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A tongue tie, medically known as ankyloglossia, is a condition characterized by an unusually short, thick, or tight band of tissue (lingual frenulum) that tethers the tongue to the floor of the mouth. While tongue ties are commonly diagnosed in infancy or early childhood, there are instances where this condition goes unnoticed until later stages of development. Contrary to popular belief, not all tongue ties manifest symptoms immediately, leaving some individuals undiagnosed until childhood. Here are some of the reasons behind this phenomenon and the implications for affected individuals.

Variability in Symptoms

One of the primary reasons why some tongue ties are not diagnosed until childhood is the variability in symptoms. While some infants may exhibit clear signs of feeding difficulties, speech impediments or oral restrictions, others may have subtler manifestations or remain asymptomatic during infancy. As children grow and their oral functions become more complex, previously unnoticed tongue ties may begin to manifest symptoms, such as speech articulation issues, difficulty with certain oral activities (e.g., licking an ice cream cone or playing wind instruments), or even dental problems. These late-emerging symptoms can prompt parents and caregivers to seek evaluation and diagnosis later in childhood.

Developmental Milestones

Another factor contributing to delayed diagnosis of tongue ties is the dynamic nature of oral function and development. Infancy is a period of rapid growth and maturation, during which babies undergo significant changes in their oral anatomy and motor skills. While some tongue ties may not impede early feeding or breastfeeding, they may become more problematic as children transition to solid foods or develop speech. As children engage in activities that require greater tongue mobility and coordination, such as speaking clearly, swallowing effectively and participating in oral hygiene practices, the limitations imposed by an undiagnosed tongue tie may become more apparent over time.

Lack of Awareness

Despite increased awareness of tongue ties among healthcare professionals in recent years, the condition may still go unrecognized or misdiagnosed, particularly in milder cases or when symptoms are subtle. Parents and caregivers may not be familiar with the signs of tongue ties or may attribute certain difficulties to other factors, such as teething or developmental delays. As a result, children with undiagnosed tongue ties may not receive timely intervention or support, leading to ongoing challenges and frustration in various aspects of their oral function and development.

Multidisciplinary Approach to Diagnosis

To address the issue of undiagnosed tongue ties in childhood, a multidisciplinary approach to evaluation and diagnosis is essential. Healthcare providers, including pediatricians, lactation consultants, speech-language pathologists and pediatric dentists, play key roles in identifying and addressing tongue tie-related concerns across different stages of development. By collaborating and sharing expertise, professionals can ensure that children with tongue ties receive comprehensive assessment, timely intervention and appropriate support to optimize their oral health and well-being.

While tongue ties are commonly diagnosed in infancy or early childhood, some cases may not be recognized until later stages of development. Factors such as variability in symptoms, developmental milestones, and lack of awareness contribute to the delayed diagnosis of tongue ties in childhood. By raising awareness, promoting early screening and adopting a multidisciplinary approach to evaluation and diagnosis, healthcare professionals can more effectively identify and address tongue-tie-related concerns in children, thereby improving outcomes and quality of life for affected individuals and their families.

If your child is diagnosed with a tongue tie as a toddler or in early childhood, it is not too late to perform a tongue tie release. Dr. Levitin at NYC Tongue Tie can perform a pain-free tongue tie release procedure in about ten minutes at his office. Call our clinic in New York City to schedule a consultation.

Posted on behalf of NYC Tongue Tie

200 W. 57th St., Suite 1410,
New York, NY 10019

Phone: Call (212) 257-3546


Monday & Tuesday 8:30 AM – 7:00 PM
Wednesday & Thursday 8:30 AM – 5:00 PM
Friday 8:30 AM – 2:00 PM

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NYC Tongue Tie

200 W. 57th St., Suite 1410,
New York, NY 10019