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Tongue ties

Following on from the success of my anosmia page, I've decided to throw the spotlight on another obscure medical condition - being tongue tied.

Generally, when people refer to this, they mean that they are temporarily lost for words, or have mangled something they were trying to say. This is typically brought on by stress, such as encountering an attractive member of the opposite gender.

However, there is actually a more permanent, "official" side to this, which is also known as ankyloglossia. As you may know, your tongue is attached to the bottom of your mouth. The idea is that the front half can flop around, whereas the back half is fixed in place. This enables you to talk and eat, without choking yourself. However, in some cases, the skin attaching the tongue to the base of the mouth (the frenum) continues too far forwards, restricting the tongue's movement. As far as I know, this is something that is determined at birth; you can't develop it in later life. I was born this way, which explains my interest in, and knowledge of, the subject.

So, what exactly is the big deal? Obviously, you can still eat with this condition, otherwise I'd have starved to death (or been stuck on an IV drip) years ago. The main problem is speech, in that I had something of a speech impediment in my youth. I went along to see a speech therapist, but after a few sessions with no improvement, she concluded that I wasn't trying, and gave up on me. The tongue tie wasn't detected until much later, when I was about twelve or thirteen. I don't recall the exact situation, but I think it was when a doctor tried to take my temperature by sticking a thermometer under my tongue, and found that he couldn't push it very far in without me complaining!

The good news is that there is quite a simple operation to correct this condition (a frenectomy), which I underwent. This involves having the skin under the tongue cut away, so that it is back at the correct point. I was under general anaesthetic at the time, but I was also having another operation on my nose (a failed attempt to cure my anosmia) simultaneously, so I don't know whether a local anaesthetic would have sufficed. Anyway, this was basically a success, since it freed up my tongue. However, a word of warning - if you ever have this operation yourself, be very careful not to move your tongue much until it has had a chance to heal! I had the operation just before Christmas, and made the mistake of trying to lick the envelope for a card. One moment, I was sitting down, about to stick my tongue out; the next thing I knew, I was curled up on the floor in pain.

As a result of this operation, my tongue is now physically capable of being moved around my mouth. However, there is a problem - I don't know the mental commands necessary to move it. This is hard to explain, but I'll try anyway. Hold out your arm, with your hand open, and say the words "I want to make a fist". This, in itself, will not cause your hand to close. Now, I want you to actually close it. How did you do it? You just thought about it in a certain way, right? Could you teach that to someone else? Nope, me neither. Have you ever watched babies in cribs? They spend a lot of time gurgling and waving their arms and legs around. This is not as pointless as it may appear - they are in fact learning which mental command corresponds to which bodily action. Of course, this is all instinctive, and it is unfortunately a skill (like accelerated language learning) which seems to fade away after the first few years of life. I am now in the position where I can stick my fingers in my mouth and lift my tongue up, but I can't just tell it to rise up to the roof of my mouth. If I get food stuck up there, I generally have two approaches to shift it:

As for my speech, it is better now than it used to be, although I am still a bit unintelligible at times. I've found that I am clearer when I know what I say in advance (e.g. reciting lines for a play) than I am when I'm having a conversation "on the fly".

So, what is the upshot of all this? Firstly, if you find it difficult to move your tongue much, you may have this condition, so check with a doctor. Secondly, if you are a parent, and are concerned about your child's speech, again check with a doctor. One thing I've learned in my encounters with the medical profession is that it helps to be specific. If you ask them directly "Is this a tongue tie?", this will probably produce better results than "What is wrong?".

I would like to thank Sandra Holtzman for providing me with the technical terms I've used here.

This page was last updated on 2003-12-29 by John C. Kirk

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