Is Your Tongue Causing Your Health Problems?

Article written by Pat Pine, RDH, COM™

Ever wonder what organ really controls our body? Most assume it is the heart. The heart pumps blood to the lungs, which is needed to breath efficiently. Both heart and lungs are vital to the human body’s machinery – but consider the tongue!

Medical communities are surprised at this possible revelation. Is the tongue a muscle or an organ of the body? The tongue is comprised of intrinsic muscle and extrinsic muscle and is covered with mucous membrane. It is attached to a floating bone called the hyoid bone. This floating bone is attached to many muscles – anterior, posterior and inferiorly, which keeps it in place. This horseshoe shaped bone serves as an anchoring structure for the tongue and its surrounding muscles. This exceptional bone is found at the root of the tongue just above the thyroid cartilage, below the chin, at the midline of the neck. The four muscles above or superior to the hyoid bone provide attachment to muscles that form the floor of the mouth. But many other muscles are controlled by our tongue inferiorly or below the chin. They are
attached to the collar bone. Hum, the tongue is attached to the collar bone? Didn’t know that!

Why Do We Care About This Horseshoe Shaped Bone?

This free-floating bone is not attached to another bone in the body. Positioning of the hyoid bone is the responsibility of the infrahyoid and suprahyoid muscles. These muscles are very important for the complete act of swallowing and action of the larynx. The four-infrahyoid muscles are referred to as “strap muscles” and are attached from the hyoid bone inferior to the clavicle, or scapula. Stay with me here. The suprahyoid muscles are attached above the hyoid bone and infrahyoid below the hyoid with attachment to the clavicle or collar bone.

An ankyloglossia, or tethered oral tissue, also named tongue-tie, can be the cause of medical conditions that are not routinely diagnosed. Headaches, shoulder and neck pain can be caused by tight muscles attached to the hyoid bone. With a tongue-tie those suprahyoid muscles are typically tight, pulling on the tongue when it attempts to function, but cannot because it is anchored to the floor of the mouth. This restricts the tongue from normal movement and function. The tongue has many duties, including maintaining the airway, assisting with chewing, swallowing, and most importantly facial development, speech and digestion.

When the tongue is developing in utero at about the fourth week, its first duty is to shape the maxilla. The tongue should reach the palate to form a nice wide horseshoe shape. When the frenum is tight, short or anchored to the floor of the mouth, this shape will not take place, nor will normal facial development take place. Orthodontic treatment is sure to be scheduled in the future for patients with a tethered tongue, if it is not released at a very young age. Malocclusion is sure to develop. This singly attached muscle has not been able to do its job.

What is Instigating the Problems?

It all starts at birth. A short, tight membrane underneath the tongue, called frenum, frenulum, frenula, attaches the tongue to the floor of the mouth. The oral cavity has seven frenums. Each one can be tethered or restrict normal movement. The tongue frenum is exceedingly strong and can restrict movement and normal function. It seems like an epidemic the past years that infants are challenged with tethered oral tissues, both tongue and lip ties. This can prevent normal development, because of breast or bottle-feeding issues, and they are often diagnosed with failure to thrive. Babies are not able to nurse with a tongue that is tethered. The tongue cannot create its peristaltic action (wave like) while breast feeding. The infant’s symptoms determine if the tethered tissues are to be non-invasive surgically released. These are all very real concerns. Families are already dealing with the many concerns of a new baby. Tethered oral tissues (TOTs) shouldn’t have to be one of them.

Our tongue controls our body in ways we are unaware. The human body is amazing in the way it operates and functions together, seemingly without any thought on our part.

Airway

The airway is the most valuable system in the human body. Without it the body would not be thriving. If the tongue is anchored or tethered too tightly to the floor of the mouth, movement and function are restricted. This can be the cause of snoring, sleep apnea, gagging and vocal sounds. Without a clear airway normal breathing cannot take place. Should the tongue fall back into the airway while sleeping, snoring erupts and disrupts households. During the day with a tethered tongue, the airway may be blocked and the only way to open the airway is to place the head in a forward position to breathe through the mouth. Open mouth posture can cause fatigue, brain fog, lack of attentiveness, and also hyperactivity.

Breast feeding/Bottle feeding 

This is impossible when the tongue is anchored to the floor of the mouth. Movement, function and freedom of the tongue are needed to allow for a good latch/seal on the breast or bottle. A good latch in turn creates suction to release nourishment. The infant needs to breast feed efficiently in order to keep the breast milk supply replenished. Pain and great discomfort occurs when the nursing infant’s tongue is tethered. It doesn’t matter how tethered at this point. It is causing pain and frustration to the mother and frustration and failure to thrive to the infant. This can lead to developmental concerns. There are many other symptoms that are attached to tongue-tie and breast and bottle feeding i.e. clicking, gagging, gassiness, reflux. Children and adults can have health issues that are attached to tongue-ties.

