Short frenulum of the child's tongue: photo, cropping

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

The frenum of the tongue is a piece of mucous tissue that connects the tongue to the lower part of the mouth. It has an arched shape, and normally stretches from the middle of the organ to the gums in the region of the central lower incisors.

Often people are born with a defect in the frenulum, and then it is short, its base is either further than the middle of the tongue, or even at its edge. The identification of this defect falls on the shoulders of a neonatologist examining a newborn child, but sometimes they do not pay due attention to the condition of the frenulum. Because of this, the baby may experience a whole range of problems in the future, ranging from the inability to eat normally to serious speech disorders.

What should be the frenulum of the tongue in a child, how to determine the presence of pathology and what to do if the suspicions about the presence of a defect are nevertheless confirmed - all the necessary information in the article.

What is this?

The frenulum should be of such length that the tongue can move freely in the mouth, reach the upper teeth and easily move forward. The difficulty in performing these actions indicates that the person has a short frenulum of the tongue. ATmedicine of this pathology was given the name "ankyloglossia".

5% of newborns have to deal with a similar problem, there is an interesting fact that ankyloglossia occurs in men three times more often than in women. There are cases when the tongue is almost completely immobilized due to the fact that the mucous fold that forms the frenulum is too short. This condition is called "complete ankyloglossia".

If the bridle allows the organ to move, but limitedly, then they talk about partial shortening. Immediately after the birth of a person, the tissues that make up the fold are thin and elastic, they lack blood vessels and nerve endings. Therefore, with gross defects, the incision of the frenulum is carried out directly in the delivery room. Sometimes the neonatologist may decide not to injure the baby, but is then closely monitored.

At what stage is a pathology diagnosed?

From the above, it becomes clear that the frenulum of the child's tongue is checked immediately after birth. The primary examination is carried out by a pediatrician. We can talk about a severe defect when the tongue is immobilized or, which also sometimes happens, is turned down. This condition threatens the normal development of the baby, because the lack of mobility of the organ prevents sucking.

If the problem was not identified immediately, then we can say that the frenulum of the tongue is only partially shortened. It may not cause problems or discomfort during swallowing and sucking at all, but will manifest itself later, when the child is 3-4 years old. In thatChildren begin to talk actively as they age. If the baby has obvious problems with diction, parents should pay attention to the pediatrician, who will recommend checking the condition of the frenulum or assess its position himself. Ankyloglossia can be confirmed by a pediatric dentist or speech therapist. According to medical protocols, only a speech therapist or a pediatrician can give a direction for a surgical intervention involving notching, the dentist does not make such a decision - he is only the performer of the procedure.

It happens that the short frenulum of the tongue is trimmed already in adulthood, because such a defect does not necessarily cause problems with diction, and therefore remains unnoticed for many years. This happens when it is only a partial shortening. But even a slightly defective membrane can interfere with the installation of dental implants or prostheses, then the dentist can issue an opinion on the incision to an adult and even an elderly person who is not even aware of the existence of such a problem.

Tongue frenulum and breastfeeding

The biggest danger of a shortened bridle for a newborn is malnutrition due to improper breastfeeding. For this reason, lactation may not improve, because the weak mobility of the tongue and its underdevelopment will not allow the newborn to normally attach to the breast and capture the nipple and areola correctly. For a baby, this is fraught with a lack of weight, problems with the tummy. The mother may develop lactostasis - the child simply will not be able to suckhindmilk.

You can understand that a newborn has ankyloglossia by the following signs:

• he can't breastfeed properly;
• during the meal, he constantly throws the nipple;
• milk flows out of his mouth.

Moms should pay attention to this even during their stay in the maternity ward of the hospital. With the timely detection of a problem, doctors will make an incision with minimal consequences for the child. The frenulum of the tongue in newborns heals very quickly, the procedure is almost painless, the wound will not bleed and hurt, and after two hours the mucosa will already tighten.

Speech problems

Violation of diction due to ankyloglossia is observed because the tongue cannot reach the palate and upper teeth. Because of this, it is difficult for a person to pronounce quite a lot of letters: “Ж”, “Ш”, “Ш”, “Л”, “Р” and “Ч”. If there are speech problems, it is likely that it will not be possible to correct them with the help of articulation exercises and classes with a defectologist. Conservative methods will have a visible result only in the case of a slight disorder in the pronunciation of certain sounds.

A speech therapist can help deliver a speech, but if experts recommend surgery, then they cannot cope with the problem solely with the help of methodical exercises. Once again, we note that ankyloglossia does not always provoke speech defects. If they are not there, the child does not need to trim the frenulum of the tongue. Moreover, the operation itself will not make a person's speech intelligible and correct. After the procedure, the patientyou will have to study with speech therapists for at least six months.

