Red-faced, with flushed cheeks, stammering, stuttering, and unable to complete a thought. That, you may think, is the miserable condition of being tongue-tied. That’s only about half right.
Although we use the phrase “tongue-tied” colloquially to describe being too flustered to speak and often associate it with being socially awkward, there’s a technical meaning of tongue-tied that your dentist can probably help with. It all comes down to a lingual frenulum. Of course, as catchy as the phrase tongue-tied might be, it’s far from the reason most people will become aware of their lingual frenulum. So, what exactly is a lingual frenulum, what can go wrong with it, and what can you do about it when there is a problem?
What Is That?
If you look in a mirror while lifting your tongue to the roof of your mouth, you will be able to look at your lingual frenulum. It is the piece of tissue that connects your tongue and the floor of your mouth. It’s usually whitish in color and is very thin. The words themselves can give you a clue about what it means if you know your medical speak. Lingual is of or relating to the tongue. A frenulum is a piece of tissue that helps control how a piece of the body that is meant to move does so. The lingual frenulum helps your tongue work properly for chewing, swallowing, and speaking.
Why Does It Hurt?
Chances are very good that you don’t think about this piece of your mouth very much or at all. Still, because things can go wrong, you may first notice your lingual frenulum because it is giving you pain. Unfortunately, such a small piece can cause some serious discomfort. Anything that can irritate your tongue can cause pain in your lingual frenulum. This may include vitamin deficiencies causing one or more types of anemia. Medications, alcohol-containing mouthwash, or autoimmune conditions that cause dry mouth can be extremely irritating to all the parts of your mouth and tongue, causing pain under the tongue. Canker sores or other cores in the mouth also can cause pain in the lingual frenulum.
Most of all, an injury to your mouth can cause pain in the lingual frenulum. Piercing across the lingual frenulum has become more common in recent years. Although you may not consider this an injury since it was done deliberately, your body does not distinguish between injuries you intended and those you did not intend. If you have a piercing or any other type of injury under your tongue that is red, irritated, swollen, or has colored or unpleasant smelling discharge coming from it, seek medical attention promptly. Those are signs of an infection and any injury with serious infection signs in your mouth should be evaluated by a dentist or doctor to prevent dangerous complications.
What About Tongue Tie?
Sometimes, infants are born with a lingual frenulum that is very short or very tight. This attached frenulum is also referred to as ankyloglossia. Very tight attachment can cause problems for infants with eating and in older children with eating or speaking. It’s possible to have a procedure to correct the problem, and symptoms generally resolve quickly. There even has been some advancement using laser surgery to correct the problem, though it still commonly done with sterile scissors. If you suspect your infant has limited tongue movement, a visit to your dentist or pediatrician familiar with the condition is warranted.
So What Do I Do When It Hurts?
Your first step should be to evaluate why you are having pain. If you have canker sores or other mouth ulcers, treating the ulcers will help resolve the pain. If your tongue is red and swollen, head to your doctor or dental care team for an evaluation. If you have a vitamin deficiency, correcting your diet or supplementing the missing nutrients will help eliminate the pain. If you are suffering from dry mouth, using mouth sprays, sugar-free gum, or moisturizing rinse not only will help reduce your discomfort, it will help slow the development of caries caused by dry mouth. If you have a recent injury to your lingual frenulum, you should have it evaluated, but such injuries usually heal without major medical intervention. If you treat the underlying cause, the pain will dissipate. While you are working on the underlying causes, some people find sucking on ice (not chewing it) can provide relief.
Your lingual frenulum is a tiny structure, but it is a hard worker in the mouth. A little care for it, and you can continue not to think about it while you benefit from its hard work all day.