function of the tongue
The tongue has important functions in breastfeeding , eating, drinking, speaking and tasting. The infant needs a freely movable tongue in order to be able to suck, swallow and breathe physiologically and effectively.
The tongue ligament is a fold of muscle and connective tissue covered by oral mucosa on the underside of the tongue. It connects the underside of the tongue to the floor of the mouth. If it is too short and thereby impedes tongue mobility and function, it is referred to as frenulum linguae breve (short tongue frenulum) and the condition as ankyloglossia, also known as ankyloglosson or ankyloglossum.
When is a tongue tie too short?
The ligament of the tongue is said to be too short if it impedes the function of the tongue when eating, drinking, speaking or swallowing or if the non-physiological (normal) resting position of the tongue causes deformation of the facial skull and malfunctions of the muscles with resulting tension in the facial and facial muscles skeletal muscles, i.e. when the tongue ligament causes symptoms.
Too short on what?
When assessing tongue function, the shape of the palate is also crucial, because if it is high and pointed in a Gothic shape, the distance for the tongue to overcome is greater than with a well-formed, flat Gothic shape of the palate.
Symptomatic tongue tie
For the reasons given, we prefer to speak of a condition of symptomatic rather than a frenulum that is too short.
ankyloglossia
A tongue frenulum that is too short results in ankyloglossia, a congenital developmental disorder in which the tongue is fixed to the floor of the mouth by a frenulum that is too short, tight or thick and/or extends too far forward. Movement can be limited in all three dimensions or in just one direction forward, sideways and up.
Is the tongue tie stretchable?
Histologically, Martinelli [1] was able to demonstrate type 1 collagen in all types of ankyglossia, which is only 3% elastic. This means that assuming a length of 1 cm, a stretch of 0.3 mm is possible. Stretching exercises therefore usually only lead to an unphysiological lifting of the floor of the mouth or a change in the shape of the tongue. When the stretching is stopped, the symptoms usually return.
Insufficient definition of sufficient tongue ligament length
The widespread definition of a sufficient length of the tongue ligament would be guaranteed if the baby’s tongue goes up to half of the palate when crying with the mouth wide open Babies with too short a tongue tie often open their mouths only a little and the connection to the palate is not taken into account.
Sticking out your tongue is not a tongue function test
The sticking out only shows that the mobility of the tongue forward can be sufficient. What is decisive, however, is good mobility upwards to the palate and also to the side.
Pain-free breastfeeding
The tongue moves forward for breastfeeding and lies protectively on the lower chewing ledge. With the mouth wide open, the infant draws the entire nipple and breast tissue into the mouth. The tongue spoons around the breast tissue and stabilizes it in the mouth. With each sucking motion, the tongue goes up in a peristaltic wave motion and the floor of the mouth goes down. The middle part of the tongue creates the negative pressure. The milk ejection reflex is triggered by vacuum and wave movement and the breast milk flows into the infant’s mouth. Since no pressure is transferred from the lips or the chewing ridge to the nipple and it is protected in the cavum orum, effective, pain-free breastfeeding is possible.
