A functional swallow requires the tongue to gather a cohesive bolus, elevate to the palate, and propel the food backward in a coordinated wave. If the tongue cannot elevate fully or move posteriorly because of a frenulum restriction, the swallow is effortful, inefficient, and often compensated by head extension, liquid intake, or abnormal jaw movement.
- Needing to drink with every bite of food
- Preferring soft foods or avoiding certain textures
- Taking significantly longer to eat than others
- A sensation of food sitting at the back of the throat
- Needing multiple swallows to clear each mouthful
- Difficulty swallowing tablets or capsules
- Fatigue with eating, particularly towards the end of a meal
Tongue tie and dysphagia: where the evidence is
Dysphagia associated with tongue tie is less well-studied than the breastfeeding literature, but it is clinically consistent with what we understand about tongue mechanics. We see it regularly in adults presenting for assessment, particularly those with moderate to severe restriction. A functional swallow assessment is part of our adult evaluation.
Assessment and treatment
Our adult assessment includes detailed evaluation of tongue function, swallow mechanics, and the interaction between tongue posture, jaw position, and hyoid movement. We will advise clearly on whether functional frenuloplasty is indicated, and what preparation and rehabilitation you will need to maximise the functional gain after the procedure.
Our approach: Release Restrictions, Retrain Function, Relieve Tension, includes the pre- and post-operative swallow retraining that is essential when compensatory patterns have been established over many years.
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
Not always, but it should always be assessed. If difficulty swallowing is a new symptom or is getting worse, this warrants urgent medical review. Difficulty swallowing that has been present for years and is associated with restricted tongue movement, preference for soft textures, and fatigue with eating is the pattern consistent with tongue tie, but other medical causes should always be ruled out first.
Yes. Many adults with tongue tie have lifelong food avoidance or preference for certain textures that they have normalised. It is simply how eating has always felt. This is worth assessing, particularly if it coexists with other signs of tongue restriction such as jaw tension, speech effort, or neck tightness.
A severely restricted tongue that cannot manage adequate bolus formation may increase the risk of food entering the airway if the swallow is sufficiently disrupted. This is uncommon, but if you are experiencing choking episodes alongside the other swallowing difficulties described here, please seek assessment promptly.
Some improvement in tongue mobility is often noticed quickly after the procedure. The swallow pattern itself, having been compensatory for many years, requires specific retraining. This is part of the pre- and post-operative rehabilitation programme and is essential for achieving the full functional benefit of the procedure.
Yes. Swallowing tablets requires the tongue to cup around the tablet, hold adequate liquid, and initiate a coordinated posterior movement. Many tongue-tied adults find this disproportionately difficult, resorting to crushing tablets or avoiding them altogether.
Book a comprehensive assessment at the National Tongue Tie Centre. Our clinical team will complete a comprehensive functional assessment, explain what we find, and give you an honest discussion of what frenuloplasty is likely and unlikely to achieve in your case. 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.
