The tongue is a very unique muscle. It is the only muscle in the body that is connected only on one side. Tongue ties cause problems with tongue function. Often, babies and children can stick the tongue out and down but that is only 1 motion and we need much more movement to breast and bottle feed efficiently, breakdown and swallow food, and speak clearly. The posterior portion of tongue needs to lower in the back of the mouth, the sides need to raise up to hold milk or food in the back portion of the mouth and the tip needs to come up to just behind the teeth prior to swallowing. Babies that are tongue tied often have a humped tongue in the back and a short front attachment to the gumline which makes it hard to make the wavelike motion and create a vacuum suction to properly withdraw milk from the breast and swallow.
When the tongue is humped in the back and the baby or child is lying down, they will often open their mouth to breathe better because of the airway obstruction from the tongue. Babies are obligate nose breathers so any breathing with an open mouth is NOT normal. Often parents will complain about chronic nasal congestion but there is no mucus in the nose. This chronic congestion and difficulty breathing is actually the noise of the tongue resting against and obstructing the airway. These babies and kids will often be restless sleepers. They are noisy breathers and active sleepers. Some babies will even learn to hyperextend their neck to further open the airway make breathing more comfortable. When kids do not sleep well they will be cranky and colicky during the day and not feed well. Older children will have behavior or attention problems. They will often have enlarged tonsils and adenoids because of the forward position of the tongue and abnormal development of the midface.
When the tongue forms on the floor of the mouth then there is no stopping mechanism for the palate so it continues to grow up and become high and arched. Just above the palate are the sinus cavities. This arching of the palate alters the development of the sinuses and causes abnormal pooling areas to form which can cause an issue with recurrent and chronic sinusitis in the teen and adult years.
We see lip ties cause sensory issues with eating. When the lip is pulled down and attached to the gumline, textured foods or even just the act of using the lip to remove food from a spoon is irritating and will cause a food aversion. If the lip tie covers the teeth then it can be painful or hard to brush the teeth and causes an increased risk and incidence of cavities and gum irritation and future gum recession.