5 Ways Having A Restricted Frenum Can Impact Your Life
Restricted frenums can have a tremendous impact on your life and overall health. Frenums are membranous folds of tissue located in various areas of the body, in particular on the underside of the tongue and lips. They help to support the motion of the body part that they are attached to. These restrictions if not addressed accordingly can contribute to detrimental effects on your overall health. Below are the Top 5 ways having a restricted frenum can impact your life.
- Digestion Problems
A restricted lingual frenum (tongue-tie/tethered oral tissue) is when the string on the underside of the tongue is short and restricted. Having this restriction can impact a person’s digestion, as digestion begins at the tip of the tongue. In the event that there is a lingual frenum restriction, the tongue will be unable to shift the food around in order to create a proper bolus (a ball-like mixture of food). Having this poor bolus formation prior to swallowing leaves the food unprepared for digestion. Instead, forming large clumps with a pasty consistency, in which coughing and choking can be triggered.
During the swallowing process, progressive contractions of the tongue are initiated as the food goes down the esophagus and into the stomach. Individuals suffering from a restricted lingual frenum do not have tongue-tip-to-anus progressive contractions. “As a result, sluggish digestion develops, which leads, in turn, to gastrointestinal tract inflammation, reflux, excess gas and bloating, poor nutrient absorption, and poor elimination. In infants, this can present in the way of colic, acid reflux, and/or have secondary lactose intolerance if breastfed.” (Hazelbaker)
The lack of the tongues mobility forces the individual to use other compensatory muscle movements in order to protect their airway during the swallowing process; hence contributing to the swallowing of air. Many individuals suffering from these restrictions end up breathing through their mouths, as they are forced to chew with their mouths open in order to compensate for the lack of air; as they may be prone to holding their breath during the chewing process.
For more information on this you can check out the book “Tongue-Tie: Morphogenesis, Impact, Assessment, and Treatment” by Allison Hazelbaker.
- Obstructive Sleep Apnea
A restricted lingual frenum can lead to abnormal anatomic support. This is due to the craniofacial changes (changes in the bones of the skull and face) that take part as a result of this restriction. A lingual frenum restriction can reduce the width of the upper respiratory tract and further contribute to airway collapsibility; leading to obstructive sleep apnea.
A short lingual frenum is a known factor for altering the orofacial growth, particularly the development of the maxilla. When there is a restricted lingual frenum, the tongue will sit low and forward on the floor of the mouth; instead of on the roof of the mouth, where it should be during rest. This abnormal tongue position will then lead to a collapsed palate, which is also known as a high vaulted palate. This high vaulted palate, will further contribute to decreasing the upper nasal airway space, which can eventually lead to an open mouth resting posture and mouth breathing.
Mouth breathing does not allow for proper air filtration, as that of nasal breathing. Therefore, leading to inflammation in the oral cavity including the tonsils. This tonsillar inflammation will further contribute to a decreased airway space as the enlarged tonsils will lead to a blocked airway.
“The observed secondary anatomical changes occurring in the oral cavity are known to increase the degree of collapsibility of the upper airway during sleep, and recognition of a short lingual frenulum in a toddler and older children should lead to investigation of Sleep Disordered Breathing.”(huang et.al)
- Periodontal Disease
A great correlation exists between a restricted Frenum and periodontal disease (also known as gum disease). Periodontal disease is a gum infection that can severely damage the gum tissue and the jawbone if left untreated. Furthermore, this condition can lead to other systemic diseases as the bacteria can travel through the bloodstream and attack other vulnerable organs.
A restricted lingual frenum can contribute to periodontal disease as this restriction will force the tongue to sit low and forward on the floor of the mouth and contribute to mouth breathing and inflammation; but this can further exacerbate the malfunction of the tongue muscles creating an abnormal swallowing pattern known as a tongue thrust. A tongue thrust is when the tongue pushes up against the teeth during swallowing. This abnormal swallowing pattern can lead to malocclusions or crooked teeth, mobile teeth, and tooth loss down the road. It is wise to know that the tongue exerts a force of up to six pounds of pressure every time you swallow; therefore if the swallowing is not performed correctly, it will lead to malocclusions. Having crooked teeth will make it more difficult for someone to be able to properly clean them and can lead to gum disease and cascading oral and health effects.
It is also important to note that a restricted lingual frenum may not just be the only culprit to periodontal disease, the maxillary labial frenum (the string underneath your upper lip) can also play a very important role in periodontal disease. A maxillary labial frenum restriction will force a person to have an open mouth resting posture, as they will be unable to have a proper lip seal due to the restriction. This restriction will further lead to inflammation of the tissues in the oral cavity including the tonsils, and create spaces between the front teeth to name a few.
There are a total of seven frenums in the oral cavity. Having a restriction of any frenum in the oral cavity can also lead to gingival recession, which is when the gum tissue is pulled away from the tooth further contributing to tooth root exposure. This root exposure can lead to tooth loss as the tooth begins to lose its proper support. Another issue that may arise from this is tooth sensitivity. When the root of a tooth is exposed, the tooth becomes more sensitive and will be more prone to getting root cavities. In addition to this, if a person has a dental implant replacing one of their teeth and there is a frenum restriction, implant failure may result if the frenum is not addressed.
In order to help avoid periodontal issues, all frenums in the oral cavity should be properly examined for any restrictions.
- Jaw Pain
“Temporomandibular joint and muscle disorders, commonly called “TMJ,” are a group of conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement.” The true cause of temporomandibular disorders is still unknown, but it is considered multifactorial and includes both physical and psychosocial factors.” (NIH) This condition can be further exacerbated by having a poor oral resting posture, such as that seen with a restricted lingual frenum. The abnormal swallowing pattern that results from a restricted frenum can contribute to muscular tension and pain.
- Speech Problems
Having a lingual and/or labial frenum restriction will lead to speech impediments. This inability to move the tongue or the lips in an appropriate manner while speaking can affect a variety of sounds:
- The T, D, L, N, R, TH, sounds in English
- The Z, SH, R, TS, D, T, L, N sounds in Hebrew
- The D, L, R sounds in Finnish
- The rolling R in Spanish
In addition to poor speech sound development, drooling while speaking will also be observed.
It is imperative that frenums be addressed at an early age. Addressing these restrictions early in life can help prevent cascading oral and health effects associated with these restrictions. For more information on frenum restrictions and their detrimental oral and health effects see video below.
- Short Lingual Frenulum and Obstructive Sleep Apnea in Children Yu-Shu Huang1, Stacey Quo2, J Andrew Berkowski3 and Christian Guilleminault3. International journal of pediatric research.
- NIH: https://www.nidcr.nih.gov/health-info/tmj#:~:text=Temporomandibularjointandmuscledisorders,musclesthatcontroljawmovement.
- Hazelbaker, Alison K. Tongue-Tie: Morphogenesis, Impact, Assessment, and Treatment. Aidan and Eva Press, 2010.