Recent studies suggest that speech, solid feeding, and sleep difficulties may be linked to restricted tongue function. Children with tongue restrictions and speech, feeding, and sleep issues underwent lingual frenectomies with a CO2 laser, paired with myofunctional exercises. Questionnaires were completed before, 1 week after, and 1 month following treatment. Thirty-seven patients participated in the study (mean age 4.2 years [range 13 months to 12 years]). Overall, speech improved in 89%, solid feeding improved in 83%, and sleep improved in 83% of patients as reported by parents. Fifty percent (8/16) of speech-delayed children said new words after the procedure ( P = .008), 76% (16/21) of slow eaters ate more rapidly ( P < .001), and 72% (23/32) of restless sleepers slept less restlessly ( P < .001). After tongue-tie releases paired with exercises, most children experience functional improvements in speech, feeding, and sleep. Providers should screen for oral restrictions in children and refer for treatment when functions are impaired.
Ankyloglossia, commonly referred to as "tongue-tie," has recently seen a surge in cases and awareness with a corresponding increase in diagnosis and treatment. The evidence linking tongue-tie release and breastfeeding improvement has been published previously. However, due to a lack of published evidence for children, many medical professionals still believe that a restricted tongue does not contribute to feeding or speech issues in older children. The condition of tongue-tie exists on a continuum with variable visibility and symptoms. Some restrictions, mainly anterior or "classic" tongue-tie, are highly visible and easier to detect. However, "posterior" or submucosal tongue-ties are often more challenging to diagnose. Recently, an increase in awareness and education has led to improved detection of these posterior tongue-ties. The data presented in these case studies will demonstrate that even posterior ties restrict movement and affect oral structures that are required for speech and feeding. In this case series, five patients with posterior tongue restrictions underwent CO 2 laser frenectomy without any general anesthesia or sedation. After a quick in-office procedure, all five patients demonstrated increased lingual mobility evidenced by improved speech and feeding skills. Some improvements were observed immediately after the procedure by clinical staff and the child's family. While these patients required continued intervention from a speech-language pathologist, their improved lingual mobility allowed for more significant and faster improvement in speech and feeding skills. These cases challenge the status quo that speech and feeding are not affected by posterior tongue-tie. Continued research is warranted to determine the impact that all classes of lingual restrictions can have on speech and feeding development.
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