When trying to understand the distinction between adults with tongue tie and those without, it’s important to first define what “tongue tie” actually means. Medically referred to as ankyloglossia, this condition may not be widely recognized among adults, yet its impact can be surprisingly extensive.
Tongue tie occurs when a short or unusually tight piece of tissue connects the underside of the tongue to the floor of the mouth. Though it may appear to be a minor issue, it can create significant challenges that influence overall health and quality of life.
While most discussions focus on tongue tie in infants, the condition doesn’t always resolve with age. Many adults continue to live with it, facing effects that can influence oral health, sleep patterns, facial development, and even aspects of physical recovery. This naturally raises the question: how do adults with tongue tie differ from those without?
Recognizing these differences is key to understanding potential health risks and exploring effective solutions. In this article, we’ll take a closer look at those distinctions, supported by research and practical insights.
Facial Structure: The Role of the Tongue in Shaping Our Features in Tongue Tie vs. Normal adults
Our facial structure is a key element of our overall appearance and can influence everything from self-esteem to social interactions.
The development of facial features is a complex process. It begins as early as in the womb and continues through adulthood. One critical, and largely overlooked, factor in this development is the positioning and movement of the tongue.
Adults with Tongue Tie: Long, Narrow Faces and Less Pronounced Jawlines
Adults with tongue tie often exhibit facial structures that are distinctively different from those without the condition.
The restricted movement of the tongue due to ankyloglossia can impede proper jaw development. When the tongue is unable to rest comfortably against the roof of the mouth, as it should, the jaw does not expand to its full potential. This limitation often results in a longer, narrower face, characterized by underdeveloped jaws.
Research
Tongue Placement
John Mew, in his article for Angle Orthodontics, Mew J. The influence of the tongue on dentofacial growth. Angle Orthod. 2015 Jul;85(4):715. doi: 10.2319/angl-85-04-715-715.1. PMID: 26135232; PMCID: PMC8611756.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611756
Stated “In fact, there is much evidence to suggest that unusual function of the soft tissues in general, and the tongue in particular, are related to malocclusion. Rare cases of aglossia show major collapse of the dental arches and Harvold3 showed that the surgical removal of part of a monkey’s tongue caused a related reduction of arch size.”
Research has shown that the tongue plays a crucial role in the expansion of the maxilla, the upper jawbone, during early development.
In cases of tongue tie, the lack of adequate tongue pressure on the palate can lead to insufficient growth of the maxilla, resulting in a narrow facial appearance.
Tongue Function
Studies aimed at highlighting the importance of proper tongue function for normal facial development such as
Deregibus, A.; Parrini, S.; Domini, M.C.; Colombini, J.; Castroflorio, T. Analysis of Tongue Function from the Orthodontist’s Point of View: Not Only a Matter of Deglutition. Appl. Sci. 2021, 11, 2520. https://doi.org/10.3390/app11062520
Concluded
“On behalf of the complete diagnosis of the development of malocclusions, every aspect of the patient should be considered with caution.
Within the experimental limits, results obtained in this observational study showed that the tongue position in patients with Angle class III malocclusion, maxillary hypoplasia, and posterior crossbite seemed to influence malocclusion.
Therefore, the clinician (orthodontist or general dentist) should analyze not only the presence/absence of atypical swallowing but also anatomical aspects, such as ankyloglossia and the behavior of the tongue in the rest position, and functional aspects, such as the correct execution of certain logopedic exercises (i.e., “hold and pull” and “chuck”).”
For those not familiar the term “chuck” it is more commonly referred to as a tongue click. While the “hold and pull” is sucking the tongue up into the palate and then opening the mouth wide while keeping the tongue up.
Moreover, the lack of proper jaw expansion due to a restricted tongue can lead to a less pronounced jawline.
This can contribute to several dental issues, including overcrowding of the teeth and misalignment. These conditions further exacerbate the challenges faced by individuals with tongue ties.
Normal Adults: Balanced Facial Structure and Pronounced Jawlines
In contrast, adults without tongue tie typically exhibit a more balanced facial structure. The natural movement and positioning of the tongue against the roof of the mouth supports the proper expansion of the maxilla and mandible (the lower jawbone). This leads to a well-defined jawline and a more symmetrical face.
The balance in facial features contributes not only to aesthetics but also to functional aspects of oral health. A well-developed jaw provides adequate space for the teeth to align correctly, reducing the likelihood of dental issues such as crowding or malocclusion (misaligned teeth).
In comparing Tongue tie vs normal adults one can consider how much orthodontic work they received as a child, teen, and even adult as one major indicator to the answer “Are you tongue-tied.”
Dental Hygiene and Oral Health: The Impact of Tongue Mobility in Tongue Tie vs Normal Adults
The tongue plays a vital role in maintaining good oral hygiene by helping to clean the teeth and gums and stimulating saliva production, which is essential for neutralizing acids in the mouth and protecting against decay.
