Tongue Tie Question - Page 9

[changingseasons]

Originally Posted by waluso

What I don't understand is that the AAP article says the difference in the types of tongue tie is how close the frenulum is to the tip of the tongue, with the posterior being at the base of the tongue (unless I am reading it wrong, which is definitely possible). I had asked the dr if the clipping would be less painful for DD since it was a mild tongue tie and she said no because the important part to clip is at the very base of the tongue, and that is the part that is painful. So what would she have done differently if DD also had a posterior tie? And how can you have both?

I'm really confused about all that too. I asked the doc about the differences between anterior and posterior, and she explained it... but I still don't get it. Guess I need pictures.

I know my last question has kind of gotten lost in the thread, but I would still really like to talk about the possible consequences (if any) of the labial ties. I'm really torn on whether I want DD to go through the procedure again to have the upper labial tie clipped. It's really tight, and runs all the way through her front teeth. The doc said that often when kids are older, they will fall or something and rip that one, but that it doesn't always rip in the optimal way... so it's a toss up whether to clip or just let it resolve on it's own. I know that the lingual tie can have a lot of problems associated with it, but I wasn't sure about the labial.

[Panserbjorne]

you always clip at the base of the tongue...what is affected is where the tongue is ANCHORED. in an anterior tie you clip to the base of the tongue which frees up the front of the tongue. With a posterior you clip the base of the tongue which frees the middle of the tongue. The tie will always be in the back so to speak the difference is where the tie is attached to the tongue. Does that make sense?

With a posterior tie often you can *almost* see a dimple in the middle of the tongue on top. It won't elevate properly and will often appear flat when the child is crying. With an anterior tie the child can't lift the END of the tongue or stick it out very much. There can also be a heart shape.

[waluso]

Originally Posted by firefaery

you always clip at the base of the tongue...what is affected is where the tongue is ANCHORED. in an anterior tie you clip to the base of the tongue which frees up the front of the tongue. With a posterior you clip the base of the tongue which frees the middle of the tongue. The tie will always be in the back so to speak the difference is where the tie is attached to the tongue. Does that make sense?

With a posterior tie often you can *almost* see a dimple in the middle of the tongue on top. It won't elevate properly and will often appear flat when the child is crying. With an anterior tie the child can't lift the END of the tongue or stick it out very much. There can also be a heart shape.

So it could be anchored in 2 places, causing both an anterior tie and a posterior tie? And to fix it would have needed to be cut in 2 places? Is that correct?

[Panserbjorne]

yes. as far as the person watching concerned it's the same place in terms of the clipping, but the posterior tie often has to get clipped back a bit further through the mucosa. You are clipping the frenulum either way. And yes, you can be tied anteriorly and posteriorly.

[waluso]

Thank you FF! I am going to keep looking for a doctor who believes in this so I can at least know if DD has it.

[pitchfork]

So much good information here. Just wanted to chime in, I had TT clipped (posterior) at 1 month. It was very simple. But we needed to get excercises, even more important than CST to reeducate the tongue. My DS couldn't latch, until we did the work with the SLP, at 6 months he learned to nurse. The 5 months between the clip and when he learned to nurse were torture. But I am way glad we did it.

He has another midline defect, Hypospadius/Chordee.

Oral hygiene is another important factor.

[ellasmama2007]

Originally Posted by firefaery

you always clip at the base of the tongue...what is affected is where the tongue is ANCHORED. in an anterior tie you clip to the base of the tongue which frees up the front of the tongue. With a posterior you clip the base of the tongue which frees the middle of the tongue. The tie will always be in the back so to speak the difference is where the tie is attached to the tongue. Does that make sense?

With a posterior tie often you can *almost* see a dimple in the middle of the tongue on top. It won't elevate properly and will often appear flat when the child is crying. With an anterior tie the child can't lift the END of the tongue or stick it out very much. There can also be a heart shape.

this is the first thing that has made me understand what the heck the difference is!

[AquariusHome]

Originally Posted by waluso

She also said it is absolutely not tied to food intolerances.

