Tongue tie (ankyloglossia) and lip tie (lip tethering) are often misunderstood as simply “extra tissue” in the mouth. In reality, these restrictions involve more than just surface-level structures. Beyond the visible tissue, there lies a complex web of fascia, a type of connective tissues that plays a critical role in posture, movement, and neurological regulation. This fascia doesn’t just stop at the mouth; it integrates deeply into the body, linking the tongue to the dura mater, the protective membrane around the brain and spinal cord. That means that oral ties can influence far more than feeding or speech; they can alter neurological tone, movement patterns, and even sensory integrations.

Understanding the difference between structural and functional ties is key. A structural tie refers to what we can see physically, but that does not always mean it is interfering with function. In contrast, a functional tie may not look dramatic, yet it significantly limits movement and disrupts normal oral and neurological development. Children with functional ties often struggle with feeding, breathing, speech, or even regulation and sleep. It is not uncommon to find medical providers that only identify oral ties when they are too short, too thick, or too tight. Another often used description is whether it is anterior (easily visible at the front of the tongue or lip) or posterior (hidden further back toward palate or gums). Often times when the tie is not structurally visible it gets missed or alternatively when it is visible, a release is immediately recommended. A quick fix that has taken our culture and society by storm is the release of supposed tongue and lip ties.

From a neurological perspective, functional oral restrictions can create compensatory stress patterns throughout the body. Because the fascia of the tongue and oral cavity connects through the throat, lungs, diaphragm, hip flexors, all the way down the toes; tension in one area may cascade into others. Tongue movement affects airway patency, midline development, cranial rhythm, and vagus nerve function.

Recognizing the truth beneath the ties encourages a more integrative, functional approach to care, one that honors the body’s complexity and capacity for healing when given the right support.

WHAT IS THE ROLE OF CHIROPRACTIC?

It is not the job of chiropractors to diagnose oral ties. Current research shows, the incidence of a true tongue tie is 3-5%. The unfortunate reality is the majority of infants with suspected oral ties receive a surgical release prior to receiving any conservative care.

Oral ties should be assessed not just by what we see, but by how they affect development, behavior, and nervous system balance.

This is where neurologically based chiropractic care becomes essential for assessing and supporting how the nervous system is adapting to fascial tension.

Through its links to the craniosacral system, restricted oral fascia can impact autonomic function, vagal tone, and neurodevelopment. Whether it presents as a poor latch, colic, tension headaches, picky eating, etc., it is important to trust and support the innate design of the body to unwind and encourage proper growth.

Pathways to Family Wellness, Issue 81, Spring 2024

Gerner, Lynn; Dorough, Andrew. “Breastfeeding and TOTs- Functional Support through Chiropractic.” ICPA, 13 Feb. 2023, Lecture.