Adults with Tongue Tie: Compromised Dental Hygiene and Increased Dental Problems
For adults with tongue tie, maintaining good oral hygiene can be a significant challenge. The restricted movement of the tongue makes it difficult to effectively clean all areas of the mouth, particularly the back teeth and the spaces between the teeth and gums. This can lead to a higher risk of cavities, gum disease, and other oral health issues.
Just think of a time when you had food to clear from your back teeth and you were stretching and licking and stretching and licking the spot to clean it out. Did you end up using your finger to swipe the food out?
Did you feel like your tongue just couldn’t get it? Does that happen a lot? Even a tiny bit of food left behind can lead to dental issues.
In addition to compromised dental hygiene, tongue tie can also contribute to a host of other dental problems.
The lack of proper tongue movement can result in the buildup of plaque and tartar, leading to tooth decay and periodontal (gum) disease.
Moreover, the restricted tongue can affect the development of the dental arches, leading to issues such as an open bite or a cross bite, which require orthodontic intervention to correct.
Then there’s open-mouth breathing. Tongue-tied adults will have a low rest posture of the tongue and a slightly forward thrust. This placement can promote open-mouth breathing.
Air flowing through the mouth rather than the nose can lead to dry cracked lips. Are you always searching for your lip balm or ChapStick? Feel lost without it?
Dry lips and dry mouth are consistent complaints from adults with tongue ties.
Normal Adults: Better Dental Hygiene and Improved Oral Health
Normal Adults: Better Dental Hygiene and Improved Oral Health
In contrast, normal adults with unrestricted tongue movement are better equipped to maintain good oral hygiene.
The tongue’s natural ability to move freely within the mouth allows for more effective cleaning of the teeth and gums. This, in turn, reduces the risk of cavities, gum disease, and other oral health issues.
The ability to maintain proper oral hygiene also contributes to overall oral health. A healthy mouth is not only important for eating and speaking but also plays a role in preventing systemic health issues.
Research has shown that poor oral health is linked to a number of chronic conditions, including heart disease, diabetes, and respiratory infections.
Tonelli A, Lumngwena EN, Ntusi NAB. The oral microbiome in the pathophysiology of cardiovascular disease. Nat Rev Cardiol. 2023 Jun;20(6):386-403. doi: 10.1038/s41569-022-00825-3. Epub 2023 Jan 9. PMID: 36624275.
https://pubmed.ncbi.nlm.nih.gov/36624275
Is one such article that seeks to identify links between poor oral health and cardiovascular disease.
Adults with normal oral structures will be happy to know that they are less likely to suffer from poor oral health and thereby have healthier hearts!
Sleep Quality: The Role of the Tongue in Airway Function In Tongue Tie vs Normal Adults
Sleep is essential for overall health and well-being. During sleep, the body undergoes a range of restorative processes that are crucial for physical and mental health.
However, sleep quality can be significantly affected by airway function, which is closely related to the position and movement of the tongue.
Adults with Tongue Tie: Poor Sleep Quality and Associated Health Risks
For adults with tongue tie, airway obstruction during sleep is a common problem. The restricted movement of the tongue can cause it to fall back into the throat during sleep, leading to partial or complete obstruction of the airway.
This can result in snoring and sleep apnea, conditions that cause interruptions in breathing during sleep.
Sleep apnea, in particular, is a serious condition that can lead to chronic sleep deprivation and a host of associated health risks. These include an increased risk of cardiovascular disease, high blood pressure, obesity, diabetes, and even stroke.
Furthermore, poor sleep quality can have a significant impact on mental health, contributing to conditions such as depression and anxiety.
Relationships can suffer when one partner is snoring all night long. Often this can lead to sleeping in separate rooms so the non-snoring partner can get adequate rest.
Snoring and sleep apnea prevent you from entering into deep REM sleep which is known to be the most restful period of sleep. If you find you are cranky and irritable by mid-afternoon it may be due to poor sleep and not just that annoying co-worker!
Mouth taping has had a surge in recent years as more people try to self-regulate their sleep and reduce snoring by taping their mouths closed.
As discussed earlier, open mouth posture is not good for oral health or the airway, and while it is a positive to sleep with a closed mouth, taping is lacking in providing support to the tongue.
Open mouth posture and snoring are the outward visible sign of a malposition tongue. The tongue is the control center and fixing the tongue placement is key to improved sleep and sleep quality.
Normal Adults: Better Sleep Quality and Overall Health Improvement
In contrast, adults without tongue tie typically experience fewer airway obstructions during sleep, leading to more restful and uninterrupted sleep. The proper positioning of the tongue, resting up in the palate, helps to maintain an open airway, reducing the likelihood of snoring and sleep apnea.
Closed mouth posture and elevated tongue placement are easily maintained and oral health is not compromised which supports your ability to get to and remain in deep REM sleep.
