Heritability of Tongue Tie: Role of Family History in Assessment of the Problem

Introduction: Tongue-tie (TT), also known as ankyloglossia, is diagnosed when the lingual frenum is short and restricts the mobility of the tongue and can be an isolated finding in upto 5% of infants. It can have an adverse effect on oromuscular function, breast feeding (BF) and speech later on. While the existence of tongue- tie has never been doubted, there have been sporadic reports of familial TT that are non syndromic.

Methods: We performed a retrospective analyses of infants treated or followed for TT at a large pediatric private practice in Phoenix and its suburbs in AZ to look for patterns of inheritance of this condition.

Results: We followed 6982 patients with TT over a 13 year period from 2006 to 2019. An analyses of the patients attending the clinic over 1 year period (2018-19) was done. We identified multiple families with several members affected by TT. The patterns of inheritance included Autosomal Dominant (n=5), Autosomal Recessive (n=23) and X linked (n=1). Both males and females were equally affected. A significant number of patients had symptoms of dysfunctional BF, diastema or speech problems (in older children / adults).

Conclusion: TT can be a very common and often underdiagnosed problem in infants. Untreated TT can cause significant problems in post natal period that can lead to failure of BF. A family history should be taken to assess and identify additional family members with TT