Frenum under the tongue. What are the consequences of ignoring the problem? Causes of short frenulum of the tongue in children

Such anatomical formations are the thinnest folds of the mucous membrane that connect the mobile lips and tongue with the fixed parts of the oral cavity: the gums and the sublingual space.

In total, there are three frenulums in the baby’s mouth:

Tongue - located under the tongue.
Upper lip - localized between the upper lip and the gum mucosa above the level of the central incisors.
Lower lip - connects the inner surface of the lower lip with the gums at the level of the middle of the alveolar process on the lower jaw.

Despite their small size, such mucous folds are of great importance in human life. In a newborn, they are responsible for proper attachment to the mother's nipple. In older children, the frenulum is involved in the correct pronunciation of sounds and in the formation of a normal bite.

In the photo: a short frenulum of the tongue in a child

Short frenulum and why it is dangerous

Shortening of the frenulum is understood as a decrease in its absolute length or its incorrect location, which makes it relatively short (i.e., the length remains normal, but its incorrect localization causes all the symptoms characteristic of shortening).

A short frenulum of the upper or lower lip in a baby can negatively affect the process of breastfeeding. In this case, the child cannot correctly position the nipple in the oral cavity and create a sufficient vacuum necessary for sucking and swallowing. Therefore, in order to get enough, the baby has to make significant efforts. The baby quickly gets tired and stops breastfeeding without being properly satisfied. Such children behave restlessly, require frequent breastfeeding, but do not gain weight well.

In children over 3 years old, a shortened upper frenulum can cause an increase in the interdental spaces between the upper incisors and their advancement sharply anteriorly. A short lower labial frenulum sometimes causes malocclusion.

Also, a decrease in size or incorrect location of any of them can have an extremely negative impact on speech function. Children 2 years of age who have not had this pathology diagnosed or corrected in time often do not pronounce individual sounds. Such speech defects are difficult to correct.

How to check a child's frenulum?

A shortened frenulum between the lip and gum is diagnosed quite simply even in infants. To do this, you need to carefully pull back the child’s lips and see how pronounced the fold of the mucous membrane is and where it is attached. If it is short, then it will have a thick appearance and its attachment point will be at the very base of the incisors.

The hyoid frenulum normally has a length of at least 8 mm and is attached approximately halfway between the root and tip of the tongue. A small frenulum usually looks like a fold on the mucous membrane, attached along its entire length to the tongue or sublingual space.

In the photo: a short frenulum of the upper lip in a newborn

How to stretch

It is necessary to immediately make a reservation that, due to anatomical features, only the frenulum under the tongue can be stretched without surgery. This technique is usually taught by a speech therapist and is effective only if all recommendations are carefully followed over the course of several months.

Before performing any exercises, it is recommended to do a special massage to stretch the soft tissues. To do this, you need to carefully take your tongue by the very tip and with gentle movements move it upward, then to the sides and pull it forward a little. Gentle stroking from bottom to top along the frenulum using the thumb and index finger has a good effect.

The exercises themselves are performed sequentially twice a day:

Relax your tongue as much as possible and place it on your lower lip. Hold for 10 seconds in 3 sets.
Stick your tongue out of your mouth as far as possible. Fix in this position for 10 seconds. Repeat 3 times.
Extend your tongue and circle your lips with it.
Click your tongue for 10 seconds, imitating the clatter of horse hooves.
Open your mouth wide. Slowly run the tip of your tongue across the roof of your mouth, moving from your teeth to your throat.
Place your tongue on the roof of your mouth just behind your teeth. Holding it in this position, open your mouth as wide as possible.

Such fairly simple exercises help both stretch the frenulum on the tongue and correct some speech defects.

Surgical correction

If a short frenulum is detected in the maternity hospital, then its trimming is carried out immediately. This is done so that the baby can properly take the nipple and eat properly. If shortening is diagnosed at an older age and is not corrected by speech therapy techniques, then three options for surgical treatment are possible:

Frenotomy is cutting to increase its length.
Frenectomy is a circumcision when it is almost completely excised.
Frenuloplasty is a plastic surgery during which the place of its attachment in the mouth is changed.

In the photo: a child’s tongue frenulum after laser surgery

Despite the fact that frenulum surgery itself is quite common, most parents have a lot of questions about this procedure. We will consider the main ones below.

Why trim?

A too small size of such a fold of the mucous membrane can cause difficulty sucking at the breast in infants, and problems with the pronunciation of certain sounds and with the arrangement of teeth in the permanent dentition in older children. To avoid such problems, pruning is required.

