An operation to plastic the frenum of the tongue is a necessary procedure for those who are faced with the problem of a short frenulum or its incorrect location. It is a full-fledged operation, and therefore the need for its implementation should be clearly justified.
The purpose of the frenum of the tongue
The frenum of the tongue is one of the most important elements in the oral cavity. It is a fold of the mucous membrane. The bridle is located from the base of the gums to the middle of the tongue. Often there are cases when the bridle requires surgical intervention. Surgery in many cases is mandatory. Therefore, before revealing the features of such an intervention, it is necessary to say what functions the fold performs and what its defects are fraught with.
The bridle is part of the language, which, despite the fact that it is almost imperceptible, carries a very large functional load. It performs the following functions:
- fixes the tongue in the mouth;
- forms a bite;
- prevents tongue roll-in and dropping;
- determines the purity of sound pronunciation;
- contributes to the normal functioning of the muscles of the face;
- prevents the pathology of glossoptosis in children and adults, which causes the tongue to sink and impair all its functions.
Complications of a defective bridle
A bridle defect leads to serious complications starting at the age of four. During this period, the child forms a pronunciation and actively develops speech. Therefore, from this period there is an active development of complications in people with a short or incorrectly located bridle.
These complications include:
- Problems with the pronunciation of the sounds "l", "r" and hissing.
- Difficulty swallowing.
- The formation of malocclusion.
- Curvature of the smile due to the displacement of the front incisors back.
- Underdevelopment or slower growth of the lower jaw.
- Possible respiratory failure.
- The rapid onset of fatigue of the oral muscles during eating or talking.
- Pulling the gums down, as a result of which the roots of the teeth are exposed and diseases of the teeth and gums appear.
- Difficulty wearing dentures in adults and the elderly due to the aggravation of dental problems over time.
Based on the foregoing, it can be said that an imperceptible at first glance defect can lead to serious health problems and appearance in the future.
Checking the hyoid frenum
One fourth of all cases of anomalies are found in the first days of life, even before discharge from the hospital. The identification of such cases does not require a special examination, since there are difficulties with breastfeeding such children.
According to statistics, an anomaly of the bridle is more common in men than in women, in almost fifteen percent of the world's population. In women, this figure is three times lower.
If the pathology was not noticed in infancy, at an older age it is determined by the following signs:
- In order to at least slightly raise the tongue, children have difficulties.
- The functionality of the tip of the tongue is limited, due to the fact that it is attracted to the lower part of the oral cavity.
- When pulling or raising the tongue, its tip cannot be sharpened (it bisects visually).
- When pushing the tongue forward, its tip bends down.
- It is difficult for a child to lick ice cream and lips, as well as play the flute, trumpet and other wind musical instruments.
A home diagnosis of the problem is also possible. If a child at the request of his parents can easily touch the sky with the tip of his tongue, then there is no pathology. If this is difficult for him, then you need to contact a specialist.
In most cases, diagnosing the problem yourself is difficult, since shortening can be small. Therefore, in the maternity hospital defects are detected by a neonatologist, and in children of kindergarten age - a dentist or speech therapist.
Causes of pathology
Pathology can be hereditary, congenital or obtained as a result of external exposure to the fetus during pregnancy.
If the problem is hereditary, then it should have been with the mother, father or other close relatives. Congenital deformity of the mouth is also possible. For example, the presence of a split sky that has formed due to changes in the X chromosome.
A problem may also arise due to the mother. For instance:
- transfer of serious infectious or viral diseases during pregnancy;
- maternal alcohol abuse during early pregnancy;
- late pregnancy;
- a mother gets an abdominal injury during pregnancy, it can be, for example, a bruise or a fall;
- adverse environmental situation.
Types of pathology
Pathology can manifest itself in the improper attachment of the frenulum (ankyloglossia) or its small size (dysarthria).
With ankyloglossia, the fold is located non-physiologically, that is, its upper tip is attached very close to the lingual tip. Moreover, the size of the bridle may be standard.
With dysarthria, the size of the frenum is less than the prescribed 2.7-3 centimeters. Depending on the size of the fold, there are three degrees of dysarthria:
- Easy (if the fold length is more than one and a half centimeters) - a defect causing problems with pronunciation of sounds. A speech therapist can correct such deviations by stretching the folds.
- Medium (if the fold length is less than one and a half centimeters) - a defect corrected by speech therapy. If she was unsuccessful, then plastic surgery of the frenum of the tongue in children is performed.
- Severe (if the fold length varies from five to ten millimeters) is a defect that can only be corrected by surgery with postoperative speech therapy.
The effects of short folds in infants
Before speaking, in which cases plastic surgery of the frenum of the tongue is done, a number of points should be noted. Violation of the normal functioning of the tongue leads to the formation of a malocclusion and a delay in jaw development. The moderate and severe degree of pathology is detected from infancy.
With ankyloglossia, problems arise with the organization of breastfeeding. Due to a serious deviation, the children are malnourished due to the fact that they quickly get tired. Because of this, the feeding process is delayed.
In this regard, babies have problems during breastfeeding:
- Underweight due to malnutrition. Due to rapid fatigue, the baby refuses mother's milk without being full.
- Problems with adjoining the mother’s breast, which entails possible damage to the maternal nipples.
These problems are associated with the fact that when breastfeeding, the baby should use the tongue to help the flow of milk from the mammary gland to the nipple. With a short bridle, such movement is difficult to carry out. Therefore, it is easier for such babies to take food from a bottle. After it was transferred to solid food, the discomfort in most cases disappears.
