Your Tongue; Your Airway; and the Ties that Bind Them

There are many adults today who still have small attachments of foetal tissue to the base of their tongues; that may be the root cause of their struggles to breathe. While releasing a tongue tie is not the whole of the “treatment” to restore normal breathing patterns, it may be a factor that is reducing breathing ability – especially in people who struggle with sleep apnoea, snoring, and slight speech difficulties.

Urban Legends Or Old Protocols?

Legend has it that in ancient midwifery practice, the midwife would sever tongue and lip ties directly after the birth by sweeping a sharpened pinkie finger around the neonate’s mouth. This practice did not catch on and never made it through to today’s common protocols, probably because the idea of a scraggy fingernail in a newborn’s mouth is not exactly going to pass our modern health and safety standards. However, what was once considered routine practice  – if the story has any merit – has now fallen by the wayside, and thus, knowledge of why this practice is useful has been lost to common understanding.

What is a Tongue Tie?

To put it really simply, a tongue or lip tie is a small attachment of tissue that binds the tongue and or lip too tightly to the mouth. (Click for pic of adult tongue tie here.) This small piece of tissue restricts the movement of the tongue and will not allow it to locate correctly.

Frenectomy or Frenotomy- the cutting and releasing of tongue and lip ties is a small procedure usually done with a scalpel. Although laser options are said to be superior, this is still relatively new. Frenotomy is available as an “out patient” procedure at certain ENTs, Orthodontists, dentists and even some GP practices. According to the new field of Orofacial Myofunction Therapy (kind of like a physiotherapist for your face and tongue) the success of the procedure is dependent on following a series of small stretches to initiate within an hour or two after the ties have been severed.These exercises are given by a trained professional. Believe it or not, ties can grow back or “re-attach” due to scarring or incorrect healing growth.

A Stitch in Time…

In anyone who has had breathing difficulties from birth, tongue ties may be responsible for creating a physiological obstruction to maintaining a clear airway. While usually noted in newborn babies who struggle to latch, a frenotomy is usually encouraged to assist with breastfeeding in an otherwise healthy baby. But if there is no hindrance to breastfeeding, an un-diagnosed tongue tie may carry into adulthood and has some serious consequences for facial development and breathing function along the way.

Swallowing Your Tongue…

An un-diagnosed tongue tie – previously thought of as baby stuff – may also be a reason why adults are not breathing as well as they should  – because if the tongue cannot locate, the face cannot grow as it should. When tongues are tied into adulthood it can result in a lowered tongue lie, causing more likelihood of creating breathing patterns that are problematic, as a result. The lowered position of the tongue means that when the person sleeps, their relaxed tongue could occlude the airway, creating snoring, sleep disordered breathing – and ultimately less oxygen delivery to the brain.

Why The Long Face?

The tongue at rest is responsible for creating the arch of our palate. A high, narrow arched palate describes a tongue position at rest on the floor of the mouth, instead of in the roof of the mouth where it belongs. The pressure of the tongue in the roof of the mouth, the back teeth slightly touching and the lips sealed closed at rest widens the upper mandible and provides neural feedback for the brain to know where to grow the face and jaw to. Correct feeding and nutrition helps to develop the muscles required to hold the heavy jaw bones closed. But when the tongue is lowered and the jaw is opened, the face becomes longer. The cheekbones do not expand correctly, allowing for less space for the sinuses and making eyes appear larger. The airway becomes obstructed and the person is likely to lean forward. Over time, in order to maintain a continuous open airway, the person’s neck structure will begin to adapt to allow for a more “forward head” posture. This posture will likely cause the diaphragm to constrict and the breathing to become less active, and also for nerves and structures of the spine to change to accommodate this posture. Once the posture is re-adjusted this can cause pain and discomfort to the back, neck and shoulders, as well as headaches and, according to leading osteopath, Leon Chaitow, this can create lumbar and pelvic pain. This, in turn creates lowered oxygen delivery to cells and brain – leading to more fatigue. The fatigue leads to less interest in activity and breathing becomes more impaired over time. So, just the tongue’s posture alone has a huge role to play in breathing and dental health for the rest of one’s life and can initiate good breathing and health or impair it – right from the word Go.