Do I need to prune?

Most doctors, including the famous Dr. Komarovsky, are of the opinion that a short frenulum should be trimmed if it adversely affects the child’s ability to suck milk or pronounce certain sounds.

When a short frenulum does not negatively affect the processes of sound production and bite formation, then in such cases surgical intervention is not required.

What kind of doctor cuts?

Typically, frenulum correction operations are the responsibility of a dentist.

At what age is it best to have surgery?

When the frenulum should be trimmed is decided individually for each child. If we are talking about a fold on the upper lip, then correction is done no earlier than 6 years. Typically, the operation is performed only after the eruption of the permanent upper incisors. If correction is required on the lower lip, this is done more often after the 4th year of life.

In most cases, the hyoid frenulum is cut before 1 year of age (most often this is done in the maternity hospital). But correction is possible at any age.

How do they prune?

The frenulum trimming operation is performed on an outpatient basis in the surgical office of a dental clinic. The doctor carefully stretches the fold of the mucous membrane and makes a small incision with a sharp scalpel. After that, small sutures made of threads are applied to the edges, which after some time dissolve on their own and do not need to be removed.

A more modern technique is laser dissection, which eliminates the need for stitches, which speeds up the child’s recovery process.

Does it hurt to prune?

The dissection procedure is performed under local anesthesia, which eliminates the possibility of any pain.

What to do if a child breaks the frenulum

Children at any age are quite active and mobile. Therefore, injuries are inevitable. Quite often, parents turn to the dentist with the following problem: the baby fell unsuccessfully and tore the frenulum above the upper lip or under the tongue. At the same time, damage to the lower lip is extremely rare due to the fact that normally it is almost not expressed.

If a child cuts the frenulum, then the following signs will be characteristic of such an injury:

Swelling of the soft tissues in the mouth and above the lip (if the child has torn the upper lip).
Quite profuse bleeding.
Pain in the mouth when talking or eating.

In any case, if the baby has torn the mucous fold under the upper lip or under the tongue, you should immediately consult a doctor. It is he who will decide whether such a gap needs to be sutured and will carry out the necessary procedures. Self-treatment can lead to negative consequences: the tissues will not heal properly with the formation of rough scars, which will subsequently lead to an incorrect bite and unclear pronunciation of sounds.

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Short frenulum in newborns

When a baby is breastfed, the tongue plays an important role in this process. It helps your baby retract the nipple into the correct position to collect milk before swallowing. And if the frenulum is short, then problems arise during breastfeeding:

When sucking, it is very difficult for a baby to hold the nipple in his mouth for a long time, because he takes it incorrectly.
it is difficult for him to draw milk, and he bites the nipples, thereby provoking the appearance of cracks;
when feeding, he swallows air with milk and this causes colic and frequent regurgitation;
Incorrect sucking leads to prolonged feeding. The main indication for cutting the frenulum in a small child is insufficient weight gain.

Why and when do you need to trim the frenulum of the tongue?

The tip of a baby’s tongue at the age of eighteen months should be at least sixteen centimeters. If you see that the baby cannot lick his lips with his tongue, cannot raise his tongue to the palate or run along the gums, then this means that the frenulum is not long enough and does not have flexibility.

At preschool age, a speech therapist or dentist discovers a short frenulum due to an incorrect bite, dental problems, or a speech defect. It is recommended to trim the frenulum at the age of five to nine years, before the complete replacement of baby teeth, if there is an indication for this. But the operation can be done earlier and only for medical reasons and with a referral from a doctor.

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Difficulties associated with a short frenulum

Every person has a frenulum in their mouth. In appearance, these are thin folds of the mucous membrane that connect the moving parts of the oral cavity (lips and tongue) with the fixed ones (gums and the space under the tongue). There are three of them in total: one is located directly under the tongue, the other two are connected to the upper and lower lips, respectively.

When they talk about a shortened frenulum, they mean either its short length or its incorrect location (the length is normal, but locally it is attached in such a way that it keeps the tongue “on a short leash”). In medicine, the defect is called ankyloglossia or congenital pathology of the cord.

The first difficulty is that the correct process of grasping and sucking the breast is disrupted. After all, normally, when latching onto the breast, the baby’s mouth is wide open, so that the lower lip turns outward, and the tongue itself is located on the gum of the lower jaw. As a result, the nipple areola is completely captured, the necessary vacuum is created, and the tongue begins to work.

