2023 Author: Priscilla Miln | [email protected]. Last modified: 2023-11-26 06:25
The fact that the child has a short frenulum, the mother can find out even in the hospital. Such a pathology should be immediately eliminated. Otherwise, problems may arise when sucking the breast or nipples. The bridle is easy to correct. The procedure is well tolerated by all children, almost painless. Pediatric surgeons perform such operations all the time. You should not be afraid of this. Complications will be much more serious in a neglected case of such an anomaly.
Why should the bridle be trimmed?
Any parent wondering if it's really worth cutting the frenulum under the tongue? In children, due to its incorrect size, there may be nutritional problems in the development of pronunciation. The frenulum also affects the bite and facial muscles.
It is a jumper. Needed to connect the tongue and lower jaw. Thanks to her, the first one always stays in the right position.
If the frenulum develops with pathology, then the functionality of the oral cavity may be impaired. Normally, it should be in the center of the tongue and be 2.5 to 3 cm long. In babies who are not yet a year old, its sizeis 8 mm. The most common anomalies are either that the frenulum is attached to the tip of the tongue or is too short. The latter pathology is called ankyloglossia.
Why is a short bridle so dangerous? Because of it, the bite is disturbed and improper development of the jaw occurs. You can understand that a baby has a small one by the fact that he quickly gets tired when he eats, sucks badly at the breast, and constantly cries. If the child clicks when eating, and milk pours out of the mouth, then you need to cut the frenulum under the tongue. Children with this pathology have problems with weight gain. It hurts them to move their tongue. This situation applies to both babies and artificial babies.
At an older age, to check if the frenulum is in a normal state, you should ask the child to reach out with his tongue to the upper palate. Deviation will provoke bite problems, periodontitis, difficulty with pronunciation, discomfort during chewing and swallowing. Most often, such a disease is diagnosed by a speech therapist, as parents turn to him because of difficulties in pronouncing letters.
Ankyloglossia needs to be treated, otherwise the child may, in addition to the above problems, develop an inflammatory disease of the mouth, snoring, problems with the functioning of the gastrointestinal tract, scoliosis, nasal twang.
Pathology is transmitted by a hereditary factor. If relatives have a similar problem, then most likely the child will be born with an anomaly. Also, this defect is formed during pregnancy, if the mothersuffered a viral disease, especially in the first and third trimester, toxicosis, exacerbation of chronic ailments, stress. In addition, provoking factors are considered to be a bruise of the abdomen, alcohol, drugs, and chemical poisoning in the first three months of fetal formation. Bad ecology can sometimes cause pathology.
At what age should surgery be done?
Tongue frenulum correction is performed at any age. It can be done by young children, schoolchildren and adults. The operation is quite fast. Doctors advise doing it to a newborn child right away. This is due to the fact that it will be easier for the baby to eat, there will be no problems with weight gain, and besides, at this age, surgery is most painlessly tolerated.
For older children, it is quite difficult to do the operation, since you have to use anesthesia. This is due to the fact that it is difficult to convince a one-year-old baby to just sit still quietly. Therefore, many doctors advise cutting either immediately after birth, or already when the child is 4-5 years old. Children at this age already tolerate anesthesia well and surgery is not contraindicated for them.
But you need to understand that by this time the baby may have problems with speech, which after the procedure will require a long period to correct and eliminate them.
Which doctor should I contact and where is the best place to do the operation?
If availablesuspicion of ankyloglossia, then the pediatrician will send the child to the dentist, orthodontist or surgeon. They will either confirm or refute the diagnosis. It will be up to the orthodontist, speech therapist and surgeon to decide whether to trim the frenulum of the tongue.
There must be a good reason for the operation. These include malocclusion, speech disorders that cannot be corrected by other methods, misaligned teeth, nutritional problems.
The severity of the anomaly is divided on a 5-point scale. If the deviation is very small, it can be eliminated without surgery using special exercises. The child must be over a year old.
Parents are concerned about where to cut the frenulum of the tongue? The operation is carried out in the hospital. If the child is older, then the procedure is carried out in dentistry. In the case of a severely neglected defect, the operation is performed in surgery in the maxillofacial department.
When a baby is born, the doctor usually checks the condition of the frenulum. Therefore, the operation is better to do immediately. For children 5 years old, the procedure is performed in the surgical department, or in dentistry. No hospital stay is required, so you can go home after the operation.
There are some contraindications to cutting the bridle. These include diseases of the blood, oral cavity and teeth, infectious and oncological problems.
Types of transactions
There are several types of operations during which the shortened hyoid ligament is trimmed:
- Vinogradova's method. During the procedure from the mucous membranethe fabric is cut off and sewn to the bridle.
- Glickman's method. The bridle is cut from the side of the teeth.
- Frenulotomy. The frenulum is cut, the edges of the mucosa are sutured.
There are some other types of operations, but they are rarely used. Which version of the procedure will be used should be selected by the doctor depending on the severity of the pathology. In some situations, you can even do without surgery.
This procedure is also known under another name: the Glickman method. Clamps are used during the operation. They fix the bridle. Next, the surgeon cuts the skin between the lip and the clamp. The edges are sutured. If we are talking about cutting in newborns, then for them such an operation is painless and fast.
