The Link Between Tongue-Tie and Orthodontic Relapse: What Most Parents Aren’t Told

One of the most overlooked reasons?
A tongue-tie and the muscle habits that develop around it.

Most orthodontists are focused on the position of the teeth. But myofunctional therapists look at why the teeth moved in the first place—and why they won’t stay put.

A restricted tongue can be a key part of that puzzle.

What Is a Tongue-Tie?

A tongue-tie (ankyloglossia) occurs when the lingual frenulum—the band of tissue under the tongue—is too short, tight, or thick. This limits normal tongue movement, especially:

• Elevation to the palate

• Side-to-side movement

• Forward and backward motion

• Ability to sustain proper rest posture

A functional tongue needs full range of motion to support healthy swallowing, oral rest posture, and airway development. When those skills are impaired, the teeth and jaw adapt in ways that aren’t always ideal.

Why the Tongue Matters for Orthodontics

The tongue is not just for talking and eating—it’s a powerful, constant force that shapes the upper jaw and stabilizes the bite.

When the tongue rests on the roof of the mouth, it naturally supports:

• A wide palate

• Straight dental arches

• Nasal breathing

• Stable orthodontic results

But when the tongue cannot lift high enough—because of a restriction—it often rests low, forward, or against the teeth.

This becomes a long-term orthodontic problem.

How Tongue-Tie Leads to Orthodontic Relapse

When the tongue sits low or presses against the teeth, it can:

1. Push the teeth out of place

A tongue that thrusts during swallowing or speech puts repeated pressure on the front teeth, slowly moving them forward.

2. Prevent the upper jaw from developing fully

Without the tongue on the palate, the upper arch may stay narrow. Even after expansion or braces, it can relapse if the tongue still cannot support the palate.

3. Interfere with proper swallowing patterns

A restricted tongue creates a compensatory swallow—often a tongue thrust. This swallow can occur 500–1,000 times per day, meaning the teeth are constantly being pushed out of alignment.

4. Cause mouth breathing

Tongue-tied individuals often compensate by breathing through the mouth. Mouth breathing creates:

• Low tongue posture

• Forward head posture

• Long, narrow facial structure

• Unstable orthodontic results

5. Lead to a lifelong habit pattern

Even after the frenulum is released, the tongue does not automatically learn new patterns. These habits must be retrained, or the muscles revert to old compensations.

Why Braces Alone Can’t Fix the Problem

Orthodontics can beautifully align the teeth, but they cannot change muscle function.

If the tongue continues:

• resting low

• pushing forward

• not supporting the palate

• compensating during swallowing

…the teeth tend to drift back to where they were before, no matter how good the orthodontic treatment was.

This is why many orthodontists now work closely with myofunctional therapists before and after braces—and why tongue-tie evaluations are becoming a standard part of airway-focused orthodontics.

When a Tongue-Tie Release Is Helpful

A frenectomy (tongue-tie release) may be recommended when there is:

• Limited tongue elevation

• Difficulty keeping the tongue on the palate

• Mouth breathing

• Narrow palate or high arch

• Tongue thrust with swallowing or speech

• Recurrent orthodontic relapse

• Difficulty achieving nasal breathing

• Fatigue or strain during eating or speaking

However, the release itself is only one piece of the solution.

Myofunctional Therapy: The Missing Link

For stable orthodontic results, the tongue must learn to:

• Rest on the palate

• Maintain nasal breathing

• Swallow correctly

• Stay away from the teeth

• Coordinate with lips and jaw

Myofunctional therapy trains these patterns before and after a tongue-tie release to ensure:

• The tongue can use its new mobility

• Old habits don’t return

• The palate is properly supported

• Orthodontic changes remain stable

• Breathing patterns improve

In fact, many orthodontists see far better outcomes when myofunctional therapy is incorporated early—sometimes even preventing the need for repeat treatment.

Signs Your Child May Have a Tongue-Tie Affecting Orthodontics

You might notice:

• Teeth spreading after braces

• Open-mouth posture

• Narrow palate

• Difficulty lifting the tongue

• Speech distortions (/s/, /z/, /sh/)

• Tongue thrust swallow

• Snoring or mouth breathing at night

• Messy eating or fatigue with chewing

• Difficulty maintaining retainers comfortably

If several of these sound familiar, a tongue-tie may be part of the picture.

The Bottom Line

Orthodontic relapse is rarely just a “teeth problem.”
It’s often a muscle and function problem—and the tongue is right at the center of it.

A tongue-tie that limits proper rest posture and swallowing can undo beautiful orthodontic work over time. But with proper evaluation, a coordinated treatment plan, and myofunctional therapy, families can finally achieve the long-term stability they’ve been looking for.

Want to Find Out if Tongue-Tie Is Affecting Your Child’s Bite or Breathing?

We offer comprehensive myofunctional evaluations that assess:

• Tongue mobility

• Oral posture

• Breathing and airway function

• Swallowing patterns

• Orthodontic stability

• Sleep symptoms

You don’t have to guess—there is a reason for relapse, and we can help you understand it clearly.