The frenum of the tongue is a piece of mucous tissue that connects the tongue to the lower part of the oral cavity. 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 vice of the frenulum, and then it is short, its base is either further from 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 baby, but sometimes they do not pay due attention to the condition of the frenum. Because of this, in the future, the baby may experience a whole range of problems, starting from the inability to eat normally and ending with serious speech disorders.
What should be the bridle of the tongue in the child, how to determine the presence of pathology and what to do if suspicions of a defect are nevertheless confirmed - all the necessary information in the article.
What it is?
The bridle should be so long that the tongue can move freely in the oral cavity, reach the upper teeth and easily move forward. The difficulty in performing these actions indicates that the person has a short frenum of the tongue. In medicine, this pathology was given the name "ankyloglossia".
A similar problem is encountered by 5% of newborns, an interesting fact is that ankyloglossia is three times more common in men than in women. There are cases when the tongue is almost completely immobilized due to the fact that the mucous fold forming the frenulum is too short. This condition is called "complete ankyloglossia."
If the bridle allows the body to move, but to a limited extent, 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 malformations, the frenum is cut directly into the genus hall. Sometimes a neonatologist may decide not to injure the child, but later they closely monitor him.
At what stage is the pathology diagnosed?
From the foregoing, it becomes clear that the bridle of the tongue in the child is checked immediately after birth. An initial examination is carried out by a pediatrician. You can talk about a serious defect when the tongue is immobilized or, which also sometimes happens, tucked down. This condition threatens the normal development of the baby, because the lack of mobility of the body prevents sucking.
If the problem was not identified immediately, then we can say that the frenum of the tongue is only partially shortened. It may not cause problems or discomfort during swallowing and sucking, but it will manifest itself later when the child is 3-4 years old. At this age, children begin to actively talk. If the baby has obvious problems with diction, parents should pay attention to the pediatrician, who will recommend checking the condition of the bridle or will evaluate its position. Ankyloglossia can be confirmed by a pediatric dentist or speech therapist. According to medical protocols, only a speech therapist or pediatrician can give a direction to an operative intervention involving an incision, the dentist does not make such a decision - he is only the executor of the procedure.
It happens that a short frenulum of the tongue is cut 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 comes only to partial shortening. But even a slightly defective membrane can interfere with the installation of dental implants or prostheses, then the dentist can give an opinion on the incision to an adult and even an elderly person who does not even suspect the existence of such a problem.
Short bridle of tongue and GV
The main danger of a shortened bridle for a newborn is malnutrition due to improper capture of the chest. For this reason, lactation may not work out, because the poor mobility of the tongue and its insufficient development will prevent the newborn from applying normally to the chest and grasping the nipple and areola correctly. For the baby, this is fraught with underweight, problems with the tummy. Mom can develop lactostasis - the child is simply not able to suck out the back milk.
You can understand that a newborn has ankyloglossia by the following signs:
- he cannot take the breast correctly;
- while eating, he constantly throws a nipple;
- milk flows from his mouth.
Moms should pay attention to this during their stay in the maternity ward of the hospital. If problems are detected in a timely manner, doctors will make an incision with minimal consequences for the child. The frenum 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 mucous membrane will be delayed.
Speech problems
Disturbance 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 a lot of letters: "F", "W", "U", "L", "P" and "H". If there are problems with speech, it is probably impossible to fix them with the help of articulation exercises and exercises with a defectologist. Conservative methods will have a visible result only in the case of a mild disorder in the pronunciation of certain sounds.
A speech therapist can help deliver a speech, but if experts recommend an operation, then they can’t cope with the problem solely through methodical exercises. Once again, we note that not always ankyloglossia provokes speech defects. If they are not, the child does not need to cut the frenum of the tongue . Moreover, the operation itself will not make a person's speech intelligible and correct. After the procedure, the patient will have to deal with speech therapists for at least six months.
What to do?
