Untangling the Connection: Exploring the Genetics of Tongue Ties
Working in pediatrics, we treat children with torticollis and, often related, tethered oral tissues (TOTs) such as lip and tongue ties. These may be things children are referred for early on which is excellent for prognosis and growth, but often times play out down the line with developmental challenges when not caught early. It seems as though more and more children are being diagnosed with TOTs, and I often get the question - is this new or just the newest fad in medical care? To fully understand why there might be an increase in diagnosis now, it’s important first to understand what contributes to tethered oral tissues (TOTs). One major factor that has been associated is the build up of folic acid.
Excess folic acid in the body can cause TOTs by affecting the normal development and functioning of the nervous system. Folic acid is essential for proper neural tube formation and closure during early embryonic development. If there is an excess of folic acid in the body, it can interfere with normal neural development, leading to neural tube defects and other neurological disorders. In the case of TOTs, an excess of folic acid can cause the oral tissues to become abnormally attached to the underlying structures of the mouth, resulting in limited mobility and function. This can result in discomfort, speech difficulties, and other oral health issues. But why are we seeing so many of these cases now?
Folic acid is added to everything! Many of our processed foods are fortified with folate as we know that enough folic acid is critical to other neurologic development in children. However, the excess of folic acid must be cleared from the body somehow. In approximately 30% of the population, there is a mutation in the genes responsible for this clearing. MTHFR is the short form for the gene methylenetetrahydrofolate reductase. This gene provides instructions for making an enzyme that plays a crucial role in converting a molecule called homocysteine into another molecule called methionine. Methionine is an amino acid that is used to make proteins and other important compounds in the body. Variations in the MTHFR gene have been linked to an increased risk of several health conditions, including cardiovascular disease, stroke, certain cancers, and birth defects. However, it is important to note that having a variation in the MTHFR gene does not guarantee that you will develop these conditions, as many other factors such as lifestyle and environment also play a role.
In terms of lip and tongue tie, there is evidence to suggest that MTHFR gene mutations may increase the risk of these conditions when there is an excess of folic acid in the body. It is important to note that folic acid supplementation is important for a healthy pregnancy, but it should only be taken in recommended doses under the guidance of a healthcare provider. Excess consumption of folic acid can lead to the build up in the body, leading to adverse effects like tethered oral tissue. One relatively easy solution is to take a prenatal vitamin with methylated folate in it. We will spare you the soap box here, but we also recommend taking something that is third party tested for purity and potency as well.
Many factors can contribute to the development of lip and tongue tie, and MTHFR gene mutations are just one potential piece of the puzzle. If you're concerned about your risk of these conditions, it's best to speak with an educated health professional. They can help you understand your specific risk and provide personalized advice and recommendations based on your individual situation. In our practice, we work with our moms prior to and during pregnancy to ensure proper lifestyle, nutrition, and supplementation strategies are used to make pregnancy smooth and create a healthy family for the future. If you’d like to know more about our recommendations, please get on our calendar to find out how we can help you too. You can book a call here.
