Tongue tie occurs when free movement of the tongue is restricted.

Tongue tie is a condition in which tissue attached to the base of the tongue (lingual frenum) is positioned too far forward on the tongue, making it difficult to move the tongue.

If the tissue extends to the tip of the tongue, a V-shaped notch may be seen. Tongue tie may cause feeding problems, tooth problems, and speech problems.

• Inability to protrude tongue
• V-shaped notch in tip of tongue
• Excessive attachment of tongue to floor of the mouth by the lingual frenum membrane

Physical examination confirms that the lingual frenum is attached too far forward.

Surgery is seldom necessary. If it is necessary, it should be postponed until the child is approximately 9 months old.

Surgery involves cutting of the abnormally placed tissue. This may be done in the doctor's office (mild cases), or an operating room (more advanced cases). A surgical reconstruction (z-plasty closure) may be required to prevent scar tissue formation.

Surgery, if performed, is usually successful.

The complications are rare, but recurrence of tongue tie, tongue swelling, bleeding, infection, and damage to the ducts of the salivary glands may occur.

If you are concerned that your child may have tongue tie, have your health care provider examine it during a routine well-baby examination.

Behrman RE. Nelson Textbook of Pediatrics. 17th ed. Philadelphia, Pa: WB Saunders; 2004.

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo; Mosby; 2005.