to 30% before making a referral.
    • Ask them to swallow water with their teeth together and lips apart while they are sitting up. If they can’t or if their tongue pushes forward, refer.

    If you get a yes to the first bullet, and/or an over 30% close on the second bullet, and they cannot swallow the water, refer to an orofacial myofunctional therapist. If you want to know more, check out a couple of key websites.


    Shirley Gutkowski, RDH, BSDH, is a practicing dental hygienist specializing in orofacial myofunctional therapy. Her practice, Primal Air, LLC, is in Sun Prairie, Wisconsin. Ms. Gutkowski is also the host of Cross Link Radio, a podcast with timely information integrating oral and systemic health.

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