Tongue Tie Release and Myofunctional Therapy: Why You Need Both for the Best Results
- Tayla Weber
- Apr 22
- 3 min read
Updated: May 1
Tongue tie is one of the most debated topics in paediatric health, and one of the most misunderstood. Parents in Lake Macquarie, Morisset, Cooranbong and the Hunter Valley are increasingly seeking answers about tongue tie releases (frenectomies) and the role of myofunctional therapy in achieving lasting results. This post explains exactly what tongue tie is, what a frenectomy involves, and most importantly, why myofunctional therapy before and after the procedure is essential.
What is tongue tie (ankyloglossia)?
Tongue tie, clinically known as ankyloglossia, occurs when the lingual frenulum (the small band of tissue that connects the underside of the tongue to the floor of the mouth) is shorter, thicker or more tightly anchored than normal. This restricts the tongue's range of motion, affecting how it moves, rests and functions.
In infants, tongue tie commonly affects breastfeeding, causing poor latch, nipple pain, and inadequate milk transfer. In children, it can affect speech sound production (particularly 't', 'd', 'l', 'r' and 's' sounds), swallowing patterns, dental development, and the resting posture of the tongue. In adults, it may contribute to jaw tension, dental crowding, sleep-disordered breathing and myofunctional difficulties that have been present, unaddressed, since childhood.
What is a frenectomy?
A frenectomy (also called a frenotomy or tongue tie release) is a minor surgical procedure that divides or removes the restricting frenulum tissue. It can be performed using a laser (the most common current approach) or with surgical scissors. The procedure is typically brief and, when performed by a skilled clinician, causes minimal discomfort and heals quickly.
Frenectomies are performed by dentists (including paediatric dentists and oral health therapists with appropriate training), oral and maxillofacial surgeons, and in infants, by some paediatricians and midwives. Watagan Health Hub works closely with our sister clinic, Watagan Dental, to provide coordinated care for patients requiring tongue tie management. We are well placed to offer integrated myofunctional therapy and dental treatment in the Lake Macquarie region.
Why myofunctional therapy before a frenectomy?
Pre-operative myofunctional therapy (typically 4 to 8 weeks of structured exercises before the frenectomy) plays a critical role in preparing the orofacial muscles for the changes that will follow. The tongue has often been compensating for its restricted movement for months or years, developing abnormal muscle patterns in the surrounding structures. Pre-op therapy begins to address these patterns before surgery, improving tongue mobility and range of motion, reducing the risk of complications during healing, and setting up significantly better post-operative outcomes.
Why myofunctional therapy after a frenectomy?
Post-operative myofunctional therapy is, if anything, even more critical than pre-operative therapy. Without it, two major problems arise: reattachment and pattern persistence. Reattachment occurs when the frenulum tissue re-adheres during healing because the tongue is not being actively stretched and exercised through its new range of motion. Regular, specific exercises prevent this. Pattern persistence occurs because even after the physical restriction is removed, the brain continues to use the old compensatory movement patterns it has learned: the swallow pattern, the resting tongue posture, the breathing habit. Only systematic retraining through myofunctional therapy replaces these patterns with functional ones.
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