Cutting through the tongue tie myths

There is a lot of conjecture surrounding the diagnosis and management of tongue, upper lip and buccal ties, but what does the evidence say?

Need to know:

  • Parents need reliable, evidence-based information about feeding and normal infant oral anatomy, and GPs are ideally placed to provide this.
  • The term “posterior” tongue tie should be avoided, as it has no anatomical basis, and release of such purported ‘lesions’ risks injury to the genioglossus muscle, lingual nerves, blood vessels and salivary ducts.
  • Upper and buccal lip ties are simply anatomical variants and rarely warrant surgical intervention, and specifically not in children.
  • There are limitations to all the diagnostic assessment tools used for ankyloglossia (tongue tie).
  • The only indication to release an anterior sublingual frenulum is for nipple pain in a breastfeeding mother, where the pain is not improved by changes to positioning and attachment, and the baby clearly has a restricting anterior sublingual frenulum that extends to near the tip of the tongue and/or the gingival margins on

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