Tongue Tie Therapy Wisconsin: What is it, Why is it a Problem, and What to Expect

Maddy Vastola
3 days ago
6 min read

A tongue tie (ankyloglossia) happens when the band of tissue under the tongue is too short or tight. This keeps the tongue from moving freely, which can cause problems with breastfeeding in babies. In older children and adults, it can lead to trouble with speech, jaw growth, and even sleep. Simply having a doctor cut the tie does not fix everything. The tongue has to unlearn old habits and learn how to move properly.

At Mequon Speech and Learning Connection, we focus on helping the tongue work right. Whether you need surgery or not, retraining the tongue muscles is essential. Our Tongue tie therapy in Wisconsin includes evaluations before surgery to see how the tie is affecting function. We then provide therapy afterward to help the tongue gain strength, coordination, and the correct resting spot. This ensures you get the best long-term results for eating, speaking, and breathing.

Tongue tie is one of the most discussed and most misunderstood conditions in pediatric dentistry, lactation, and speech-language pathology. The conversation has shifted significantly in recent years from "should we release it?" to "how do we get the best outcomes after we release it?"

What Is Tongue Tie?

The lingual frenulum is the band of tissue that connects the underside of the tongue to the floor of the mouth. A tongue tie exists when this band is short, thick, or tight enough to restrict the tongue's range of motion in ways that affect function.

Tongue tie can show up in a few different ways. Sometimes, it's very easy to see: the frenulum (the little bit of tissue connecting the tongue to the bottom of the mouth) is short, pulling the tongue down and creating a "heart" shape when lifted. Other times, the tongue tie is further back (called a posterior tongue tie) and isn't as obvious to the naked eye, but can still cause significant issues with movement.

Functional restrictions from tongue tie can affect:

- Breastfeeding in infants: poor latch, maternal pain during nursing, inefficient milk transfer, poor weight gain

- Bottle feeding in infants: excessive air intake, slow feeding, frustration

- Speech in older children: difficulty with sounds requiring tongue elevation (l, t, d, n) or tongue-palate contact (r, sometimes th)

- Oral hygiene in older children and adults: reduced ability to self-clean oral surfaces with tongue movement

- Orofacial development: low tongue resting posture associated with tongue tie contributes to palatal narrowing and malocclusion

- Sleep-disordered breathing: restricted tongue mobility can contribute to airway compromise during sleep in some patients.

Image of an infant with a finger in its mouth

When Is Tongue Tie Release Appropriate?

This is where the clinical debate comes in. Not all tongue ties need treatment. A frenulum that looks like a "tongue tie" might not actually restrict movement in a way that affects a person's daily life. On the other hand, a posterior tongue tie that's hard to see can cause significant functional problems.

The decision to perform a frenectomy (surgical release of the frenulum) should be based on a functional assessment, not just what it looks like. Key questions to ask include: Is there clear evidence that the tongue can't make the necessary movements for its job? Has its function been impaired in a measurable way? Have simpler options been tried first?

If your infant is having trouble breastfeeding, the first step is an evaluation by a lactation consultant and a provider experienced in tongue tie assessment. For older children and adults with concerns about speech or dental development, an evaluation by a speech-language pathologist should come before a frenectomy referral.

At Mequon Speech and Learning Connection, we offer pre-frenectomy evaluations to determine if the functional issues you're seeing are indeed caused by restricted tongue mobility and whether a frenectomy is likely to help improve function.

The Critical Role of Post-Frenectomy Rehabilitation

This is where the story often takes a turn. A frenectomy can give the tongue more physical range of motion, but it doesn't automatically teach the tongue how to use it. It also won't restore a normal tongue resting posture or correct the compensatory habits that developed while the tongue was restricted.

If you have a tongue tie, you've likely spent years—or for infants, a critical developmental period—using other muscles to get by. These patterns don't just vanish after the restriction is released. They stick around as habits that need to be retrained.

Research consistently shows that patients who get structured rehabilitation after a frenectomy have better results than those who don't. This is true for everyone: infants can learn to integrate their new tongue mobility into breastfeeding, and older children and adults can work through OMT programs to address the full range of muscle function.

Tongue tie release and OMT Infographic Guide for visual learners

Mequon Speech and Learning Connection's Tongue Tie Program

At Mequon Speech and Learning Connection, our coordinated tongue tie therapy program includes a friendly and thorough pre-release evaluation. We'll assess tongue function, mobility, and any specific functional limitations to establish a baseline. This helps us understand if a release is the right step and what kind of rehabilitation will be most helpful for you or your child.

Referral coordination. When frenectomy is indicated, we coordinate with dentists and ENTs in the Milwaukee/Mequon area who perform the procedure to ensure evaluation findings are communicated and that the post-release plan is in place before the procedure.

Post-release rehabilitation. Beginning in the days following frenectomy and continuing for weeks to months, rehabilitation addresses stretching exercises to prevent reattachment, myofunctional exercises to develop tongue strength and coordination, and retraining of swallowing and resting posture as appropriate to the patient's age and presentation.

Speech therapy integration. When speech sound errors are present that relate to tongue tie and mobility, speech therapy is integrated with the myofunctional rehabilitation program to address both skill areas in a coordinated way.

Frequently Asked Questions About Tongue Tie Therapy

How soon after frenectomy should rehabilitation begin?

Immediate post-frenectomy exercises, typically gentle stretching to prevent reattachment, usually begin within 24 to 48 hours of the procedure. Structured myofunctional therapy typically begins 1 to 2 weeks post-procedure, once initial healing is underway. Some providers recommend pre-frenectomy therapy to prepare the tongue muscles and establish baseline movement patterns before release.

Can older children and adults benefit from tongue tie release?

Yes, a tongue-tie release can be beneficial at any age as long as there's a documented functional restriction. The rehabilitation process looks a little different depending on the person's age. For infants, the focus is on improving feeding. For school-aged children and teens, we work on speech, dental development, and breathing. Adults often seek a release to help with speech, oral hygiene, or issues related to sleep-disordered breathing. At Mequon Speech and Learning Connection, we have experience helping patients of all ages.

Is my child's speech problem definitely caused by tongue tie?

Not necessarily. If your child has speech sound errors, a tongue tie could be one of the potential causes. The best way to know for sure is through a speech-language pathology evaluation. A professional can determine if your child's speech concerns are related to tongue mobility or other factors. It's common for parents to think a tongue tie is causing speech errors when it's actually something else. On the flip side, sometimes a tongue tie does affect speech in ways that parents and teachers might not realize are connected to the structural restriction.

Partner with the Greater Milwaukee Area's Top OMD Specialists

Mequon Speech and Learning Connection works with families across the Milwaukee and Mequon area to provide the complete continuum of tongue tie care from evaluation through rehabilitation. We offer a level of specialized care you simply will not find anywhere else nearby.

Our dedicated therapists—Jennie Herklotz, Kim Harrison, and Tiffany Rindt—are the only Speech-Language Pathologists in the greater Milwaukee area that are trained to treat Orofacial Myofunctional Disorders. On top of that, Jennie is the only Certified Orofacial Myologist (COM) in Milwaukee. If you're considering frenectomy for your child or yourself, or if you've already had a release without the outcomes you expected, contact us for a comprehensive evaluation.

The integrated approach of pre- and post-frenectomy evaluation and rehabilitation makes a real difference in outcomes. Tongue tie release is just the structural intervention. Functional change requires the rehabilitation that follows.