A short frenulum does not allow the nipple to be properly grasped, and the baby quickly gets tired while eating. By giving up the breast prematurely, he does not receive adequate nutrition, gains weight worse, is restless during feeding and requires frequent feeding.

Staying at the breast for too long and weight loss indicate that you need to consult not only a breastfeeding specialist, but also a pediatric dentist

Another problem becomes obvious closer to the age of 2, when the child begins to have speech disorders. The baby cannot pronounce individual sounds and has to work hard to eliminate such defects. A shortened frenulum of the lower lip provokes the formation of an incorrect bite.

Causes and symptoms

A short fold is formed during intrauterine development in the presence of pregnancy pathologies. However, most often its small size is explained by genetic predisposition. That is, when close relatives had similar problems, the likelihood of a frenulum correction in the heir increases.

Symptoms that may indicate that something is wrong with the sublingual fold are the following:

the child “hangs” at the breast for more than 30 minutes, but does not eat enough;
does not gain weight well;
the baby smacks his lips while eating, bites the nipple with his gums, or cannot hold it in his mouth for a long time;
often burps, he is tormented by flatulence (a consequence of air ingress);
milk stagnates in the breast.

At an older age, ankyloglossia causes the following problems:

speech defects;
formation of malocclusion;
early onset of caries (in case of frenulum defect above the upper or lower lip);
formation of crooked teeth;
excessive drooling;
difficulty sleeping, sleep apnea.

Diagnostics

The hyoid frenulum is easy to check. Normally, it is attached somewhere in the middle between the root and the tip of the tongue, and its length is at least 8 mm. Professor Alison Haselbaker has developed a special test that takes into account the ability of the tongue to stretch forward, rise to the upper palate, turn in different directions, evaluate the sucking reflex, how elastic the frenulum is, etc.

Based on specially designed tests, the doctor determines whether there is ankyloglossia

Visually, with ankyloglossia, the tongue takes on a heart shape due to a fold pulling from below. This is clearly visible when crying. If you stick your tongue out to your baby, he won't be able to copy you and do the same.

Trim or stretch?

If the defect under discussion is diagnosed, there are two ways to eliminate it:

try to stretch the frenulum with the help of special exercises;
trim it.

To be fair, it should be said that you can do without surgical intervention and try to stretch only the hyoid frenulum, provided that the child is already able to independently perform the necessary exercises under the supervision of an adult. The stretching technique is usually taught by a speech therapist, and the exercises are done at least twice a day for several months.

A child with ankyloglossia will not be able to do this.

However, such procedures are not suitable for a newborn. And if we are talking about the possibility of further normal breastfeeding, it is better to agree to trimming. As we will see later, such an operation does not have any negative consequences for health.

When to prune?

How do you know when is the best time to trim your bridle? If the problem was noticed immediately after birth, pruning will be offered right in the maternity hospital in order to forget about further unpleasant consequences once and for all.

If the child is more than 9 months old, it means that there are no difficulties with feeding, and the frenulum does not bring any particular inconvenience. Therefore, it makes sense to wait until the child speaks. Perhaps the tongue frenulum will not affect the baby's speech ability in any way, or it will stretch. In principle, correction with surgery can be performed at any age. Only the older the patient, the greater the likelihood that it will be necessary to use anesthesia (though in the vast majority of cases, local) and stitches.

In addition, at school age, when a speech therapist or orthodontist refers you to a surgeon for trimming, the operation will “free” the tongue only mechanically, but you still have to learn how to use it correctly. An operation at 6 years of age does not guarantee that the child will stop lisp, since pronunciation skills have already been firmly formed. Correcting crooked teeth will also take time.

As for trimming the folds on the lower lip, it is recommended to do it from the age of 4, and on the upper lip - not earlier than reaching the age of 6. In most cases, the tongue frenulum is trimmed in infants under one year of age.

How does pruning happen?

The operation to cut the frenulum of the tongue is called frenotomy. It is performed by a pediatric surgeon or dental surgeon. The child's face is fixed, after which the cutting is carried out with special scissors or a laser. In infancy, the procedure is painless, since the nerve endings in the mucous gum tissue have not yet formed. After the frenulum has been cut, it is recommended to immediately attach the baby to the breast.

Even if the baby cries, know: it’s not because he’s in pain. It’s just that no one likes it when for some reason they hold their face tightly and go into their mouth, and even under the light of a lamp. The procedure itself lasts a matter of seconds - nothing compared to the relief that the baby then experiences.

