Tongue-Tie

Exams and Tests

Diagnosis of tongue-tie is usually based on a physical exam and any symptoms your baby may have. To check for tongue-tie, the health professional may:

• Lift your baby's tongue and examine the tissue that attaches the tongue to the bottom of the mouth (lingual frenulum). The lingual frenulum may be thick or thin and may extend to the tip of the tongue.
• Measure the strength of your baby's suck by inserting a finger into the baby's mouth and noting how hard he or she sucks on it.
• Weigh your baby and determine whether he or she weighs less than expected.
• Ask whether you have sore nipples.
• Watch you breast-feed to see how well your baby latches on and sucks.

Older children or adults

To diagnose tongue-tie in an older child or an adult, the health professional examines the mouth for:

• Restricted tongue movement. The health professional may measure the tongue's protrusion beyond the lower teeth. This measurement may be used as a comparison after tongue-tie surgery. The health professional looks for difficulty lifting the tongue to the upper teeth and upper lip and for limited side-to-side tongue movement.
• Abnormal spacing between the front lower teeth. The space may be caused by rubbing of the lingual frenulum during protrusion of the tongue.
• A notched or heart-shaped tongue when protruded. The tongue may roll or curl when the person tries to protrude it.

Other tests

• If your baby is primarily having breast-feeding difficulties, evaluation by a lactation consultant may be required. The lactation consultant may be able to help teach you how to assist your baby in latching on and sucking effectively.
• If your child is having speech problems, evaluation by a speech therapist may be required. The speech therapist may be able to rule out other conditions that could be causing the speech problem.

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Author:	Debby Golonka, MPH	Last Updated: September 6, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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