The most common question I get when patients, friends, and family ask about what I do as a myofunctional therapist is,
"How do I know if I have a tongue tie?"
Thanks to leading experts in the airway field, there are resources available for quick, easy, and reliable (i.e. research-proven) ways of screening for tongue ties and subsequent airway disorders.
Historically, it has been assumed that if someone can stick their tongue out "far enough," they are not tongue tied, and they have nothing to be worried about. Or, if a patient does have a tongue tie, they will grow out of it.
These notions are incorrect
and often prevents patients from seeking further support and answers for the subsequent symptoms of dysfunction that arise from tethered oral tissues (TOTs).
To truly identify ankyloglosia, or a tongue tie, what needs to be evaluated instead of tongue protrusion is tongue elevation.
More specifically, as part of a comprehensive myofunctional therapy assessment, patients are evaluated for an anterior tongue tie by assessing the range of motion (i.e. elevation) of the tip of their tongue. See TRMR-TIP image below.
Conversely, the posterior tongue is assessed for restriction via the range of motion of the middle of the tongue body through lingual-palatal suction techniques. See TRMR-LPS image below.
As a quick chairside reference, have a patient open as wide as they can comfortably and lift the tip of their tongue to their palate as in the TRMR-TIP top left image above.
If someone is unable to lift their tongue to their incisive papilla or unable to elevate the tip of their tongue more than 50% while open, they likely have an anterior tongue tie.
For a posterior tongue tie assessment, have the patient suction their tongue to their palate and open as wide as they can comfortablywithout losing the suction.
Depending on how far they are able to open their mouth while suctioned gives a good indication of how tethered their posterior tongue is.
The less someone is able to open while holding their tongue suctioned to their palate the more they likely are to have a posterior tongue tie.
Although the above information is proven by research to identify tethered oral tissues, it's important to acknowledge that a tongue tie cannot be diagnosed on appearance alone.
As oral healthcare workers, we're able to identify potential tethered oral tissues. From there, a referral to a myofunctional therapist for a comprehensive functional assessment is imperative to identifying not only TOTs but also compensations and other contributing dysfunctional patterns and habits based on each patient's symptoms and clinical evaluations.
Essentially, a tongue tie diagnosis is based on function and symptoms, not just appearance.
Like anything in medicine, it's important to understand that each patient presents symptoms in their own unique way.
Thankfully, there is a quickly growing number of providers identifying airway restrictions and disorders as part of larger systemic symptoms such as ADD/ADHD, anxiety and depression, acid reflux, and more. Read more on the systemic impacts of airway disorders in my other blog post.
Talk soon,
Liz Laney, Myofunctional Therapist
*None of the information included in this post is intended to be medical advice. Please talk with your healthcare provider(s) before making lifestyle changes or starting/stopping any medications and/or diets.
Resources:
1. FAirEST6.org
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