The tongue is the primary articulator in speech. For sounds such as l, r, t, d, n, s, and z, the tongue tip needs to elevate to the alveolar ridge and move with precision and speed. A tethered tongue cannot achieve this range of motion, and compensations develop — lisps, substitutions, and articulation errors that speech therapy alone may not fully resolve if the underlying restriction is not addressed.
Which sounds are most commonly affected by tongue tie?
The most commonly affected sounds are those requiring tongue tip elevation or precise tongue placement: t, d, n, l, r, and the sibilant sounds s and z. Children with tongue tie may also have difficulty with sounds requiring tongue retraction or lateral movement.
- Difficulty with t, d, n, l, r, s, and z sounds
- Persistent lisp, particularly on s and z sounds
- Speech described as mumbly, unclear, or imprecise
- Articulation errors that have not fully resolved with speech therapy
- Difficulty with tongue tip elevation to the alveolar ridge
- Speech that sounds like the child is speaking with something in their mouth
Tongue tie and the limits of speech therapy
Speech therapy is valuable and important. But if a structural restriction is limiting tongue mobility, therapy will hit a ceiling. Our approach is to assess whether the restriction is functionally significant, complete the frenuloplasty where indicated, and ensure myofunctional rehabilitation follows to support the new range of motion. Working in partnership with your child's speech and language therapist gives the best outcomes.
What age can children be treated?
We treat children of all ages for speech-related tongue tie concerns. There is no upper age limit. Outcomes depend on the degree of restriction and the commitment to post-procedure rehabilitation, but significant improvement in articulation and speech clarity is achievable with the right approach.
When is tongue tie not the cause?
Not all speech delay or articulation difficulty is caused by tongue tie. Hearing, motor coordination, developmental factors, and other structural differences can all contribute. We will give you an honest assessment of whether tongue tie is likely to be a functionally significant contributor in your child's case, and what realistic outcomes look like.
Our approach: Release Restrictions, Retrain Function, Relieve Tension considers the whole functional picture. We will not recommend a procedure unless we are confident it is clinically indicated.
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
There is no upper age limit. We treat children, teenagers, and adults for speech-related tongue tie. The key is whether the restriction is functionally significant and whether the individual is able to engage with the pre-operative preparation and post-operative rehabilitation required.
It depends on the underlying cause. If the lisp is primarily driven by restricted tongue elevation preventing correct sound placement, addressing the restriction creates the structural possibility for correct articulation. The sound still needs to be learned and established through speech therapy and myofunctional practice. Treating the tongue tie is the foundation, not the complete treatment.
If your child has persistent articulation difficulties after a course of speech therapy, a specialist tongue tie assessment should be sought if it has not already been completed. We see many children in this situation, and in a significant number a functionally relevant restriction is identified that was not previously considered.
Yes. Tongue mobility in adults can be improved through frenuloplasty and myofunctional rehabilitation. The degree of improvement depends on the severity of the restriction and the extent to which compensatory speech patterns have become habituated. We will assess this individually and give you honest expectations.
Tongue tie is not considered a primary cause of stuttering, which is a complex neurodevelopmental speech fluency disorder. However, if a child with a stutter also has restricted tongue mobility, assessment and treatment of the restriction may improve articulatory ease and reduce speech effort, which can be a secondary benefit.
Book a comprehensive assessment at the National Tongue Tie Centre. Our clinical team will assess your baby's tongue and lip function thoroughly, explain what we find, and give you an honest recommendation. 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.
