Thursday, April 18, 2019

Adult Tongue-Tie and Frenectomy

Ankyloglossia is commonly known as tongue-tie, which is a congenital condition where the tissue membrane connecting the tongue to the floor of the mouth is unusually short, thick, and/or tight. This often causes problems throughout development, first interfering with breastfeeding ability in infancy and continuing to affect feeding, swallowing, and speech in childhood, as well as palate formation and the placement of incoming permanent teeth.

Additionally, improper resting position of the tongue can restrict the airway and cause sleep apnea in children and adults, which in turn negatively affects sleep quality and attention & focus during the day. Moreover, sleep apnea is linked to a number of other health conditions across age groups, including obesity, hyperactivity, high blood sugar and type 2 diabetes, high LDL cholesterol, cardiac and liver problems, acid reflux, and cognitive symptoms such as memory loss, confusion, learning difficulties, and depression.

While the symptoms of ankyloglossia present differently over time as our bodies learn to compensate for the restricted muscles and tissues, tongue-ties are easily corrected by frenectomy: a simple procedure where the restrictive webbing under the tongue (or the lingual frenulum) is released, mobilizing the tongue and enabling it and the supporting musculature to function more optimally.

My Experience

I've been a massage therapist for 11 years, but it was only recently that I began learning about tethered oral tissues (i.e., tongue/lip/buccal ties) and their long-term effects. Many of the symptoms of tongue-tie in adults resonated with me, particularly jaw clenching, teeth grinding, neck & shoulder tension, and forward head posture. So, I decided to get a functional evaluation myself, at 37 years old. I'd always attributed my symptoms to the everyday stresses of life, a somewhat anxious personality, and the physical nature of my job. However, I was eager to see if there might also be a structural cause or contributing factor, as I'd had limited results from regular yoga practice, acupuncture, bodywork, aromatherapy, etc. for tension relief.

I met with Samantha, the Oral Myofunctional Therapist who is part of our team at the PA Tongue-Tie Center, for the evaluation. She guided me through a series of activities to test the functional limitations of my oral musculature, and found that my tongue was quite restricted. This was affecting my chewing, swallowing, and causing my jaw and other facial muscles to work especially hard to compensate. We also realized that my tongue was resting against my teeth instead of my palate, which explained part of my dental history where my occlusion (bite) had been adjusted from open to closed, but over time became open again. That is, my tongue was gradually pushing my front teeth forward so that the top and bottom teeth no longer touched.

Once Samantha determined that a tongue-tie was present and I would benefit from a frenectomy, we began the therapy process to strengthen my tongue in preparation for the procedure. Oral myofunctional therapy (OMT) before and after release is critical because the tongue and supporting muscles don't automatically know what to do once they have the proper range of motion; they must be retrained because they have been unable to move and function as they should.

Another important adjunctive therapy in treating ankyloglossia is bodywork, specifically craniosacral therapy (CST) and/or chiropractic care. These modalities target and correct abnormal strain patterns in the body that result from compensatory muscle actions caused by ties. As with OMT, it's often helpful to receive CST or chiropractic before frenectomy to loosen the tissues and facilitate a more complete release, as well as after the procedure.

After almost 3 months of weekly OMT, I reached the point where I couldn't progress any further without having my tongue released, so we scheduled the frenectomy with Dr. Cockley, who performs releases via laser. The entire procedure lasted only a few minutes, including time for the numbing agents to take effect. I felt minimal discomfort and no pain during the frenectomy, but the effects of the release were immediately noticeable.

My Results and Aftercare Plan

Aside from the sudden ability to fully elevate my tongue, the first thing I noticed just minutes after my release was that my neck & shoulder tension relaxed as my shoulders settled into a new resting position. It seemed to require less conscious effort for me to maintain good posture. That night during yoga, I was able to bend and fold further into the poses without the familiar stiffness or pain shooting from my neck down my spine, as though a cord of tension connecting my upper and lower body halves had been severed.

I am now one week post-op and I've noticed less tension in my body overall, which has reduced my general stress & anxiety levels. I'm able to chew and swallow certain foods more easily, so I don't feel the usual fatigue in the floor of my mouth while eating. My face and jaw feel more relaxed more of the time, particularly while driving and sleeping when I tend to clench my teeth. Doing the post-op tongue exercises and stretches 5 times a day as recommended has kept any soreness to a minimum, and I always feel better afterward.

For my aftercare plan, I am continuing weekly OMT with Samantha to gain optimal strength, mobility, and function of my tongue and supporting muscles. I received monthly CST treatments prior to my frenectomy and will receive a few more biweekly treatments, as recommended by my practitioner. Ultimately, I'm very happy that I decided to pursue this. My tongue-tie release has already made a tangible difference in my life, and it was well worth it!

Dentist East Berlin PA
Cosmetic, Childrens, Implant, NTI, DURAthin Dentistry