TMJ in tongue tie or lip tie patients
Tongue-tie, or clinically referred to as “ankyloglossia”, is an obstruction to the movement of the tongue due to a string of tissue (frenulum), that is thicker or shorter than usual. Facial restriction and limited tongue functionality can lead to difficulty in breastfeeding in infants, sucking, swallowing, eating, drinking, chewing, breathing, speech, jaw growth, posture and digestion.
Accompanying the tongue restriction, there is a tension in the temporo-mandibular joint movement, lower jaw, mouth, neck face and head.
An open mouth, incorrect bite, clenching and grinding or constant compensations of the muscles while swallowing and speaking can result in orofacial pain and TMJ dysfunction.
In addition, tongue tie can have an effect on the oral hygiene of the patient, as the tongue cleanses the teeth inside the mouth.
A tongue tie cannot be self-diagnosed since a comprehensive functional assessment of the tongue is essential. Hence, to best resolve escalating issues and future chronic pain, patients can seek help from qualified chiropractors or TMJ specialists, who are specifically trained to diagnose a personalised treatment plan for the patients.
Lingual frenulum and Abnormal lingual frenulum
TMJ in sleep apnea patients
Due to the tongue and/or lip impairment caused by ankyloglossia, the oral structures and airways tend to be smaller than normal. This may lead the oral tissue to collapse, blocking the airway multiple times during sleep and causing Obstructive Sleep Apnea (OSA). OSA interferes with restful sleep, and in worse cases, it contributes to the risks of a heart attack or stroke.
TMJ dysfunction can occur in patients who do not have a tongue or lip tie. Medical researchers have found nearly half of people with TMJ also have trouble sleeping. Those suffering from obstructive sleep apnea often experience a collapse in their airway, which then causes the body to push the lower jaw forward to open up the airway. This constant motion by the TMJ throughout the night can cause stress and tension on the jaw joint and increase the likelihood of sleep apnea.
If you have TMJ disorder, you may clench or grind your teeth at night. A tongue tie patient can snore during sleep, leading to unrestful sleep. Clenching not only puts strain on your teeth and jaw, but it can cause you to wake up from discomfort.
TMJ dysfunction can lead to serious consequences if left untreated, particularly the health risks such as:
Frequent migraines
Chronic jaw pain
Extreme fatigue and anxiety or depression.
Tooth loss or tooth damage
Tinnitus
Vision problems
Compromised hearing
Vertigo (trouble balancing and dizziness)
Because TMJ and sleep apnea are heavily intertwined, it is best to seek a TMJ specialist to ensure your quality of life is improved.
TMJ and sleep apnoea
How does a tongue tie affect jaw?
A tongue tie can negatively affect the growth of both upper and lower jaws due to limited tongue stimulation to expand the jaw area. This can cause various problems including sleep apnea, difficulty breathing, jaw and mouth pain, crooked teeth, as well as tooth decay due to the crowding of the teeth.
How painful is tongue tie surgery?
Under local anaesthetic, the tongue tie procedure is quick, simple and almost painless and allows the patient to return to normal habits much faster. The benefits will be seen immediately, as the tongue would have the freedom to move around the jaw and not block the airways, causing sleep apnea in some patients.
Can a frenectomy help with TMJ?
Frenectomy, or commonly called a tongue or lip tie release, is a surgical procedure whereby the dentist will cut the frenulum to expand the movement of the tongue within the mouth. It is not preferred to have your tongue tie cut using a laser, due to the cauterising or coagulating effects that a laser may bring. Since the area under the tongue is very vascular, there will be less bleeding and the area will heal much more quickly. The dentist may choose to stitch up the area under local anaesthesia to prevent bleeding.
Should adults get tongue tie snipped?
It is in the best interest of a patient to get their tongue tie snipped as soon as possible. Getting a tongue tie release makes it easier for the tongue to participate in regular jaw movements.
This not only helps the jaw to move more comfortably, but it can also relieve the tension in various muscles and reduce the risk of chronic pain conditions.
What age is best for tongue tie surgery?
Babies younger than 3 months old can have their tongue snipped without local anaesthesia because the tongue area has few nerve endings or blood vessels. A tongue tie is a hereditary condition, hence untreated tongue tie can negatively affect the feeding and speech problems of the child, which may magnify during adulthood.
Anyone at any age can undergo a tongue tie release, but earlier treatments ensure the patient does not develop growth issues involving their surrounding jaw structures. Furthermore, it ensures the patient does not develop TMJ dysfunction and/or myofascial pain (chronic muscular pain).
What happens after tongue tie release in adults?
Depending on each individual, the healing process can range from a few days to a few weeks. It is perfectly normal for bleeding to occur when stretching the area, so you should always try to do some tongue tie exercises more regularly to avoid reattachment of the tongue tissues. With time, the snipped site will be filled with some whitish or yellowish fiber. This is not pus and you should not try to remove it.
You may eat or drink immediately after the treatment, however it is best to wait until the anaesthetic wears off and/or the bleeding stops. Avoid hot, spicy or crunchy food that can poke onto the wound in order to speed up the healing process and prevent any infection.
Do you have to do tongue tie stretches at night?
For babies, parents can try to position the baby onto their lap or on a bed with feet away. Do one stretch on the evening of the release, and the next stretch can be done the following morning. On average, stretches should be done about 6 times a week. The duration of tongue tie stretches can be reduced slowly until the end of 4th week. Never stretch for more than 4 hours each session.
For adults, you can try to follow an exercise structure by sticking your tongue out 10 times and moving left to right, up to down 10 times. This exercise should be done daily to stimulate the tongue muscles and avoid tongue reattachment. If in pain, medications such as oral paracetamol or ibuprofen can be taken, however you should first consult this with a medical doctor to be prescribed the right amount.
Eating lukewarm or cold food such as ice cream can prevent irritation of the wound and also stimulate the healing process of the tongue.
Suspect you or a loved one has a tongue tie?
Call us now at 02 9558 8988 or email us at info@painfreedentistsydney.com.au to organise a consultation today!
