Being tongue tied is not simply a nervous stutter or lisp; it is an actual restriction of the movement of the tongue caused by a short lingual frenum, the whitish cord underneath the tongue. This condition is also called “ankyloglossia”.

There is much misinformation and confusion surrounding tongue ties, so continue reading to properly educate yourself. There are lifelong health effects of untreated tongue ties that make it an important consideration in the oral health and functional development of your infant.

Normally, the lingual frenum is long enough and elastic enough that the movement of the tongue is not restricted. Sucking, eating, and clearing food off of the teeth is no problem. Speech is also not restricted by a normal, elastic lingual frenum.

Early in development, frenum are important in guiding the growth of the oral structures and may or may not recede over time. If a this cord is too short, thick, or tight, adverse outcomes may occur related to eating, speech, and oral structures. These problems caused by such structural abnormalities are not always severe, but still prohibit enjoying a normal range of motion of the tongue.

Some very important factors to consider when it comes to tongue tie presentation are:

  1. They cannot be diagnosed purely on appearance. It takes a trained eye to properly diagnose, classify, and identify tongue ties. Every patient is different, and the determination of whether the lingual frenum is structurally abnormal or not requires an experienced professional.
  2. Every tongue tie looks different! There are several different types of tongue ties, and it takes a trained eye to properly classify them:
  • Class 1 ties are attached on the very tip of the tongue. These are the ones that most people think of when they talk about tongue ties.
  • Class 2 ties are a little further behind the tip of the tongue.
  • Class 3 ties are closer to the base of the tongue.
  • Classes 1, 2, and 3 are also known as anterior ties.
  • Class 4 ties, also known as posterior ties (PTT), may be submucosal, i.e. underneath the mucous membrane covering, so  they must be felt to be diagnosed. Babies with this kind of tie are often misdiagnosed as having a short tongue.

Also, it is important to understand the different terminology, and abbreviations, related to tongue ties:

“TT”: Tongue Tie that is usually easy visible and goes to the tip of tongue (also called an “anterior tongue tie”). The tongue may appear heart shaped or the tip of the tongue is indented. The tongue may not lift well, and may or may not extend past lower gum line.

“PTT”: Posterior Tongue Tie- this type of tongue tie is not easily seen, and is hidden under the submucosal floor of the tongue. The tongue may appear short. A PTT may affect tongue functionality to extend and lift.


  1. Tongue functionality, observed symptoms, and appearance all form the “diagnostic triad”.  These three factors all are part of the determination a trained professional will make in identifying a tongue tie.