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Baby Talk

Does Tongue-tie Affect Speech?

By Donna Smith

"As a speech-language pathologist, I was concerned that my boys' tongue-tie could impair their speech development so I had them both evaluated by an ear, nose and throat physician," says Hudon. She feels it's important to have a child with tongue-tie evaluated by an ENT to determine if he is a candidate for a frenulectomy, a procedure where the tissue is clipped. Hudon notes, however, that not every child who has tongue-tie requires surgery.

In fact, it is a surgery that many medcial professionals hesitate to do. "It used to be that all newborns and infants who were tongue-tied were 'clipped' or had a frenulectomy, but this is much less commonly done these days, except by more 'old school' pediatricians," says Dr. Vincent Iannelli, a board-certified pediatrician near Dallas, Texas, fellow of the American Academy of Pediatrics and associate professor of pediatrics at Southwestern Medical School. "The biggest reason is likely that many doctors just don't feel that it is necessary. And there is little research or proof to convince them otherwise."

Tongue-tie affected each of Hudon's twins differently. "One of my boys could not protrude his tongue past his teeth, lateralize his tongue into his cheeks or elevate the tip to touch his upper teeth," she says. "Also, he was frequently gagging and vomiting on textured foods. My other son had much better range of motion of his tongue and no feeding issues."

Hudon's doctor only recommended a frenulectomy on the first twin because he felt the second had a better range and that the tissue would eventually stretch even further.

"So, at 2 years of age, only one of my boys had a frenulectomy," she says. "They both developed excellent articulation skills without any need for therapy, and my son's gagging problem disappeared after surgery. Today, my second son can elevate, lateralize and protrude his tongue past his lips without any problem. However, he still has that 'v' or heart-shaped tongue shape when he protrudes his tongue because it is still somewhat tied in my opinion. My first son (who had the surgery) can wiggle that tongue around his mouth (which he often does) without any problem."

The risks of a frenulectomy can include bleeding and infection. "I think that you have to also be concerned of complications if the procedure doesn't go well, like if too deep of a cut is made," says Dr. Iannelli. "The thing to consider is that this is still a surgical procedure, even though it is minor."

If a parent wants the procedure done despite her doctor's objections, Dr. Iannelli recommends seeing a pediatric surgeon, pediatric ENT or even a pediatric dentist. He says if he or she is experienced, a pediatric dentist would be as good as any other health professional in performing this procedure. "They are often called upon to evaluate and sometimes remove natal teeth (teeth that babies are born with) and so have experience with oral disorders of infancy," he says.

The decision to have the procedure or not is not cut and dry and can be a big decision for some parents. Every child is different and every situation must be assessed individually.

For Chamberlain, the decision will come down to whether her son will have a major speech problem that could cause him problems in life. "I think that children are cruel to one another and a child with a speech impediment will be singled out in school and will be teased," she says. "It is sad that we live in a society [where] this happens, but it does."

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