Skew Teeth is not just Genetic…

The teeth erupt around the tongue according to Orthodontist, Dr. John Flutter, an Australian pioneer in the field of Orthotropics – a method of looking at the entire body and health instead of just treating the skew teeth with surgery. And by that he means that means that the tongue has a pivotal role to play in how our teeth and jaws develop and function. This growth also affects how the cranium grows, and as Dr. Flutter explains, cranium growth is dependent on ALL bones of the cranium developing correctly and optimally. Dr. Flutter says, they are like “pieces of a puzzle” that all need to fit together. If one bone is out of place, they all become displaced. “It is a pity that dentists got hold of this area of treatment. Because they just see it as a problem of the teeth. But actually, this is a breathing problem.”

Your Breathing Shapes Your Face:

Encouraging good bone development in the face leads to creating the best airway and face you have the potential to grow. And you can’t encourage good growth and development without establishing good, nasal breathing habits. Breathing through the nose with the lips sealed and the tongue firmly located in the roof of the mouth is actually what provides the impetus to drive facial and upper airway development. Without it, we are fundamentally impaired. So if the tongue is tied, we cannot expect good location, if we cannot expect good location, we cannot expect a good facial structure and thus, our airway development will also be impacted. It’s not always necessary to seek surgery and there are plenty of Myofunctional exercises you can do that may stretch or increase your jaw and tongue expansion. But as with all things, you need to have an expert walk you through the process for it to be successful. Still, many people are finding they have little option but to have the procedure.

Breast is Best:

The art of nasal breathing begins with breastfeeding. It’s not just the milk your mother provides you, but the action of breastfeeding is the first start to airway development outside of the womb. Any interruptions at this point can have dire consequences. The action of suckling is what drives the palate to expand and the tongue to locate correctly, the aerodigestive tract to develop and grow correctly and the face to widen allowing sufficient space for all the teeth to erupt naturally around the tongue. Thus, latching is the first sign of a healthy baby, and a baby who does not latch easily and also suffers with reflux, probably needs better attention to establish the cause before the last resort of abdominal surgeries.

Mouth Breathing Starts at the Bottle, Baby:

Sadly, modern life does not lend itself to constant breastfeeding required in the first two years to create and drive the optimal growth and development of young faces and airways. Often, a baby with reflux is typical of an aerodigestive issue as the kink in the airway created by an incorrect latch due to an under developed or tied tongue could be the cause of swallowing air – leading to colic and gastric symptoms. Most mothers are encouraged to bottle feed their reflux babies and to give them formula, in the belief that reflux is mostly due to allergies or food sensitivities – which may be the case, but this too is increased due to aberrant breathing patterns. Bottle feeding only exacerbates the issue further due to the mechanics of bottle vs breast.  A bottle-fed baby often becomes a mouth breathing child because the action of bottle feeding means they need to release the bottle as air in the bottle creates a vacuum pressure which must be released to allow the fluid to pass into their mouths.

Open Mouth Leads to Mouth Breathing:

In adults, the effect of a tongue tie leads to the tongue never allowing the palate to expand to it’s full potential. Most adults who mouth breathe also struggle with crowded teeth and narrowed palates; and suffer with poor oral resting posture because the tongue has no space in the mouth to locate properly. Open mouthed resting oral posture leads to open mouthed breathing. And open mouthed breathing leads to dehydration and severe stress to the body while trying to overcome the overload placed on lungs, heart and other organs. Open mouthed breathing is linked to many diseases, including sleep apnoea, asthma, hayfever, chronic blocked nose, sinus, excitable airways, scarring in the airways, anxiety, disturbances and loss of energy.

In Integrated Approach to Correcting This:

Breathing retraining techniques like the Buteyko Method, along with Non-Force release techniques and Orofunctional Myotherapy and a good, wholesome diet will go a long way to helping overcome a life long breathing disorder. Establishing nasal breathing right from day one is the way to prevent breathing disorders and is the One Thing you can do to make sure your child gets the best start in life possible.

©Buteyko South Africa




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