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This post is the second in a series on tongue tie, its symptoms and classification, and its treatment using functional frenuloplasty and myofunctional therapy. If you haven’t read part 1 yet, I recommend you do before continuing.
In a class 4 tongue tie, the connection point of the lingual frenulum may be submucosal, meaning beneath the mucus membrane. This class of tie must be diagnosed by feel rather than by sight. Babies with class 4 tongue ties are sometimes misdiagnosed as having a short tongue, since the lingual frenulum cannot readily be seen.
Babies have been born with tongue ties for a very long time. In the old days, many midwives used to keep one sharp fingernail so they could correct tongue ties at birth. However, when bottle feeding began to gain widespread popularity around the middle of the twentieth century – oftentimes because it was promoted by doctors as a superior alternative to breastfeeding – fewer tongue ties were diagnosed in infants because they weren’t being breastfed. Now that science has come around again to promoting breastfeeding over bottle feeding, we are once again seeing many cases of tongue tie getting diagnosed in infants.
While many tongue ties my never present any symptoms, in cases where they do the most common treatment is surgical. This surgery is called a functional frenuloplasty. Just like in other medical procedures like rhinoplasty, the “-plasty” refers to the molding or shaping of a specific part of the body – in this case, the frenulum.
Check back soon for Treating Tongue Tie – The role of surgery and myofunctional therapy, part 3. In the meantime, check out our page on tongue tie treatment and myofunctional therapy.