After 2-3 years, vessels and nerves appear in the frenulum. It becomes more dense and fleshy. Therefore, you need to use anesthesia and after dissection, you have to stitch.
This method is considered the easiest. It allows you to easily increase the length of the frenulum of the tongue. The surgeon must cut the jumper itself at a distance that is 1/3 of the entire length. Next, you need to cut the mucous membrane. The sides of the mucosa begin to converge. Sutures are placed every 4 mm.
This method is called the Vinogradova method. During the operation, the location of the frenulum is changed. The procedure is carried out in three approaches.
- First, a flap is cut out in the form of a triangle. Woundis pulled together with seams.
- Next, an incision is made from the septum to the papilla, which is located between the front teeth.
- A triangle is sewn to the wound.
After that, the operation is considered completed.
How is the trimming procedure?
If the child is already over 2 years old, then he will have to explain why the frenulum is cut under the tongue. So you can avoid severe stress in the baby. The operation will be performed under general anesthesia. The manipulation time is no more than 5-10 minutes. At this age, there are no nerve endings and blood vessels in the frenulum, so you should not be particularly worried.
If the child is older, then lidocaine or an anesthetic gel is applied to the site of the future incision. After - the doctor makes an incision with a scalpel or scissors. Stitches are not always applied.
Many are wondering if it hurts to cut the frenulum of the tongue with a laser? This procedure is considered completely safe and refers to microsurgery. Complications after such an operation are excluded. Seams are not applied. The rehabilitation period lasts two days.
The laser operation is carried out for no more than five minutes. Doctors often use this method for trimming the frenulum of young children, as it is painless, accurate, and does not allow infection to attach.
The rehabilitation period depends entirely on the age at which the frenulum of the tongue is cut. If the child is less than 9 months old, then after a few hours it can beapply to the chest. In older children, rehabilitation lasts about a day. If the operation is performed by a laser, then the period is halved.
Immediately after the operation, it becomes easier for newborns to eat, milk helps the wound to heal quickly. Babies immediately begin to gain weight. If the frenulum was cut in a newborn, then he will not have problems with speech. Older children will have to undergo corrective therapy with a speech therapist. The doctor will tell you what exercises to do.
It is forbidden to eat for two hours after the operation. The first three to four days should not be given s alty, spicy, sour and hard crumbs. Too hot food and drink should be avoided. At first, it is better to eat mashed food. Too much talking is forbidden. After eating, you need to rinse your mouth with special antiseptic preparations. It can be infusions of chamomile or calendula, a solution of "Furacilin". If the child is already at least five years old, if there is pain, he can be given pain medication. It is necessary to apply sea buckthorn oil or Solcoseryl on the seam. The doctor will definitely tell you what exercises to support speech should be done, they should be observed. If necessary, you need to visit a speech therapist regularly.
Complications after surgery
If a child needs to cut the frenulum of the tongue, then parents should not worry. With proper postoperative treatment, no complications will arise. Surgical intervention is well tolerated by the child, therefore, in addition to the fact that for a while the child will lose the opportunity to speak for a long time and eat ordinary food.
If badtreat the wound, then pain and inflammation may appear. If the child has a scar, it is necessary to do a second operation.
Can the bridle be stretched?
If the child does not pronounce hissing, it is not necessary to immediately go to cut the bridle. You can try to stretch it. To do this, a speech therapy massage is performed and exercises are performed.
You should stretch out your tongue, and then move it around. It is necessary to reach its tip to the lower lip, then to the upper. You can click your tongue. To do this, you need to hold it near the sky and lower it down. Between the cheeks should be driven with the tongue, while the mouth should be closed. Also stick out your tongue with a tube and smack.
If the child is small, he can often be given to lick the spoon. Another way helps: you can drip jam on your lip, and then ask the child to lick it.
Cutting the frenum of the tongue is best when the child is not yet a year old. What is it connected with? There are no vessels or nerves in the area to be dissected. Therefore, the baby will not be hurt. Doctors won't have to use anesthesia or pain medication.
If the parents had no desire or reason for trimming the bridle at an early age, it is better to wait until 5-6 years. This is due to the fact that children at this age tolerate anesthesia well. The operation is carried out quickly for both infants and adult children. The only difference is the recovery time. In the first case, it takes only a few hours. In the second -a few days.
What kind of operation the surgeon will perform depends on the indications and reasons. If the child has a mild stage of pathology, it is enough to make a small incision. Stationary monitoring is not required, so you can go home immediately after the procedure. Above in the article it was described what is prohibited in the first days after the operation. You need to carefully choose a diet, food should not be hard or irritating to the mucous membranes (spicy, smoked, and so on).
Do I need to trim the frenulum of the tongue? This question worries many parents. Doctors advise to do this either immediately after childbirth, or look at the situation. Many children do not experience any discomfort with a mild form of pathology when eating, talking, and so on. Experts in this case recommend waiting for 5-6 years to check whether the child can pronounce words and sounds correctly. If there are any defects, for example, the baby cannot say "r", then he is sent for an operation. In other cases, you can not worry and do only exercises to stretch the frenulum. They will facilitate the daily life of the child and help prevent pathological changes.
You need to understand that the anomaly does not get worse over the years. The frenulum does not shorten, therefore, if they have not been identified before a year, this will not lead to serious complications. Pronunciation can always be corrected, and the operation is allowed to be done even in adulthood.
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