The lip and tongue has to attach somewhere on the body. Everyone has attachments, but some have a tongue or lip-tie which can complicate things. The real question is whether the attachment is restrictive, either causing problems right now or will it cause problems in the future.
The first place where tongue or lip-ties create problems occur is while breastfeeding. Either babies or mothers—or both—can have symptoms, including painful or prolonged nursing, reflux, gas, colic, blistering or bloody nipples. If any of these issues are present, it would be prudent to have your baby evaluated for ties. Having an evaluation is not a commitment to revise. It will equip you with the information you need to make the best decision for your family.
It is possible that, even though there are no breastfeeding symptoms, there is a tie. If this is the case then the tongue has limited mobility, it can still cause issues with facial development. The tongue is what drives the growth of the middle part of the face, called the maxilla. In order for the maxilla to develop as it was designed to, a person must have what is called a proper oral rest posture. This means that while the mouth is at rest, the lips are sealed, breathing occurs through the nose and—most importantly—the tongue is resting on the roof of the mouth. When one is tongue-tied, the tongue is almost always prevented from resting on the roof of the mouth. The tongue is such a powerful muscle that when it is resting on the roof of the mouth, it causes our maxilla to expand and develop forward. This is what creates the proper facial proportion and size. A short lingual frenulum can lead to an increased incidence of sleep apnea in not only adults, but in infants and children. Infant sleep apnea is beginning to be closely tied to SIDS.
Additionally, when the tongue isn’t able to rest on the roof of the mouth, there will be crowding of the upper teeth, an overbite and a very narrow smile, and a high palate. Once these issues have developed they can only be fixed with orthodontia. However, fixing the developmental issues will only address the symptoms of the underlying problem, which is the tongue-tie. I see a significant amount of orthodontic relapse, and a tongue-tie is frequently the culprit.
In addition to facial development, if your little one’s tongue is tethered to the floor of her mouth, it can also cause delayed speech issues or a difficulty making certain sounds. The tongue must have full range of motion for it to be able to form certain sounds. If a tongue is tied, speech therapy alone may not be enough to correct the issue and releasing the tongue may become necessary.
If the tongue-tie is released when your child is older, they will likely benefit from working with a myofunctional therapist. The myofunctional therapist will help your child learn proper tongue placement, how to strengthen the tongue and use their new found mobility, improve speech, help eliminate food texture issues and many other things.
Even with no symptoms, the upper lip tie may need to be revised as well. Depending on how far the upper lip tie extends it can cause a gap to form between the two front teeth and can it can lead to an increased possibility of decay on the front teeth.