Description

Anatomic variation of the tongue in which the lingual frenulum is unusually tight and short. Also known as tongue-tie. This condition may result in impaired tongue mobility with early breastfeeding problems, maternal nipple pain, and, later speech problems.

Epidemiology

• Prevalence ranges from 2 to 10% in various studies.
• About half of breastfeeding infants with ankyloglossia will have difficulty feeding or will cause maternal nipple pain during feeds.
• Incidence of speech articulation disorders due to ankyloglossia is unknown.
• Male-to-female ratio of 3:1

Risk Factors

No known environmental risk factors

Pathophysiology

• Pedigree analysis suggests significant hereditary component, possibly X-linked.
• Studies show 40–50% of patients with ankyloglossia had a relative with the same condition and an inheritance rate of about 21%.
• Mutations in the T-box transcription factor TBX22 have been associated with heritable ankyloglossia with or without cleft lip, cleft palate, or hypodontia.
• Newborns with ankyloglossia
  • Are often asymptomatic but problems can occur with breastfeeding
  • May have poor or ineffective latch or may cause maternal nipple pain due to poor tongue mobility and prolonged feeding times
• Later in childhood, the effect of ankyloglossia is controversial.
  • May cause problems with articulation of certain sounds that require tongue to reach teeth, palate, and lips (e.g., “t,” “d,” “z,” “s,” “th,” “n,” “l”)
  • Not a cause of speech delay
  • May also result in mechanical problems including difficulty with oral hygiene (inability to lick lips), inability to lick ice cream cone, play wind instruments, or French kiss (cataglottism)

Commonly Associated Conditions

• Smith-Lemli-Opitz syndrome
• Simpson-Golabi-Behmel syndrome
• Oral-facial-digital syndrome
• Beckwith-Wiedemann syndrome