What to do?

The solution to the problem depends on the severity of the defect. It's possible that you won't have to do anything. But if the patient has one of the following signs, it is likely that the frenulum still needs to be trimmed:

• difficulty chewing and swallowing food;
• wrong pronunciation of sounds, fuzzy diction;
• bite pathology;
• diseases of the gums and other periodontal tissues.

The tongue frenulum in a newborn is usually trimmed even without the use of anesthesia, in older children and adults, the area of operation is anesthetized with topical drugs.

Is it possible to do without surgery?

Quite, if the shortening of the frenulum does not affect the patient's quality of life. But if there are problems, the operation cannot be avoided. In general, this procedure is very easy to perform, does not require hospitalization or preparation. A contraindication may be the presence of acute infectious diseases, oncology, poor blood clotting, inflammation of the mucous membrane in the oral cavity. But, in any case, you can’t let things take their course.

Let this problem not threaten life, but it can significantly spoil it. It is in the interests of the parents not to delay the resolution of the issue and to carry out the operation as soon as possible. Recovery will take a lot of time and it is better to teach the child to speak correctly beforeschools so as not to send him to an educational institution that specializes in working with children who have speech disorders.

Traditional surgery

The child's frenulum is cut under the tongue with surgical scissors. This is a matter of one second, but it can have consequences. When an incision is made on a newborn, the tissues grow together quickly and the risk that the scar becomes coarse is minimal. In older children, the procedure is not so painless. The wound may bleed for some time and cause discomfort to the child, although it still heals quickly.

The problem is that after traditional surgery with scissors, a small defect may appear on the bridle, which in the future will have to be solved with the help of plastic surgery. Its essence lies in the fact that the scar is smoothed by cutting it along its entire length, then the correct submucosal flap is formed and the place of the lingual frenulum is transferred to the proper place. The new “construction” is fixed with the help of absorbable sutures. The surgeon must perform the operation very carefully to avoid damage to the excretory ducts of the salivary glands.

Laser cutting

Laser undercutting of the frenulum of the tongue is a more gentle procedure compared to the traditional operation. Notching is done using modern equipment and the latest technologies. The laser allows you to make a more precise cut, after which the risk of bleeding, scarring,bacterial contamination of the wound. The place where the operation was performed heals much better and faster, and the procedure itself is accompanied by less pain. Within two hours after it, the patient can eat, drink and talk, and after two days he does not feel any consequences of the past intervention at all.

Wound healing: how to behave after surgery

Plasty of the frenulum of the tongue with a laser is, in principle, a safe procedure. But after it, you need to follow certain rules. As we have already said, you can’t eat only in the first two hours after the operation, in addition, over the next seven days, you should avoid eating foods that irritate the oral mucosa - s alty, spicy and sour. You should also avoid eating dry and hard foods. After each meal, you will need to rinse your mouth with antiseptic solutions.

Exercise after tongue frenulum surgery

In the future, a person who has undergone a frenulum cutting will have to undergo a rather lengthy rehabilitation. Its essence is to perform a set of exercises that help stretch the frenulum, as well as develop the muscle tissues of the tongue. They need to be carried out daily, for 15-20 minutes, making small pauses for a break.

1. Alternately lifting the protruding tongue up to the nose and down to the chin (20 times), and then to the left and right (also 20 times).
2. Open your mouth wide and, resting your tongue on your upper teeth, press them on your jaw. You need to be in this position for about 10 seconds.
3. Lick your lips with a strongly protruding tongue - first the top,then bottom.
4. With your mouth closed, touch the inside of your cheeks with the tip of your tongue, trying to push as hard as you can.

Such an activity will need to be done even for those who did not have speech problems, and the frenulum of the tongue was cut for other indications. In case of violation of diction, the complex is supplemented with exercises for the development of the speech apparatus. It also improves kinesthesia of the tongue. The bridle, the photo of which is presented above, has already been trimmed. But it needs to be stretched so that a person can still speak correctly.

What is the risk of prolonging the problem?

The operation is best done at an early age. Namely, when problems with diction have already appeared, but there is still time to fix them with the least amount of time and labor. In children, the development of the speech center in the brain closes by the age of five. After that, teaching a child to speak correctly will be an order of magnitude more difficult. Therefore, in order to save both your own and his strength, it is better to do an elementary operation as soon as a specialist has given a referral for it. This will reduce the problems of the child in the future, and will help him quickly and easily adapt to society.