The bridle is trimmed quickly. Anesthesia is either not used at all, or is used locally in the form of an aerosol or injection

There are two more methods of surgical treatment:

frenectomy - when the frenulum is excised almost completely;
frenuloplasty is an operation that changes the location of the fold in the oral cavity.

No special postoperative care is required. The blood vessels are still located deep, so a few drops of blood are all the consequences. However, over the next week, scar formation occurs, and the tongue must move to avoid re-fusion. The doctor will show you special exercises to promote it.

If the child breaks the frenulum

Little fidgets are often in search of adventures, sometimes unsafe. What should you do if your baby falls and cuts the frenulum in his mouth? Of course, you should immediately seek medical help, especially in cases where there is constant bleeding, it is painful for the child to talk or eat, or the soft tissues in the oral cavity are swollen.

The doctor will decide whether the tear needs to be stitched and tell you how to care for the wound. Do not try to treat the baby yourself. If the fusion is improper, rough scars are formed, which negatively affects the formation of bite and articulation.

Summarize. A tongue frenulum that is too short directly affects the child’s quality of life. Whether to trim it or not is up to you, dear parents. Just do not reject the opinions of doctors on this matter. After all, sometimes you need to make small sacrifices in order to save your baby from physical and emotional problems associated with speech defects in the future.

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Home » Child upbringing and development » Trimming a child’s frenulum: is it really necessary?

In V. Dahl’s dictionary we read: “A bridle is a leash, a link, a hitch, a bridle or a bundle. The hyoid frenulum is a fused membrane...” Our tongue, like a horse, needs a device that helps it move in the right direction at one speed or another. Then speech flows smoothly and clearly. Each of the three frenulums in a child’s mouth is responsible for both the purity of sounds and the beauty of the face.

Before you start searching for all three frenulums in your child's mouth, clean up your own hands: trim your nails, thoroughly wash and wipe each finger with alcohol. In addition, the examination must be carried out correctly so as not to scare the baby! Start your “search” with these words: “I wonder what’s hiding in that pretty little mouth?” Gently pull and lift the baby's upper lip towards the nose. Your eyes will appear frenulum of the upper lip .

It is shaped like a triangle. Its two sides (“legs”) are attached. One - to the inner surface of the lip from the oral cavity. The second is to the gum above the incisors. The charm of a smile largely depends on how this last one connects to the gum. Normally, the lower edge of the connection should be several millimeters above the base of the gingival papilla. If the fastening is located low, almost at the junction of the incisors, problems arise. They are aggravated if the frenulum itself is dense and massive. In this case, its ridge is intertwined and grows into the gingival papilla located between the upper incisors.

This feature significantly limits the mobility of the upper lip. It looks upturned and exposes the upper teeth. Often the mouth is slightly open: the lips cannot close. The child’s face takes on a “squirrel” expression. Moreover, short and tight frenulum in a child's upper lip prevents the growing upper incisors from closing. A gap (diastema) appears. As milk teeth erupt, sometimes it not only does not decrease, but, on the contrary, increases, “spreads”. Permanent teeth often take over this defect. In the old days, the grandmother-neighbor said about the young owner of such a “gap” in the teeth: “He will be lying!”, and an adult was called gap-toothed.

Upper lip frenulum in a child

Modern parents are concerned not so much about the possible talkativeness of their own offspring as about the cosmetic defect of the child’s dentition. In a slight panic, they rush to the dentist and ask to cut the frenulum, believing that then the gap will close. I would not like to upset some overly hasty parents, but such an operation is not performed at the stage of milk teeth. You will have to wait until the permanent upper incisors erupt. However, even then, it would first be advisable to take a picture of the upper jaw (with the rudiments of permanent teeth), and only then, together with the orthodontist, decide whether there is any point in the surgical operation.

The persistence of individual parents knows no bounds... And under the pressure of their requests and tears, dentists sometimes decide trim the frenulum of the upper lip in a child and with milk bite. This leads to the fact that the permanent incisors, when born, begin to overlap each other, and after them, all the other teeth in the upper row grow at random. How can one not remember the saying: “Haste is only needed when catching fleas”! In addition, if the operation on the upper frenulum is performed prematurely, the upper jaw arch can form narrow, and this threatens progeny (bite defect, when the lower jaw moves forward, the upper jaw is small or underdeveloped, and when the jaws are closed, the lower teeth overlap the upper ones). Need I say what problems a child may have with such a bite? This is a defective pronunciation of all whistling, hissing sounds and, of course, the sounds [L’], [L], [R’], [R].

