Every day in my clinic, I encounter young parents who come in to ask about their baby’s short tongue tie and worry that it will affect their baby’s future speech. Let’s take a brief look at the problem of short tongue tie. 1.What is a short tongue tie? Even doctors do not have a consistent standard for this issue. Often, when a baby goes for health care at full term, it is recommended to come and see a dentist. A simple judgment is that the tongue is not free to extend forward and the tip of the tongue is “W” shaped. This is the basis for most people’s judgment of a short tongue ligament. A more experienced doctor will also determine if the tip of the tongue crosses the lower lip when the baby extends the tongue. Of course, these two items are a bit simplistic and crude. If the baby does not have these two conditions but still has slurred speech (e.g., curled tongue), he or she will need to see a speech specialist for a speech evaluation. However, it is important to note that the baby is still developing speech until the age of 4. Speech assessment is usually scheduled between the ages of 4 and 4.5 years old, when the baby is able to cooperate with the phonetician in order to complete it successfully. Based on the results of the assessment, the next step of treatment (training or surgical treatment) will be carried out. 2.When should I come for the examination? When a baby is just a month old, the teeth have not yet erupted, the dental bed is still relatively low and flat, and the lingual tether is directly attached to the dental bed and looks very short. Parents should not be anxious at this time and wait patiently until the baby’s lower front teeth erupt before observing them. Generally speaking, around 6-7 months for girls and 7-8 months for boys, the tongue tie will recede and lengthen backwards and downwards as the teeth erupt. Therefore, it is important to check if the tongue tie is too short at least after the baby’s lower front teeth erupt. 3.Does the tongue tie have to be cut if it is too short? A short tongue tie is not the main factor that affects speech. Family education, surrounding environment, development, congenital defects (e.g. cleft palate, palatal malformation) can all cause slurred speech. In our clinical work, we have repeatedly stressed to parents that speech does not improve immediately after cutting the tongue tie. In particular, it is important to note that a short tongue tie only affects slurred speech, but it does not cause the baby to stop talking altogether. Some babies may come to us at the age of 2-3 years old and still cannot speak or can only say superlatives such as “daddy” and “mommy”. We would recommend that the baby first consult an ENT department to rule out ear disease and a neurological rehabilitation department for a developmental assessment. 4.When is the best time to treat? Many parents think that tongue tie is just a minor surgery, just a cut in the clinic. In fact, if the diagnosis of lingual tethering is really confirmed, most of them need to be treated with surgery under general anesthesia. There are two reasons for this: (1) the baby’s cooperation is poor, and the results under surface or local anesthesia are not good; (2) some tongue ties that are too short need to be fully loosened and sutured to stop bleeding completely, which is not well controlled under local anesthesia and can easily cause choking.