What is a tie?
People think of being tongue-tied as a figure of speech meaning you can’t find the right word you want to say or can’t speak correctly. But truly being tongue-tied is a congenital condition (born with it) where the membrane that runs from the underside of the midline of the tongue to the gums behind the lower front teeth is too short, too tight, or both and prevents some degree of movement of the tongue. The big medical term for this is Ankyloglossia (ANKYLO meaning tight or rigid, and GLOSSIA referring to the tongue). WE ALL HAVE THIS MEMBRANE, but for reasons we have not yet figured out, some of them just aren’t long enough or flexible enough for proper function. The main symptoms relate to feeding, speaking, swallowing and breathing in all phases of life. With a proper assessment of the symptoms, a thorough and proper examination some of these tight membranes, (called FRENUM or FRENULUM) need to be surgically released with a small incision, called a frenectomy or frenotomy. Read below on what a Frenotomy is.
The lips and cheeks also have frenulums, and sometimes these are too short, or tight, or attached to the gumline in a wrong spot. When appropriate these can also be released. Together, these are referred to as TOTS, Tethered Oral Tissues.
It must be stressed that this tightness and poor function of the tongue may not ONLY be related to the frenulum. Muscles in the face, jaw, neck, shoulders, back, etc. may be out of balance and it shows up in the mouth. Under our skin we are covered with a fine mesh layer that holds us together from the top of our head to the end of our toes, called FASCIA. Sometimes this fascia is out of balance and with proper therapy it can be re-balanced along with nerves, muscles, tendons and ligaments. Sometimes having some bodywork therapy can reduce the tension and prevent the need for surgery.
What is a Frenotomy?
Frenotomy/frenectomy is a minor surgery to treat TOTS, to release the frenums. The tension in the tight "wrapper" under the tongue, lip or cheek is released so muscles of the tongue, lip or cheek can move more freely. Most of the time the release is done with a laser. However, for years the surgery was done with scissors or a scapel. In the case of medievil days, midwives kept a well-sharpened fingernail to release the frenums. The point here is that it IS NOT THE TOOL used to do the release, but the skill and experience of the surgeon to obtain a COMPLETE release that most of the time results in a diamond-shaped wound.