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Tongue-Tie - A Brief History

Tongue-tie, medically known as ankyloglossia, is a congenital condition where the frenulum, the thin membrane connecting the tongue to the floor of the mouth, is unusually short or thick, restricting tongue movement. This seemingly simple anomaly has, however, sparked centuries of debate, evolving from a suspect in breastfeeding problems to speech difficulties and beyond. The history of tongue-tie is a journey through medical curiosity, cultural anxieties, and evolving scientific understanding.

The earliest mention of tongue-tie appears in ancient Greek and Roman texts. Around 400 BCE, Hippocrates recognized the frenulum's role in speech, proposing its division in cases of lisping. Celsus, a Roman physician in the 1st century AD, also described frenulum division as a technique to improve speech. These early interventions, however, were crude and often based on limited knowledge.

In the Middle Ages, tongue tie caused a power struggle between Midwives and Surgeons. Midwives who are traditionally responsible for childbirth and infant care, would snip the frenulum using their fingernails. This practice, however, clashed with the burgeoning medical field. Surgeons felt it was their right to divide the frenulum using scalpels. This tension between midwives and surgeons, fueled by professional rivalry and evolving medical knowledge, continued for centuries.

The 16th and 17th centuries saw a shift in focus, with tongue-tie primarily linked to breastfeeding difficulties. Mothers struggling to nurse their babies often blamed the frenulum, leading to a surge in frenulum division procedures. However, the effectiveness of these interventions remained largely anecdotal, and the practice was often shrouded in superstition and cultural beliefs.

Woodcuts showing the operative techniques of Fabricius  in 1620.
Tongue-Tie in the 1600's

The 20th century brought a renewed interest in tongue-tie, fueled by advancements in medicine and research. The focus shifted from breastfeeding to speech difficulties, with concerns about lisping and articulation problems. However, the debate surrounding frenulum division remained contentious, with conflicting evidence and a lack of standardised diagnosis.

The 21st century has seen a surge in tongue-tie awareness, driven by advocacy groups and media attention. Diagnostic tools have become more sophisticated, and research on the long-term effects of tongue-tie is ongoing. Yet, controversy persists, with questions about the optimal age for intervention and the true prevalence of speech-related issues. As research progresses and awareness grows, we can hope to unravel the mysteries of tongue-tie, ensuring that every voice has the freedom to be heard.


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