Tongue-tie (Ankyloglossia), is a condition where a strip of skin connecting the baby’s tongue to the bottom of their mouth is unusually shorter, thicker or attached closer to the tip with differing degrees of severity and many variations. This condition mainly restricts movement of tongue causing difficulties in breastfeeding in newborns and infants and speech difficulties in older children and adults. Tongue tie may also cause narrowing of airway leading to sleep apnea. This can suppress movements that are vital for breathing, breastfeeding, sucking, eating, drinking, chewing, swallowing, digestion, speech, jaw growth, and postures.

Signs of Tongue-tie:

1. Breastfeeding difficulties: Tongue tie causes difficulties for both baby and the mother mainly because the baby cannot latch properly to the breast.
2. Difficulty in latching:

• For a successful latch, the tongue of the baby needs to cover the lower gum, however in tongue tie; due to short frenum tongue cannot extend beyond a certain point. 
• Babies may also have difficulty staying attached to the breast for a full feed. 
• Babies may feed for a long time, have a short break and then feed again
• Often clicking sound while feeding can be an indication for possibility of tongue tie
• Babies may remain unsettled and hungry

1. Problems to the mother:

• Mothers may experience sore or cracked nipples
• Since the baby cannot feed well, mothers may experience depletion in milk production
• Mothers may experience mastitis (Inflammation of breast)

1. Restricted tongue movement and speech difficulty: Tongue tie restricts movement of the tongue; difficulty lifting the tongue, touching the roof of mouth and side to side movements, which invariably leads to speech difficulties.
2. Jaw development: Tongue restrictions influences jaw growth and development leading to underdeveloped mandible which causes Class II malocclusion.
3. Obstructive Sleep Apnea: Due to tongue tie the muscles of the mouth may not develop properly and this associated with underdeveloped, posteriorly positioned lower jaw leads to the tongue to fall back and cause airway obstruction. Such people would experience episodes of shortened or absent breathing while sleeping.

Treatment:

Tongue-tie division (Frenectomy) wherein the short, tight piece of skin connecting the underside of the tongue to the bottom of the mouth is cut. In older children and adults, frenectomy should be associated with muscle training