Indications for frenum plastic
In most cases, children eventually get used to the fact that their language does not fully function. In addition, very often the fold stretches with age and becomes a normal size. Therefore, if the child has revealed defects of the frenulum, you can wait some time for an independent correction of the pathology. If changes do not occur, you must consult a specialist and have plastic surgery of the frenum of the tongue.
It is important for parents to understand that, even if the child does not feel severe discomfort, the folding pathology can cause some problems during the process of growing up. Therefore, plastic frenulum of the tongue in children should be done.
Indications for the operation to restore the functioning of the bridle in full by age are as follows:
- for newborns - with problems with sucking;
- for preschoolers - in the presence of difficulties with diction and pronunciation;
- for preschoolers and schoolchildren - with a slowdown in the growth of the lower part of the jaw, which can cause the incisors to roll inward;
- for people of different ages - if necessary, wearing braces and other similar designs;
- for adults - if it is necessary to install prostheses, because due to the pathology of the fold, removable dentures can fly off the lower part of the jaw;
- for adults and the elderly - at the preparatory stage of prosthetics with implants, since in the wrong position of the fold, reimplantitis can develop.
Contraindications for plastic frenum of the tongue
There are cases when surgical intervention is strictly prohibited. Such cases include:
- the presence of cancer;
- clotting problems;
- the presence of infectious diseases;
- mucosal inflammation;
- the presence of untreated teeth and pulpitis.
In relation to minors, contraindications are the lack of parental consent and the absence of a speech therapist's opinion. A speech therapist and a dentist-surgeon jointly determine the possibility of stretching the bridle without surgery, using speech therapy massage. In addition, a speech therapist determines the ratio of benefits and risks of surgical intervention. For various disorders of speech development (general speech underdevelopment, dysarthria, or delayed psychomotor development), plastic frenum of the tongue in children can lead to a worsening of the speech therapies defect.
Age restrictions
If the pathology of the fold was detected even in the maternity hospital due to problems with the baby's nutrition, plastic frenulum is best done right away. In newborns, surgery involves dissecting the frenum.
As for older children, the opinions of doctors are divided. Some say that plastic surgery must be done immediately upon detection, while a scar may appear in a dissected area, requiring further new surgical intervention. According to other reviews of plastic frenum of the tongue, the operation should be performed after the child reaches the age of four years, if there are obvious speech problems. In this case, a speech therapist after the operation will have to visit in any case to restore speech skills in full.
For adults, there are no age restrictions. Tongue frenum surgery in adults can be done at any time.
Surgical Options
Types of surgical intervention, as well as reviews of plastic frenum of the tongue in adults and children, are different.
You can correct the bridle with one of the following types of operations:
- frenotomy;
- phrenectomy or frenuloplasty;
- laser method.
Frenotomy is used to dissect folds in infants. In newborns, the bridle lacks blood vessels, so the tissue on it is whitish. In this regard, during the operation, neither suturing nor anesthesia is used. The dissection of the fold is performed by surgical special scissors. If there is slight bleeding after surgery, it stops if you attach the baby to the chest.
Plastic surgery of the bridle in older children is called phrenectomy. Since the blood vessels in the fold are already formed, the operation is performed under anesthesia with suturing. There are several types of equipment:
- frenum cutting;
- bridle removal;
- change of the place of fastening.
When a fold is cut, its dissection is carried out, and then its lateral edges are sutured, while capturing deep tissue.
When using traditional technology, the mucous fold is cut, a submucosal flap is formed, and then the bridle is attached. Then there is a suturing.
According to reviews, plastic frenum of the tongue with a laser is the most sparing method of operation. This type of surgical intervention has several advantages:
- the operation is carried out within five to six minutes;
- pain is absent;
- bleeding after surgery is excluded;
- you can easily predict the results of the operation;
- comfortable conditions;
- lack of a stitching stage;
- fast recovery;
- accuracy of the procedure;
- protection against bacteria and germs entering the wound.
With laser plastic surgery of the frenulum of the tongue, the specialist first places a swab soaked in anesthetic composition under the patient's tongue and makes an anesthetic injection. Then, to dissect the fold, he directs the tip of the laser device to the bridle. The device forms a laser that dissolves the crease. After the operation, medications are applied to the wound, which accelerate the healing process. The rehabilitation period after such a procedure is about two days. Laser surgery is the fastest and most convenient method of operation.
In order to avoid complications after surgery, several postoperative recommendations must be observed:
- Two hours after plastic surgery of the bridle, you can not eat.
- Within a few days after the operation, products that can irritate the wound site (acute, sour, hard, salty) should be excluded from the diet.
- Avoid excessive tension of the vocal cords and vocal apparatus for some time.
- About a crescent, take special care of the oral cavity and rinse your mouth with antiseptic agents.
- Perform special language exercises prescribed by your doctor.
Subject to all these requirements, the fact of surgery will not subsequently cause any inconvenience.
Reviews about the procedure for plastic frenulum are various. Most of the parents of the operated children and adults themselves respond positively to the procedure itself. Another issue is the negligent attitude of the personnel of the dental treatment institution where the operation was performed. Opinions differ here. Moreover, if the staff treated the procedure in good faith, then problems in the future, judging by the reviews, do not arise.
Prices for surgery to trim or transfer the bridle also vary widely. They range from five hundred to seven thousand rubles, depending on the clinic and the technique of the procedure.
You can find many photos of plastic frenulum, especially with a laser. Therefore, if a similar problem arose, do not pull. You need to contact a specialist immediately until you have to deal with the consequences of inaction.