Tongue tied and twisted

The somewhat controversial issue of tongue ties hit the media last week, with a newspaper article that again highlighted some harrowing patient stories and the boom in popularity of the tongue tie release procedure. There were two keys issues that the articles highlighted – firstly the significant increase in the number of Medicare funded tongue tie releases for children aged 4 years and under – up 700% over the past 20 years. And this doesn’t include procedures performed by dental practitioners. The second is relates to risks and complications – highlighted by the case of the 7-week old son of comedian Jimmy Rees who was rushed to hospital with major bleeding after a main blood vessel was accidentally cut during a tongue tie procedure, and spent time in intensive care following CPR and a blood transfusion.

Ankyloglossia is the restricted movement of the tongue that causes functional limitations and is accompanied by a visually restricted lingual frenum. Diagnosis and treatment should involve a multidisciplinary team to assess not only the anatomic restriction but also the functional impact. Given that this is usually related to issues of breastfeeding, it should involve an observation and assessment of breastfeeding by an International Board Certified Lactation Consultant.

First line management should be non-surgical, with a surgical option considered only after there has been no resolution of the functional issues following a period of non-surgical management.

In this episode of the Dental as Anything podcast I speak to Dr Mihiri Silva about diagnosis and management of tongue ties. Mihiri is a specialist paediatric dentist who is a Senior Lecturer at the Melbourne Dental School, a Clinician-Scientist Fellow at the Murdoch Children’s Research Institute and Consultant Paediatric Dentist and the Research Lead for the Department of Dentistry at the Royal Children’s Hospital in Melbourne. She also led the Australian Dental Association’s position statement on tongue ties and ankyloglossia, and is eminently qualified to talk to about this issue.

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Previous Episodes

In case you missed it, you can catch up with the previous episodes of the Dental As Anything podcast here. Or check-out the top 3 most listened to episodes:

• Episode 4: If in doubt, fill ... dogma, myths and clinical judgement in caries management.

• Episode 5: How will artificial intelligence change dentistry?

• Episode 7: Do we have too many dentists?