Does Posterior Tongue Tie exist?

[PookBob]

I am pretty sure that my DS shows all the signs of posterior tongue tie.

I took him to the GP today to be told that they had never heard of it. And that was that.

I have asked for a second opinion and have another appointment next week, but will the same thing happen?

It does exist, also called class 4 tongue tie.

Or submucosal ankyloglossia.
Is diagnosed on palpation.
The baby (I am assuming) will need to be referred to a paediatric surgeon for treatment.

If it doesn't, then I'd like to know what the lactation consultant was snipping with her scissors in DS's mouth!

Yes it does exist, but the NHS is patchy at best with tongue tie. In my area they basically don't acknowledge it unless the baby isn't feeding at all. You may have luck with another GP but you may not. The most reliable way to get an opinion from someone who knows what they're talking about is probably from a breastfeeding counsellor, lactation consultant or tongue tie practitioner.

My DS is actually 4yrs old.

When he was born he was on the 91st percentile, after 4mths exclusive breast feeding, almost constantly day and night, he had dropped to below the 0.4th percentile at which point I gave up and switched to formula as he was skin and bones, with not an ounce of fat on him.

His speech sounds like he has some kind of lisp, especially with letters that require your tongue.

He is unable to elevate his tongue at all.

He can stick his tongue out but it does not go to a point, it is like a soup spoon.

His father and paternal grandfather both required speech therapy as children due to short tongue/tongue tie.

The GP told me he was just talking like a baby??

A class 4 tie can lead to dyslalia (difficulty pronouncing certain sounds) particularly sounds l, d, th, s may be affected. If the tie is treated at the age of 4 he's likely to still need speech therapy afterwards as the tongue will have learned some "bad" habits whilst the tie has been in place.

Most speech and language therapy services accept self referrals, check the one in your area. They will be able to differentiate difficulties caused by a tongue tie v. "baby talk" and refer you accordingly if needed.

That does sound rather like it could be posterior tongue tie to me- and it definitely runs in families. The lactation consultant who did DS said that with posterior tongue tie they often do latch to start with, but it's often not great and they have efficiency problems once they hit 4-6 weeks. My DB had a posterior tongue tie snipped at 11 years old (chorister who couldn't roll his 'r's). My DM said he was always tough to feed and wanted to feed very frequently (she got round this by weaning to solids at 11weeks!) He also needed speech therapy as a child.

And he also still dribbles.

Thank you so much for your responses. What are tongue tie practitioners?

Tongue tie practitioner is health professional (midwife, health visitor etc ) trained to snip tongue ties in babies.

Thank you, I've looked up practitioners in my area, but they are all limited to very young babies.

Whereabouts are you based? There are a few people in London who can deal with older children (eg Malcolm Levinkind) and are specialists in this area. I believe there is someone similar in Huddersfield (?) but can't remember the name - you could try a search on MN. For a 4 year old you really need a specialist surgeon or dentist.

If you can't find anyone in your area, I'd suggest emailing Levinkind and asking if he knows of anyone near you. He's a known specialist in this field so should know any others.

Yes. It definitely exists. DS1 had one. He had it lasered by John Roberts at the Cote Royd Dental Practice in Huddersfield when he was almost 7yo. It has caused him no end of problems over the years which are now either gone since revision, or being dealt with by our orthodontist (private).

Take it from me, may, many, many, and a few more HCPs know fuck all about posterior tongue tie.

My advice would be to go and see Malcolm Levinkind if you can. It would be worth travelling for. Last I heard, John Roberts was only doing under 1s and over 6s.

Really interested in this thread. My dd is 4 and had a front tongue tie snipped at a couple of weeks old but she has really struggled with speech. She just can't lift her tongue up at all and has always seemed to have had a reflux problems. I am going to try and find out more but can she have the laser treatment without a general ?

My DS has one. GPs are terrible with all bf'ing issues in my opinion. Contact your HV team and any bf'ing specialist they have.

If you can afford it just get a lactation consultant to diagnose and snip.

Yes it flipping does. Getting so annoyed with all gps out there.

Mrskent or anyone I am looking for someone on East London to tell about my daughter,s speech. Any recommendations please greatly appreciated? Tongue snip rehealed but not sure if to same extent.

craziedaisy - yes, laser is done without a general. DS1 had his done when he was almost 7yo.

As mentioned earlier on the thread, the dentists doing laser revisions in the UK are Malcolm Levinkind in North London and John Roberts in Huddersfield.

Also, it sounds like your dd had an anterior tie revised as a tiny baby. In many cases, there is also a posterior tie which can go unnoticed if the HCP does not have an understanding about posterior ties. This is sometimes why some people still have trouble, despite having had a tongue tie snipped.