Tongue tie is one of those topics that generates a lot of opinions. Some parents are told it needs to be dealt with immediately. Others are told it is nothing to worry about. Some have had a procedure done and expected their child’s speech to improve automatically, only to find that it did not quite work out that way.
The truth sits somewhere in the middle, and it requires an honest, individualized assessment to find it.
At Next Level Speech and Physiotherapy Center, Dubai, we assess and treat children with tongue tie at every stage — before any procedure, after a procedure, and in cases where a procedure may not be necessary at all. Our goal is always to give families accurate information and practical support, not a one-size approach.
What Tongue Tie Is
Tongue tie, medically known as ankyloglossia, is a condition where the strip of tissue connecting the underside of the tongue to the floor of the mouth — the lingual frenulum — is shorter, thicker, or tighter than typical. This restricts the tongue’s range of movement.
The degree of restriction varies considerably. Some children have a very visible, tight tongue tie that significantly limits movement. Others have what is called a posterior tongue tie, which sits further back and is harder to see but can still affect function. The impact depends not just on the anatomy but on what demands are being placed on the tongue.
Tongue movement is important for two main things in children: feeding and speech. Not every child with tongue tie has difficulties in either area. But when they do, it is worth addressing properly.
How Tongue Tie Can Affect Feeding
For many families, feeding is where tongue tie first becomes apparent — often within days of birth.
Breastfeeding requires the baby to extend and cup the tongue around the breast. When tongue movement is restricted, this can be difficult or impossible to achieve effectively. The result is often a painful latch for the mother, poor milk transfer, and a baby who is working very hard to feed but not getting enough.
Bottle feeding can also be affected, though usually less severely. As children move to solids, restricted tongue movement can make managing certain textures difficult, and some children become selective eaters partly as a result.
How Tongue Tie Can Affect Speech
The relationship between tongue tie and speech is more nuanced than many parents expect. Not all tongue tie causes speech problems, and not all speech problems in children with tongue tie are caused by it.
The sounds most likely to be affected are those that require significant tongue elevation or extension — sounds like l, r, t, d, n, th, and s. A child with restricted tongue movement may substitute, distort, or omit these sounds.
That said, many children with tongue tie develop perfectly clear speech because they find compensatory ways to produce sounds. Others have speech difficulties for reasons unrelated to the tongue tie entirely. Assessment is what establishes the connection — or rules it out.
Signs Worth Paying Attention To
These are the signs that most commonly bring families to us:
- Breastfeeding difficulties in a newborn, including poor latch, prolonged feeds, or maternal nipple pain
- A clicking sound during feeding
- Difficulty moving food around the mouth when starting solids
- Specific speech sounds that are consistently unclear, particularly l, r, t, d, or s
- A child who sticks their tongue out and it appears heart-shaped or cannot reach beyond the lower lip
- Previous diagnosis of tongue tie that was not treated, or treated but with ongoing speech concerns
Our Assessment Approach
At Next Level Speech and Physiotherapy Center, Dubai, our assessment looks at both the structural and functional picture.
We examine the frenulum itself — its length, thickness, and attachment points. More importantly, we assess what the child can actually do with their tongue. Range of movement, elevation, lateralization, and the ability to perform the specific movements needed for speech and feeding all matter more than anatomy alone.
For children with speech concerns, we assess the specific sounds affected and whether the pattern of errors is consistent with restricted tongue movement or more likely caused by something else. This distinction matters enormously for making the right recommendation.
We give you a clear, honest picture of what we found and what we recommend. If we think a frenulotomy or frenuloplasty is worth discussing with a medical professional, we will say so and guide you on next steps. If we think speech therapy alone is likely to address the difficulty, we will tell you that too.
Speech Therapy Before and After a Procedure
For children who do go on to have a tongue tie procedure, speech therapy plays an important role both before and after.
Pre-procedure therapy helps establish the specific speech targets the child is working toward and begins building awareness of correct tongue placement. This gives the child a head start on using their improved range of movement effectively after the procedure.
Post-procedure therapy is where the real speech work happens. A procedure releases the restriction, but it does not automatically teach the tongue new movement patterns. Many children need structured therapy to learn to use their tongue in the new way, particularly for sounds they have been producing incorrectly for months or years.
Without post-procedure therapy, many children continue with the same speech errors even after a successful procedure, simply because the old patterns are established and the new movements need to be taught.
What Families Can Expect
Progress depends on the child’s age, the degree of restriction, and whether a procedure has been carried out. Younger children tend to adapt more quickly to new tongue movements. Older children with well-established error patterns may need more time and consistent practice.
Most children who receive appropriate therapy, with or without a procedure, make clear progress with the speech sounds affected by tongue tie. Home practice is part of this — short, specific exercises that reinforce what is being worked on in sessions.
We will always give you a realistic picture of what to expect and how long the process is likely to take for your child specifically.
Book a Tongue Tie Assessment
If you have concerns about your child’s tongue tie, whether related to feeding, speech, or both, an assessment is the clearest way to understand what is actually going on and what, if anything, needs to happen next.
Visit our pediatric speech therapy page for more on how we support children across a range of speech and feeding concerns. To get in touch, head to our contact page or message us on WhatsApp. We are based in Al Fattan Marina Business Hub in JBR, and we see families from across Dubai Marina, JLT, Palm Jumeirah, Bluewaters, and The Greens.
Frequently Asked Questions
My baby was diagnosed with tongue tie at birth but the midwife said it was mild and to wait. Now they are two and have unclear speech. Are the two things connected? They may be. A mild tongue tie that did not cause significant feeding problems in infancy can still affect speech as the demands on tongue movement increase. Whether the connection is direct depends on which sounds are affected and how the tongue is functioning now. An assessment will establish whether the tongue tie is contributing to the speech difficulty or whether something else is driving it.
We had a frenulotomy done six months ago but our child’s speech has not improved. Why? A procedure releases the physical restriction but does not automatically change speech patterns. If a child has been producing sounds incorrectly for months or years, those patterns are established and need to be actively relearned through therapy. Post-procedure speech therapy is often essential for meaningful improvement in speech clarity, and without it, many children continue with the same errors despite a successful procedure.
How do I know if my child’s tongue tie needs a procedure or just speech therapy? This is exactly the question a thorough assessment is designed to answer. It depends on the degree of restriction, which functions are affected, the child’s age, and whether speech therapy alone is likely to be sufficient to address the difficulty. We give you an honest recommendation based on what we find, and we refer to appropriate medical professionals when a procedure is warranted.
Can tongue tie affect a child’s eating as well as their speech? Yes. Restricted tongue movement can affect how a child manages food in the mouth, moves food to the back for swallowing, and handles certain textures. Some children with tongue tie are selective eaters partly because certain textures are genuinely harder to manage. We assess feeding function as part of our tongue tie assessment and address it in therapy where relevant.
Is it too late to address tongue tie in an older child? It is not too late. Older children can still benefit from assessment and intervention, whether that involves speech therapy, a referral for a procedure, or both. Progress may take longer in older children because error patterns are more established, but meaningful improvement is still achievable with the right approach.