Small injury, big problems. Children very often injure the frenulum of the upper lip, resulting in its rupture. In this case, you should immediately contact your dentist. He will treat the wound (and if necessary, apply stitches) and give a prognosis regarding the further formation of teeth. You may also need an x-ray (if the injury is severe, the rudiments of permanent teeth are injured). A doctor’s help is also necessary because with “spontaneous” healing of the wound (without surgical treatment), the edges of the frenulum may grow together asymmetrically with respect to the central incisors, or a rough scar may appear, limiting the mobility of the upper lip. What could this lead to? As you yourself may have guessed, this leads to defective pronunciation of sounds.

Frenum of the lower lip in a child

Having admired the frenulum of the upper lip, let's move on to the lower lip. Gently pull back the baby's lower lip. Was this easy to do? So everything is fine! Normally, if a child has a frenulum of the lower lip, it is a barely noticeable film.

It is located deep in the hollow between the gum and lip (on the inside), approximately at the level of the gingival papilla of the central lower teeth. But this frenulum should not be attached to the gingival papilla itself! If you see something massive and dense, attached on one side almost to the red border of the lips, and on the other to the gingival papilla of the central lower teeth, you should be concerned. Of course, there is nothing dangerous in this! It’s just that such a frenulum “keeps in check” the baby’s lower lip. That is why he speaks reluctantly, and the sounds are not quite correct...

Tongue frenulum in a child

Everyone knows the third frenulum - the sublingual frenulum, but it is not so easy to see it in the baby’s mouth. Don't even try to grab your tongue and lift it! The child is unlikely to tolerate this. In addition, you can seriously injure the mucous membrane of the tongue. The baby himself must demonstrate the hyoid frenulum, and voluntarily. And you use little tricks.

Open your mouth wide and pull the tip of your tongue towards the roof of your mouth. Then say: “My tongue rises high, high! And you?" Take a moment to examine the baby's hyoid frenulum.

Compete to see who can click their tongue loudest. We open our mouth wide and press our tongue firmly to the roof of our mouth. For a short moment, the child’s hyoid frenulum will appear in all its glory. But it quickly ends, and the tongue leaves the palate with a resounding click.
Ask your child with a sly look: “Is there a mushroom growing in your mouth? And it’s growing for me!” Show your baby the wonders of articulation by sucking your tongue to the roof of your mouth and holding it there for a while. Then, without wasting time, suggest: “Let’s grow a fungus in your mouth.” Sit together in front of a mirror and “sculpt” a fungus from your tongue. The child will not be able to do this right away. But when the fungus finally “grows”, slowly examine its leg - that very coveted frenulum.

Have you seen a film that absolutely does not interfere with the rise of your tongue? Great! However, various deviations from the norm are also possible.

The frenulum is thin, almost transparent, but prevents the tongue from rising.
The bridle is thin. Its front edge is attached close to the tip of the tongue (when the tongue rises upward, the tip bifurcates into a “heart”).
The bridle resembles a dense short cord. When you try to stick your tongue out of your mouth, its tip curls up and the back of the tongue “bulges out.”
A dense short cord of the frenulum is tightly fused with the muscles of the tongue. All movements of the tongue are sharply limited.
The tongue seems to have fused with the bottom of the mouth. With such a language it’s not only impossible to speak, it’s impossible to eat...

In this case trimming the frenulum of the tongue in children could be a way out.

Should a child's tongue frenulum be trimmed?

Oh, how parents don’t like to listen to arguments in favor of surgery on the child’s hyoid frenulum. Believe me, speech therapists are dragging their feet until the very end with its dissection. But there are cases when surgery is necessary. In the first, second and third options, only the frenulum will be dissected. In the fourth and fifth cases, the intervention is more complex, sometimes under general anesthesia. I know that parents will talk about mental trauma, stress, etc. I will not argue, but will only list the main consequences of our inaction.

Formation of malocclusion: progenia, oblique bite, anterior open bite, lateral open bite.
Incorrect formation of the velopharyngeal ring: the child’s voice will take on a nasal tone.
Violation of physiological and speech breathing; formation of persistent mouth breathing: endless colds.
Quiet “fading” voice, inexpressive speech.
Poor posture: stooping and curvature of the spine.
Complex dyslalia (numerous disturbances in sound pronunciation or disturbances in sound pronunciation across all phonetic groups). If you do decide to have surgery, be sure to visit a speech therapist, pediatrician, and oral surgeon. The latter gives directions for a clinical blood test with hemosyndrome and a clinical urine test.

