The study concluded that tongue-tie division may be a possible benefit for infants experiencing breastfeeding difficulties due to ankyloglossia and further investigation is warranted.
They noted that the phonemes likely to be affected due to ankyloglossia include sibilants and lingual sounds such as 'r'.
Based on the findings, the authors concluded that it is possible for children with ankyloglossia to have normal speech in spite of decreased tongue mobility.
Limitations of the study include a small sample size as well as a lack of blinding of the speech-language pathologists who evaluated the subjects' speech.
Several recent systematic reviews and randomized control trials have argued that ankyloglossia does not impact speech sound development and that there is no difference in speech sound development between children who received surgery to release tongue-tie and those who did not.
Furthermore, the authors note that some patients may be unaware of the extent of the limitations they have due to ankyloglossia, since they have never experienced a normal tongue range of motion.
[4] Lalakea and Messner[12] note that mechanical and social effects may occur even without other problems related to ankyloglossia, such as speech and feeding difficulties.
When the tongue normally rests at the roof of the mouth, it leads to the development of an ideal U-shaped palate.
Ankyloglossia often causes a narrow, V-shaped palate to develop, which crowds teeth and increases the potential need for braces and possibly jaw surgery.
[17][18] According to Horton et al., diagnosis of ankyloglossia may be difficult; it is not always apparent by looking at the underside of the tongue, but is often dependent on the range of movement permitted by the genioglossus muscles.
[19] A severity scale for ankyloglossia, which grades the appearance and function of the tongue, is recommended for use in the Academy of Breastfeeding Medicine.
Intervention for ankyloglossia does sometimes include surgery in the form of frenotomy (also called a frenectomy or frenulectomy) or frenuloplasty.
[19] According to Lalakea and Messner, surgery can be considered for patients of any age with a tight frenulum, as well as a history of speech, feeding, or mechanical/social difficulties.
[citation needed] Horton et al.,[2] have a classical belief that people with ankyloglossia can compensate in their speech for a limited tongue range of motion.
Thus, Horton et al.[2] proposed compensatory strategies as a way to counteract the adverse effects of ankyloglossia and did not promote surgery.
[23] An alternative to surgery for children with ankyloglossia is to take a wait-and-see approach, which is more common if there are no impacts on feeding.
[12] Ruffoli et al. report that the frenulum naturally recedes during the process of a child's growth between six months and six years of age.