What is the difference between ‘anterior’ and ‘posterior’ tongue tie?

Tongue tie is a condition in which the frenulum, the thin band of tissue that connects the tongue to the floor of the mouth, is too short, tight or far forward. This can restrict the tongue’s range of motion and cause a difficulty feeding

There are two main types of tongue tie: anterior and posterior.

Anterior tongue tie occurs when the frenulum is too short or tight at the front of the tongue. This can cause the tongue to have a heart-shaped appearance and make it difficult to lift and extend the tongue. Every anterior tongue tie has a posterior part also.  

Posterior tongue tie can be more difficult to diagnose. It occurs when the frenulum is too short or tight at the back of the tongue. This can make it difficult to move the middle of the tongue up and down.

How to identify anterior and posterior tongue tie

Anterior tongue tie is usually easy to identify by simply looking at the tongue. However, posterior tongue tie can be more difficult to see. It is often necessary to lift the tongue and look underneath it to identify a posterior tongue tie. It is important to distinguish between posterior tongue tie and a normal frenulum (which most people have).  The key is for someone trained in tongue tie assessment to assess tongue function (often using a recognised scoring tool), as this is the most important factor.

How to treat anterior and posterior tongue tie

The treatment for tongue tie is a simple procedure called a frenulotomy or tongue tie division. A frenulotomy involves cutting the frenulum to release the tongue’s range of motion.

Which type of tongue tie is more serious?

Both anterior and posterior tongue tie can cause problems, but anterior tongue tie is often considered to be more restrictive. This is because anterior tongue tie can restrict more of the tongue’s movement. However, tongue function (sucking skill, range of movement etc) is always the most important factor to consider.