How the tongue shapes the face
During childhood, the bones of the face are malleable and responsive to the forces placed upon them. The tongue, resting against the palate, provides the outward pressure that keeps the palate broad and creates room for the developing teeth. When tongue tie prevents correct tongue posture, the palate develops high and narrow, the upper arch becomes crowded, and the teeth have insufficient space to erupt correctly.
- High, narrow palate
- Crowded upper or lower teeth
- Recessed or set-back chin
- Open bite (upper and lower teeth not meeting at the front)
- Gap between the upper front teeth (diastema)
- Orthodontic relapse after braces or retainers
- Mouth breathing at rest
Orthodontic relapse and tongue function
One of the most frustrating experiences for families is completing orthodontic treatment, often involving years of braces and significant cost, only to see the teeth drift back toward their original position after retainers are removed. This relapse can be driven by an unaddressed tongue restriction and low tongue posture. The teeth go where the tongue tells them to go. If the underlying functional pattern is not addressed, orthodontic correction will not hold.
The gap between the front teeth
A gap between the upper front teeth (diastema) in a child or adult is sometimes associated with a high labial frenulum (lip tie). However, low tongue resting posture from tongue tie also contributes to forward positioning of the lower jaw and dental spacing. A comprehensive oral function assessment should accompany any orthodontic assessment for unexplained spacing.
Working with your orthodontist
We work alongside orthodontists and paediatric dentists to assess and treat the functional component before, during, or after orthodontic treatment. Timing and sequencing matters, and we will guide you through the appropriate approach for your child's situation.
Our approach: Release Restrictions, Retrain Function, Relieve Tension, ensures that the myofunctional rehabilitation needed to support structural change is built into the treatment plan from the beginning.
The National Tongue Tie Centre was established in 2007 as Ireland's first clinic dedicated entirely to the assessment and treatment of tongue tie. The centre treats over 1,000 patients per year and receives patients from across Ireland and internationally.
Led by Dr. Justin Roche (Consultant Paediatrician, FRCPCH, FRCPI, IBCLC), Kate Roche (Chartered Physiotherapist, IBCLC, Feeding Therapist). Clinics in Clonmel, Co. Tipperary and Naas, Co. Kildare.
Frequently asked questions
In some cases, treating tongue tie early enough, before significant arch narrowing has occurred, can reduce or eliminate the need for orthodontic intervention. In other cases, both are needed. The benefit of early treatment is that it supports better facial development going forward. We will give you an honest assessment of where your child is in that trajectory.
Orthodontic relapse is one of the strongest signals of an unaddressed functional cause. If tongue posture and oral function were not addressed alongside orthodontic treatment, the functional forces acting on the teeth will continue to move them back toward their pre-treatment position. Assessment and treatment of the functional issue is warranted.
Orthodontic training historically focused on dental and skeletal relationships rather than soft tissue function. Awareness of the role of tongue tie in dental development is growing but is not yet universal in orthodontic practice. Many orthodontists now actively seek functional assessment as part of treatment planning; others do not yet. Asking your orthodontist directly about tongue function is entirely appropriate.
In growing children, palatal expansion through orthodontic appliances is possible and effective. However, without addressing the underlying tongue posture that contributed to the high palate, expansion is likely to relapse. Tongue tie treatment and myofunctional rehabilitation, in combination with orthodontic expansion where needed, gives the most stable outcome.
The earlier the better, because the most significant palatal and jaw development occurs in the first six years of life. However, treatment at any age can prevent further deterioration and support stability of orthodontic outcomes. There is no age at which assessment and treatment become pointless.
Book a comprehensive assessment at the National Tongue Tie Centre. Our clinical team will assess tongue and lip function, explain what we find, and give you an honest recommendation about whether treatment is indicated and what to expect. Call us, complete our online enquiry form, or visit www.tonguet.ie. Clinics in Clonmel, Co. Tipperary and Naas, Co. Kildare.
Frenuloplasty is a surgical procedure. Risks, benefits, and individual expectations will be discussed in full at your assessment appointment before any decision to proceed is made.
