My Tongue Tie Story Part I - Futile Orthodontia

Hello again!

In this post I will begin sharing the story of my tongue tie and its impact on my life.  I of course was born tongue tied but my tongue tie story really doesn't begin until I was ten.  

At age ten I was told I needed braces to straighten out my godawful teeth.  Gaps, crowding, an open bite (my front teeth didn't meet), all symptoms of, or made worse by, my tongue tie. I didn't know this at the time, I wouldn't find out the full effect my tongue tie had on me until I began orofacial therapy.

It didn't help that I was still a thumbsucker at age ten.  The thumbsucking probably caused the open bite but the tongue tie helped maintain it (I'll explain in a bit).  All I knew at age ten was my teeth were jacked up and braces were called for. I was told I would have braces for two years... I had them for five.

I had braces for FIVE YEARS. From age ten to fifteen.

During the last year of treatment, my orthodontist (a lovely man, seriously) did not charge my parents for his services because he could not figure out why he couldn't get my front teeth together.  My teeth were stubborn.  My left-hand eye tooth had refused to erupt for several months during which time my orthodontist thought I would need to have my gums cut to bring the tooth down.  And my front teeth refused to meet.  We tried rubber bands to no avail.  Finally, my orthodontist gave up and removed my braces figuring this was the best my teeth were going to be:

The open bite that would not die. My back molars are touching. Notice the canine on the left sticks out: that's because it never fully erupted.

You may be wondering, what has a tongue tie got to do with orthodontics?  A lot more than you may realize.  Because a tongue tie frequently goes hand in hand with the bane of orthodontists everywhere: the tongue thrust.

You see, with a tongue tie your tongue is literally tied to the floor of your mouth, severely (depending on the degree of the tie) restricting its range of motion.  Basically, your tongue can only move down and forward because it's positioned down and forward.

See the string of flesh just below the tip of my tongue? That's the lingual frenulum and it was holding my tongue captive.

As you can see in the above photo, I could barely pull my tongue back into my mouth. 
That is key for a normal swallow.  In a normal swallow, our tongues move up and back to pull food and liquid backwards for swallowing. I couldn't do that so my tongue just hung out by my front teeth and that's bad news for braces.  My tongue tie led to a tongue thrust in which I was constantly pressing my tongue against my front teeth.  During eating, drinking, talking, even when it was at rest, my tongue pressed against my front teeth.

Because of that almost continual contact, my front teeth did not fully erupt, refused to meet up, and my orthodontist was left scratching his head.  In the meantime, my back molars had 'over' erupted further complicating attempts to bring my teeth together.  

While braces absolutely improved my smile (I wish I had before photos to show you, it was painful) they also did a lot of harm.  After having them for five years, they had worn away my tooth enamel.  I had to get fillings in the front of my teeth where the braces attached.  Both my eye teeth have enamel colored fillings in the front as well as several teeth on either upper side as well.  All these fillings have been replaced at least once, some twice.  They are prone to staining and wear and I now have sensitivity in all the teeth that received fillings after my braces come off.  Eating cold and sweet foods can be quite painful at times.  Also, some of the fillings are darker than my natural enamel color so some of my teeth look stained even though they are not.

 Of course, being left with an open bite after 5 years of braces was very disappointing but I accepted my fate.  However, sometime between the ages of 15 and 17 I made two very important observations.  First, I began to realize that my tongue was different from everyone else's.  I couldn't stick my tongue out like my friend's could, I could barely extend it past my bottom teeth.  Also, when I stuck my tongue down my chin (like when making a face) it had a rounded, 'heart shape' at the bottom.  It dawned on my one day that I was 'tongue tied'.  I had never heard of ankyloglossia nor had I done any research on tongue problems, it was simple deductive reasoning.  I can barely stick my out, therefore I am tongue tied.  I had given myself a diagnosis. 

Also around this time I began to notice my swallow pattern.  When I swallowed, particularly when drinking, I pressed my tongue against my front teeth, putting a lot of pressure on them.  I knew from having braces that it wasn't good for me to bite into hard foods like apples with my front teeth but I had never paid attention to how I swallowed.  I noticed that swallowing was very effortful for me.  I would press my tongue tightly against my teeth as I worked very hard to get food and liquid to the back of my mouth.  I also noticed that my tongue pressed against my teeth even at rest.  Noticing this pattern I thought, "I bet this is why my front teeth wouldn't come together despite my braces."  Though I did not know the term tongue thrust, and I did not know then it was related to my tongue tie, I had in fact figured out what my orthodontist hadn't.  I had a tongue thrust that was preventing my teeth from coming together.

Now, I realize it must sound pretty obnoxious for me to claim to have figured out as a teen something a medical professional with years of training and experience could not but it's true.  And I'm relating this story not to condemn the orthodontic profession but to illustrate the fact that there are doctors out there whose understanding of the problem of tongue tie is limited.

Many orthodontist will make their patients wear 'habit appliances' - also known as cribs, rakes, and cages - designed to discourage the tongue from thrusting against the front teeth.  It is my personal opinion that such appliances would have little to no effect on a tongue tie.  How can you make someone's tongue move in a way it can't?  To me it's like telling a person in a wheelchair they need to run more.  Again, this is my opinion and all I can say is that I'm eternally grateful my orthodontist never thought to put one on me.

I'm not alone in my opinion.  Here is a Position Statement From the International Association of Orofacial Myology Regarding Appliance Use for Oral Habit Patterns (link opens up as a PDF).

By the way, here is the IAOM's website which provides a lot of helpful information regarding orofacial myology and where to find an orofacial myologist.  I used this site to help me locate mine

In my next post, I will talk about my experience with speech therapy. Happy trails!