Good sleep quality is essential for overall health. It allows the body to repair and regenerate tissues, supports immune function, and promotes cognitive function and emotional well-being.
Adults who enjoy high-quality sleep are less likely to experience the health issues associated with chronic sleep deprivation, such as heart disease, obesity, and mental health disorders.
Childbirth and Recovery: How Tongue Tie Affects Muscle Function and Posture in Tongue Tie vs Normal Adults
Childbirth is one of the most physically demanding experiences a woman can undergo. The process requires the coordinated function of multiple muscle groups, including the pelvic floor muscles, which play a critical role in labor and delivery.
The ability to recover quickly and effectively after childbirth is also heavily dependent on muscle function and overall physical health.
Adults with Tongue Tie: Challenging Childbirth and Slower Recovery
For adults with tongue tie, the impact of the condition extends beyond the oral cavity and can affect overall muscle function and posture.
The interconnectedness of the body’s muscular and fascia system means that a restriction in one area, such as the tongue, can have ripple effects throughout the body. Causing hiccups of tension through the diaphragm, pelvis, and all the way to the toes.
In the case of childbirth, tongue tie can contribute to poor posture and muscle tension, poor diaphragmatic breathing, and recruitment of pelvic muscles when stressed or anxious, which can exacerbate labor difficulties.
The restricted fascia can lead to compensatory postures and muscle imbalances that affect the alignment of the pelvis and spine. This can make labor more challenging and increase the likelihood of complications during delivery.
As well, the recovery process after childbirth can be slower for those with tongue ties. Poor posture, muscle tension, and restricted fascia can contribute to pelvic floor dysfunction. This can make it more difficult for the body to recover after childbirth.
This can lead to embarrassing leakage of pee, and pain during sex, and contribute to the overall feeling of depression. This is especially true when it’s seemingly more difficult for you to recover as compared to your friends.
Normal Adults: Easier Labor and Faster Recoveries
Adults with a normal frenulum will have an easier flow through the body systems of muscle, fascia, and bone. They will be less impacted by poor pelvic floor movements allowing for an easier transition of the baby through the birth canal.
An easier transition of the baby means a much easier recovery for the mother. Making it less likely to suffer from leakage, pain with sex or depression.
Visual inspection: How the Tongue looks comparatively in Tongue Tie vs Normal Adults
Below is an image shared on the blog by The Alabama Tongue Tie Centers Dr. Richard Baxter, DMD, MS http://tonguetieal.com/do-tongue-ties-affect-adults-what-symptoms-do-they-have/ presented here side by side with a picture of a normal frenulum.
Normal tongue frenulum
Here Dr. Baxter uses the Tongue Range of Motion Ratio (TRMR) to easily show restrictions in the frenulum of adults with tongue ties. Notice how in the pictures for the Grade 1 and Grade 2 that they can appear relatively normal. The decision to treat Grade 1 and 2 restrictions is based mainly on the functional impact. Is the person dealing with issues of oral health, oral hygiene, sleep quality, or pelvic floor problems? Then along with what we see visually it may be decided to intervene.
Frenulum – Tied Tongue
What we visually see upon inspection is that the frenulum looks blanched white and strained. It is popping out and looks taught in Grade 3 and 4 pictures.
Tongue Body – Tied Tongue
The body of the tongue appears squat and short. The tip of the tongue does not reach the top of the mouth and there is a dip in the center of the tongue, often referred to as heart-shaped.
You are literally looking at the tip of the tongue being pulled down and unable to reach its target.
Frenulum – Normal Tongue
The normal tongue, upon inspection, has a pink or reddish-colored frenulum. It does not appear strained or taught and is not popping out away from the muscle.
Tongue Body – Normal Tongue
The body of the tongue appears long and straight with toned lateral edges. It comes to a rounded point or tip at the top.
You can see how easily this tongue can reach its target. This person has no complaints of strain through the jaw. Also, no oral health issues or overall health issues that could be commonly linked to ties.
Looks and Function – It’s a Combination Thing!
Dr. Baxter’s images help to show that each restriction can look and act differently. You should be looking not only at the visual component of your suspected adult tongue tie but also the functional impact upon your health. An adult with a very pronounced visual tie may report very few interfering issues in their oral and overall health.
Whereas someone may have a very minimal visual tie in appearance and have many oral and general health complaints that can be linked back to the tethered tissue. It is important to consider both the visual and the functional impact when identifying Tongue Tie vs. Normal Adult issues.
Summary: Tongue Tie vs. Normal Adults Are There Differences?
Yes! It is not just dependent on what the tongue/frenulum/tethered oral tissue looks like. But also and maybe more importantly how you feel. If you’ve been searching for the underlying cause of oral and general health issues that seem to have no answers, then a lifelong undiagnosed Adult Tongue Tie may be the culprit.
