When the tongue is tied to the floor of the mouth, it not only affects speech, passion, personal oral hygiene and spontaneity but it also inhibits proper development of the roof of the mouth and often leads to crowded upper teeth. In proper skeletal development the tip of the tongue rests in the “N” position and the remainder of the tongue fills the roof of the mouth or palate. The tongue is a very strong muscle and the palate will form around the width and breadth of the tongue. If the tongue is absent from the roof of the mouth because it is tied to the floor of the mouth, the palate will not develop to its full width but will be narrower than it should be. When the development of the upper jaw is restricted and narrow, the teeth do not have enough space and will be crowded. Sometimes even a cross bite will develop in which the lower jaw is wider than the upper jaw.
It is true that the palate can be expanded with orthodontic appliances and the teeth put in proper alignment with each other. However, if the tongue is not free to rest in the roof of the mouth, the palate will again narrow after braces are removed unless an upper retainer is worn continually. I have seen this time and again in individuals who have had beautifully straight teeth when their braces were removed and then wore their retainers continually for 2 years without a problem. In those individuals who are tongue tied and who refuse to have their tongue released so it can move freely, once they stop wearing the upper retainer their upper jaw will collapse and get narrower and the teeth will go crooked again.
So why don’t tongue tied people wish to free the tongue? It is a very simple procedure done with a laser and takes about 5 minutes. Fear that it will hurt is the main reason. Does freeing the tongue eliminate the possibility of orthodontic failure? One would think “yes,” but the answer is “no,” unless the person learns where the proper placement of the tongue is and practices it. If the tongue has gone to the same position for 10 or more years and the tongue-tied person has learned to speak and function with it in that position, just freeing it so it can go to the right position does not make it go there. It will continue to go the habitual position unless it is retrained. Through practice one can learn the proper tongue placement and then can make the proper position a habit that will keep the palate in its proper shape.
If you or someone you know can’t stick out the tongue and are considering braces or Invisalign, please have the tongue evaluated for being tied to the floor of the mouth. If it is tied, free it and learn the proper placement of it. The outcome and stability of your orthodontic treatment will be far better.