Chewing

Without proper movement and function, the tongue cannot move food from side to side for sufficient chewing for complete digestion. It’s been stated that we need to chew our food 30 times before we swallow it. Not sure if that happens, as many people are in the eat and run mode.

Cleaning of the Mouth

Freedom and movement is needed for the tongue to clean each and every tooth in the mouth. If it can’t reach to the posterior molars, 3rds included, it could be tethered.

Facial Development

Our nose is not an ornament on our face but allows the body to keep functioning. Nasal airway is important to breath filtered, moist, humidified air. There is a saying, “If we don’t use it we lose it!” This is true. When not using our nasal passages to breathe the mid-face will not develop or grow normally.

Obstructive Sleep Apnea (OSA) 

OSA has become an important topic of discussion and study in the dental and medical communities. It should be a topic of conversation with all patients, at each dental visit as it can impact life or death. Patients with sleep apnea can die from heart attacks. These patients are unaware that they snore or stop breathing at night or while taking a nap. Some patients are aware of their snoring, but feel it’s normal for their age or weight. This is not true. This involuntary period when breathing stops is called apnea. Normally, air is flowing through the nose to the lungs at all times. If the air space in the throat is too narrow the flow of air stops. Snoring is a trait of OSA. Symptoms include headaches, forgetfulness, grumpiness, irritability, poor job performance, depression, and loss of interest in sex. More severe health issues can be hypertension, heart disease, stroke, and diabetes. Proper diagnosis is essential followed by treatment.

Open Mouth Posture 

This is also called mouth breathing. Mouth breathing allows infections to enter the body easily since there is no filter via the oral cavity. The tonsils are present to help filter but many times they enlarge and become part of the problem with obstructive sleep apnea for children and adults alike. Mouth breathing does not allow proper respiration. The inhaled air mixes with nitric oxide (NO). NO is a vasodilator and enhances the uptake of oxygen. Breathing (or respiration, or ventilation) is the process of moving air into and out of the lungs to facilitate gas exchange with the internal environment, mostly by bringing in oxygen and flushing out carbon dioxide.

Nasal passages act as a tunnel to filter, moisturize and humidify the air entering the lungs. The lungs will not perform correctly as they are struggling to provide concentrated oxygen for the body with non-filtered air. Every cell in the body is affected by mouth breathing due to the lack of essential oxygen. Other symptoms of mouth breathing can include: snoring, sleep apnea, headaches, migraines, hypertension, TMD – pain, dark circles under eyes, and ear and sinus infections.

School Work

This can be hindered when the airway is compromised by the tongue, resulting in insufficient breathing. Foggy brain and fatigue can be common when sufficient oxygen is not getting to the brain. Mouth breathing, forward head posture, enlarged tonsils, sore throat from mouth breathing can all be symptoms causing school work concerns. These disorders can be evaluated and addressed by an Orofacial Myologist for myofunctional therapy.

Speech 

Communication is a must with or without cell phones. Our verbal language starts at a very young age. First words, cooing, sounds like mama, dada, are normal for infants. Infants are mesmerized by our voice, tone and words. Movement of the tongue is important for pronunciation of words and working words into sentences. Without clear interaction with others, social speaking skills can be hindered. The tongue has several jobs. Clarity of speech is definitely an essential one. The tongue requires the freedom to move and reach the palate to sound out letters, words, phrases. If it cannot perform as nature intended then lisping and other disorders can occur. Test yourself – place your tongue tip below your lower anterior teeth, push and hold, now try to talk. Can’t do it right! When restricted the tongue can’t perform as it was intended to do.

Swallowing

The tongue assists in swallowing 1200-2000 times per day. Restricted to swallowing via tongue-tie does not allow saliva or food to be chewed completely and swallowed normally. The digestive system needs the salivary enzymes to mix with chewed food for complete digestion. The four to six pounds of pressure on the teeth with an abnormal swallow is called a reverse swallow, or tongue thrust. It can create havoc on the oral cavity. Malocclusion, called open bite, can occur. This includes bi- lateral, unilateral, anterior, molar to molar, anterior-bilateral and several others.

Pleasure

Our tongue brings pleasure in different ways. The tongue is the sensory organ that detects sweet, sour, salty, and bitter, thus enhancing our enjoyment in eating and drinking. Vocalization, singing, playing musical wind instruments would be impossible without the tongue. On a more serious social note – French kissing and affectionate words to partners would be impossible.

Do you have questions for Dr. Dierkes? We encourage you to make an appointment to bring your child in for a consultation. We'd love to meet you!