Restrictive tongue brake: what is it?

During embryogenesis (development of the embryo at the very beginning of pregnancy), some cells will multiply and create different tissues, others will disappear. This is the case of the cells located between the human fingers: the embryos have webbed hands until the membrane disappears between the fingers, which are individualized.

This is also the case for the small membrane under the tongue, which forms and then disappears in most babies. The tongue will then be able to move, allowing a good formation of the oral cavity, a desensitization of the mouth, good swallowing, etc.

We speak of a restrictive tongue tie when the membrane remains under the tongue and prevents it from moving properly. The restriction of the tongue interferes with its normal functioning, and it is therefore the study of the function of the tongue that will determine whether the frenulum poses a problem or not, more than the anatomy, which can be misleading.

What are the different types of brakes?

There are different anatomical kinds of tongue ties, divided into four types:

• type 1: the membrane clings to the tip of the tongue, the frenulum is very visible, the tongue is in the heart;
• type 2: it is inserted a little behind the tip of the tongue but always in the anterior part;
• type 3: the membrane is barely visible and is inserted behind the tongue, near the base;
• type 4: the frenulum is not visible at rest, it is submucous, and is inserted at the base of the tongue. It cannot be seen without further examination, but it can still lead to a restriction of movements of the language.

Type 1 and 2 brakes are easily identifiable and can be cut in maternity wards. Sometimes they are cut incompletely, since they also have a posterior part that can go unnoticed.

Those of types 3 and 4, called posterior, require the advice of a specialist trained specifically in this pathology. They will then be detected by careful examination of the tongue, extensive questioning, and for babies, tests of suction.

There are also lip and cheek frenulums, often associated with tongue frenulums.