My Story Part IV - Beginning Therapy and My Tongue Tied Face

Hello Kiddies!

In this post I want to talk about the beginnings of my therapy and the benefits I quickly started seeing.

My therapy with my orofacial myologist (OM) began just two days after my lingual frenectomy.  Once again, I cannot stress enough: myofunctional therapy must begin right away after a lingual frenectomy.  Why?  Because you run the great risk of the tongue healing up and sticking to the floor of the mouth again.  That's right.  You can get a frenectomy and have your tongue wind up just as tied as before.

This is why so many people think frenectomies are not worth it, because they had one (or know someone who did) and had their tongue heal and scar up in pretty much the same position as before.  So, people will often say "You only gain a few millimeters" when the truth is "You only gain a few millimeters if you do not do therapy after your frenectomy."  Two days after my surgery I had gained about 5 mm.  Two weeks later, I had gained 22 mm!  Today, I am up to 26 mm :)

Two days post op tongue on spot (read further for explanation of 'the spot').

Two weeks post op tongue on spot!

Most oral surgeons will tell you not to overstretch your tongue after a frenectomy.  That's exactly what mine told me.  Did I listen?  No.  I did my myofunctional therapy.

Now, here's where I have to cover my a**, if you'll pardon my asterisks.  If you have had a lingual frenectomy recently, and happen to be reading this, consult with your oral surgeon or an orofacial myologist/myofunctional therapist before attempting to exercise your tongue.  While I am all for exercising the tongue after a frenectomy, I am not trained in myofunctional therapy and therefore am not recommending anyone start performing tongue gymnastics.  Whatever work I did was under strict guidelines.

At the same time, I want to acknowledge the discrepancies between the recommendations of my oral surgeon and the recommendations of my myofunctional therapist.  My surgeon was wary of me engaging in any orofacial therapy and wanted me to avoid stretching my tongue.  My OM wanted me to work right away.  As grateful as I am to my oral surgeon for the wonderful job he did - he really did do a great frenectomy - I am convinced that if I had listened to him I would not have made nearly as much progress as I have.

In the beginning of therapy, my OM had me do series of exercises that helped me to stretch my tongue and increase its muscle tone.  She used a great analogy to describe my recently freed up tongue: it was as if it had been in a cast all my life and we now had to build up its strength and range of motion.  And that's just what we have been doing.  I would dearly love to share details of the exercises I have done and continue to do but it would be unethical of me to release information on material that should be used under the guidance of a myofunctional therapist.  

I can tell you that one of the most important goals of myofunctional therapy is to retrain the tongue to stay in its proper place: up against the roof of your mouth with its tip on the alveolar ridge, the hard ridge just behind your upper front gumline.  This ridge is also called  the spot by myofunctional and speech therapists and it is imperative that your tongue stays on the spot.  This position is the basis for learning proper eating, drinking, swallowing, and speaking habits.  Obviously, as a tongue tied person, I had an extremely hard time doing this

Believe me when I say the gains from therapy have been tremendous.  In fact, some of the benefits I began to experience after my having my lingual frenectomy went above and beyond what I expected.  For one, having a lingual frenectomy greatly improved my looks.  What does having a tongue tie have to do with looks? Much more than you realize.

Several hours after I had my lingual frenectomy, I looked at myself in the mirror and noticed something: the corners of my mouth had lifted and the 'jowls' I had begun developing (in my early 30s no less!) had diminished.  All my life, I had down-turned, pouty lips.  The corners of my mouth were in a perpetual frown.  I never thought too much of it, I just figured it was how I was made.  Little did I know that my down-turned lips were the result of my tongue tie.

You see, the tongue is a powerful craniofacial muscle, one of many.  These muscles all interact to help us eat, chew, talk, and make facial expressions.  When one of these muscles is out of whack - if you'll pardon the technical jargon ;) - it affects the functioning of the others.  Because my tongue was cemented to the floor of my mouth, it pulled on my other facial muscles, drawing them down.

When I spoke, as in the photo below, my lips were often drawn down and tended to remain  pursed.  Again, this is because my tongue pulled the muscles of my mouth and lips down and forward.  

Now, sometimes a pout can be sexy.... the pout of a tongue tied person is not (see above photo... lol).  If I was not actively smiling, I looked like I was frowning.  Even when I was relaxed people would ask me what was wrong because I looked unhappy!  I could be sitting there thinking pleasant thoughts but those around me would see an unhappy person.  I would try to hold the corners of my lips up, to try and look more pleasant or even neutral, but to no avail.  The corners of my mouth would start to tremble and I could not maintain the effort so I gave up.  What was happening was that I was trying to go against the force of my tongue.  Not to mention that the muscles around my mouth were likely weakened from not being used properly.

This is my face, relaxed, before my lingual frenectomy.  Notice the down-turned corners of my mouth and the tension in my lips.  I ask you: Does this look like the face of a happy camper?...

Me today. The corners of my mouth are lifted  and you may notice less tension in my lips and in the area below my bottom lip.  This is because before therapy, it was harder for me to keep my lips closed so I strained to keep my bottom lip up.

So imagine my delight when I looked in that mirror, mere hours after my surgery, and saw an effortlessly  pleasant look on my face!  I called my boyfriend to come look.  Initially, he wasn't sure that he saw a difference (love IS blind after all!) but several weeks later, over dinner, he said to me "You know, I think I do see a difference! You used to have these jowls down there and now they're gone!"  

That was another thing, after years of looking young for my age, I was deeply chagrined to enter my early 30s and suddenly see myself prematurely aging.  I did in fact have the beginnings of jowls from years of a constant down-turned smile and lines on either side of my mouth.  Well, no longer!

Just today I met with my OM and she pointed out that I no longer had frown lines between my eyebrows.  This was because releasing my tongue essentially released my face.  All the tension brought on by my tongue tie was gone.  My lips, cheeks, and forehead were now free to relax.

If my face were a cat, this is how relaxed it would look....

Another aspect of my appearance that my tongue tie unexpectedly changed: my weakish chin.  I have a strong jawline as you can see from some of my photos but from the side the area under my chin appeared weak, with a bit of a 'pooch' to it.  At least that's how I saw it.  It bothered me but I tried not to think about it too much.  Well, one day I was looking at myself in the mirror, admiring my more pleasant countenance, when I realized my tongue wasn't on the spot.  So I lifted my tongue to its rightful place.... and my chin pooch lifted!!!

Tongue on spot!

Tongue resting on the floor of my mouth...

All those years I thought I had a weak chin when in fact it was my tongue stuck at the bottom of mouth with nowhere to go.  Now, my chin has a sleeker profile and I couldn't be more pleased.

At this point, the 'story' leading up to my orofacial therapy is told.  Future posts will continue to focus on my treatment gains, such as improvements in my speech, as well as discuss the  problems people with ankyloglossia continue to face, including some of the inadequacies of the dental, orthodontic, and speech pathology fields in addressing this condition.  That's right, I went there.

Having said that, I know there are a great number of professionals out there who are just as frustrated as their patients when it comes to treating tongue tie and who legitimately want to help their patients.  While this blog is meant to inspire others with tongue tie to get treatment, I also hope that professionals may find it and learn from it.  Ankyloglossia is a more complicated condition than many realize - my own story illustrates that.  Professionals need to be more aware of the implications of tongue tie for dental and orthodontic health, as well as speech quality. Also, I want professionals to understand that ankyloglossia is not merely a physiological problem, it has sociological and psychological implications as well.  I will talk more about these things in the future.

I encourage anyone with their own tongue tie story to write me and share their experiences, ask questions, even give me feedback on my postings.  I'd love to hear from you!!

Happy trails!