I got a similar response today. I had dd at the Geneticist and was trying to figure out if the typical anatomy of girls with Turner Syndrome can mimic posterior tongue tie. I really wish I would have asked it like that but instead I was trying to explain why she seems to have a lot of similarities of ptt but then some of these things are common with TS as well blah, blah, blah... Anyway, I mentioned the ptt / food intolerance connection and got an immediate "There isn't much support for that theory in the literature."

I wasn't all that surprised that she would poh poh it, but I was surprised that a Geneticist feels well enough versed on the latest research in GI / ENT issues to have an opinion on this one.

I never did figure out the answer to my question other than that ptt is not commonly associated with TS.

[sprouthead]

I am jumping in here.. I have a 15 month old who I think has a posterior tongue tie.. The LC suggested it when he came home from the hospital, but I never looked into it because the speech therapists I talked to told me he was fine and he was latching fine. Now he's just learned to swallow without spitting liquid all over the place, and he's in speech therapy. He has a very high, narrow palate but no other signs that I know of. When I talked to his pedi about it, he sounded supportive like "Oh, yeah, like in the back" like he'd at least heard of it before , but I still don't know what to do. I guess I'm going to just try to call that doctor on long island and see what she says. I'm just worried because it's so late. I mean, he did latch well, he did learn to swallow, he is making some sounds, but obviously as a mom I want to do everything I can to get him on the right track..

[Panserbjorne]

Originally Posted by LaurieG

I got a similar response today. I had dd at the Geneticist and was trying to figure out if the typical anatomy of girls with Turner Syndrome can mimic posterior tongue tie. I really wish I would have asked it like that but instead I was trying to explain why she seems to have a lot of similarities of ptt but then some of these things are common with TS as well blah, blah, blah... Anyway, I mentioned the ptt / food intolerance connection and got an immediate "There isn't much support for that theory in the literature."

I wasn't all that surprised that she would poh poh it, but I was surprised that a Geneticist feels well enough versed on the latest research in GI / ENT issues to have an opinion on this one.

I never did figure out the answer to my question other than that ptt is not commonly associated with TS.

You have a specialized enough question that I would think about contacting Dr. C on your own. You can simply ask the question. She's been doing this longer than anyone.

[changingseasons]

Ok guys- one last plea for labial tie info... our followup appointment is in an hour!!

[mtn.mama]

I know this isn't the most well-rounded advice, but our pedi-dentist says an upper lip tie isn't a big deal when babies are small. You just want to have it taken care of (if it doesn't take care of itself) before baby teeth start to fall out. He likes to clip at age 5.5. If it doesn't get clipped then, he said it starts to show major effects at age 40. FWIW.

[changingseasons]

Thanks. So do you think it would be better to clip now, or clip at 5.5? DP thinks it would be better to do it now because she won't remember it... but I'm not sure if it would be more or less traumatic when she's older.

[Panserbjorne]

better to do it now before it really interferes with spacing. JMO.

[WuWei]

Sounds like there are years and years for her to choose to have it clipped.

Pat

[Panserbjorne]

yes, but sadly by the time she understands the impact and subsequent choice the teeth are misaligned and after the clipping more interventions are often utilized (braces.) From my perspective I would rather do everything I can to avoid orthodontic work which can create ALOT of damage. I know there are many opinions on this, but that is where mine comes from. That is why for *me* given the chance I'd do it know so it doesn't impact structure at a later point. It is not, of course the only answer.

[nalo]

I'd just get it taken care of now I think.

[tanyalynn]

I'm one who's gonna have to have the joy of dealing with it in a 5yo, the space between my daughter's top two teeth is really, really wide, and I could skip it if it were just aesthetics, but I think for dental health/alignment type issues, I think we're going to need to do this within a year or so. She's not gonna be thrilled, methinks.

Best of luck to you CS!

[AquariusHome]

Originally Posted by firefaery

You have a specialized enough question that I would think about contacting Dr. C on your own. You can simply ask the question. She's been doing this longer than anyone.

Any idea how to reach her? I've been scouring the Winthrop University Hospital website with no luck.

I did find a reference to an article that I think would have the answer but could only get the abstract on Pubmed.

[Panserbjorne]

she's in Long Island.

Elizabeth Coryllos MD,MS,FAAP,IBCLC
8 Jaegger Drive
Glen Head NY 11545
United States
Phone: [phone]
Fax: [phone]

This should be current.