The solution to the problem depends on the severity of the defect. It is possible that you do not have to do anything. But if the patient has one of the following symptoms, it is likely that the frenum must be trimmed:
- difficulty chewing and swallowing food;
- incorrect pronunciation of sounds, fuzzy diction;
- pathology of the bite;
- gum disease and other periodontal tissues.
A short frenulum of the tongue in a newborn is usually cut even without the use of anesthesia; in older children and adults, the area of operation is anesthetized with local drugs.
Is it possible to do without surgical intervention?
Well, if shortening the bridle does not affect the quality of life of the patient. But if there are problems, the operation cannot be avoided. In general, this procedure is very simple to perform, does not require hospitalization or preparation. The presence of acute infectious diseases, oncology, poor blood coagulation, inflammation of the mucous membrane in the oral cavity can be a contraindication. But, in any case, it is impossible to let things go by themselves.
Let this problem not threaten life, but it can significantly spoil it. It is in the interest of the parents not to delay the resolution of the issue and conduct the operation as quickly as possible. Recovery will take a lot of time and it is better to teach the child to speak correctly before school, so as not to send him to an educational institution specializing in working with children who have speech disorders.
Traditional surgery
The bridle of a child under the tongue is cut with the help of surgical scissors. This is a matter of one second, but it can have consequences. When an incision is made to the newborn, the tissues heal quickly and the risk that the scar will be roughened is minimal. In older children, the procedure is not so painless. The wound can bleed for some time and cause the child discomfort, although it still heals quickly.
The problem is that after the traditional operation with the help of 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 is that the scar is smoothed, cutting it along the entire length, then the correct submucosal flap is formed and the lingual bridle is moved to its proper place. A new “structure” is fixed using self-absorbable seams. The surgeon must be very careful about the operation to avoid damage to the excretory ducts of the salivary glands.
Laser cutting
Laser cutting of the frenum of the tongue is a more gentle procedure compared to the traditional operation. Notching is done using modern equipment and the latest technology. The laser allows you to make a more accurate cut, after which the risk of bleeding, scarring, bacterial infection of the wound is reduced. The place where the operation was performed heals an order of magnitude better and faster, and the procedure itself is accompanied by less soreness. Two hours after it, the patient can eat, drink and talk, and two days later he does not feel any consequences of the past intervention.
Wound healing: how to behave after surgery
Laser frenum plastic surgery is basically a safe procedure. But after it you need to follow certain rules. As we already said, you can’t eat only in the first two hours after the operation, in addition, during the next seven days you must avoid eating foods that irritate the oral mucosa - salty, spicy and sour. Also, do not eat dry and solid foods. After each meal, you will need to rinse your mouth with antiseptic solutions.
Exercises after surgery on the frenum of the tongue
In the future, a person who has undergone trimming of the bridle will have to undergo a fairly long rehabilitation. Its essence is to perform a set of exercises that contribute to the stretching of the frenum, as well as the development of muscle tissue of the tongue. They need to be carried out daily, for 15-20 minutes, making small pauses for respite.
- Alternately raising the protruding tongue up to the nose and down to the chin (20 times), and then left and right (also 20 times).
- The mouth is wide open and, resting your tongue on the upper teeth, press them on the jaw. In this position, you need to be about 10 seconds.
- With a very extended tongue, lick the lips - first the upper, then the lower.
- With a closed mouth, touch the tip of the tongue of the cheeks from the inside, trying to put pressure on them as hard as possible.
Such a lesson will need to be done even for those who did not have problems with speech, and the bridle of the tongue was cut according to other indications. In case of impaired diction, the complex is supplemented by exercises for the development of the apparatus of speech. At the same time, kinesthesia of the tongue improves. The bridle, the photo of which is presented above, is already cropped. But it needs to be stretched so that a person can still speak correctly.
What is fraught with delaying the problem?
The operation is best done at an early age. Namely, when the problems with diction have already appeared, but there is still time to fix them with the least expenditure 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 his and his strengths, it is better to perform an elementary operation as soon as a specialist has directed it. This will reduce the problems of the child in the future, and help him to adapt faster and easier in society.