After the operation, the child must undergo a rehabilitation course with a speech therapist (classes on stretching the muscles of the tongue and hyoid frenulum). All this equally applies to operations on the frenulum of the upper and lower lips: the same doctor visits, tests and stretching exercises.

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In the oral cavity, under the tongue, each person has a fold of mucous membrane that connects the lower part of the tongue with the bottom of the cavity. It holds the tongue in the desired position near the lower dentition and is elastic. With its help, the tongue is controlled, as well as swallowing, eating, etc. In appearance, it appears as a thin fold, but some children experience pathological disorders, such as an incorrect placement of the fold or it is small in size. To correct it, the frenulum under the tongue in children is trimmed. Otherwise, the tongue moves in the oral cavity with obstacles.

Determining the causes of incorrect frenulum formation

There are situations when the frenulum may be thicker than usual, which also creates certain difficulties for the child. Recently, parents have been faced with such problems quite often, and if this is not detected in infancy, then with the baby’s first words they begin to manifest themselves noticeably. Pathologies are divided into congenital and hereditary, and the concepts have certain differences.

The problem of a short frenulum in medical terminology is called “ankyglossia” (curved tongue) and is very common nowadays. The main reasons include heredity, and a greater percentage of the phenomenon is observed in boys.

Moreover, not only parents could have a short frenulum, but also close relatives, which determines the genetic disposition. Other causes of the problem include various pathologies of intrauterine development of the fetus, poor environmental conditions, and bad habits of the mother during pregnancy. It is also observed in children at birth with other problems, in particular deformation of the skull and facial part of the head. The picture of a short frenulum is expressed in such manifestations as:

the tip of the tongue does not extend beyond the oral cavity due to rigid fixation;
when pulled out, the tongue forms an arc;
bifurcation of the tip during lifting of the tongue with the formation of a heart;
sounds of clicking and clattering when folding.

Why trim a child's tongue frenulum?

Starting from infancy, tongue frenulum trimming in children is performed for many reasons. Infants need this for proper breastfeeding and further normal development. If a problem is detected during feeding, then difficulties in absorbing milk and biting the nipple are likely, which leads to the appearance of cracks and wounds. The baby swallows a large amount of air, resulting in frequent belching and colic.

When the procedure for cutting the frenulum of the tongue in children was not carried out in the maternity hospital, or after a lapse of time, the dense, short strip cannot be stretched in the future.

If the frenulum is not formed correctly, the child may experience problems in speech therapy development

Over time, problems arise in speech therapy development, such as failure to pronounce sounds, even words, burr, lisp and other unpleasant speech defects appear. Disorders also occur in the oral cavity and other organs. The growth and development of the jaws slows down and a malocclusion develops. In one embodiment, the dentition may intersect at several points, similar to a checkerboard pattern. Also characteristic is the lack of closure of the front teeth; the central teeth of the lower row are turned inward. Food is chewed poorly, air often enters the esophagus, which provokes bloating, colic, and gas formation. Snoring and sleep apnea also appear.

Trimming the frenulum of the tongue in children at any age

Before the operation, the child's blood is taken for analysis. It displays various indicators, including platelet count, clotting rate.

The operation of cutting the frenulum of the tongue in children at the age of infancy can be performed immediately after birth in the maternity hospital or in dentistry. In terms of time, the procedure is carried out quickly, without blood loss, since the child has not yet developed blood vessels and weak nerve endings. There is no anesthesia, and the operation is performed with special scissors. The doctor makes a small transverse incision in the area of the frenulum. The baby is often soothed by applying it to the mother's breast.

Under the age of five, children are given local anesthesia due to the presence of pain; otherwise, the operation is similar to that performed on infants. As the healing process progresses, in some cases it is necessary to undergo treatment with an orthodontist to correct the bite.

Plastic frenulum of the tongue

Parents who have not done the procedure for eliminating a short frenulum in a timely manner often wonder how to trim the frenulum of the tongue in a school-age child or teenager. For older children, frenuloplasty is performed - an operation that is performed using local anesthesia and suturing. The procedure can be performed in several ways with material that has absorbable properties:

removal is carried out by triangular incisions at the bottom and top, the resulting wound is stitched with threads;
moving the fastener, namely, the surgeon makes cuts that help move the tissue strip, and with the help of sutures reduces the distance between the edges of the wound with sewing the strip;
dissection, in which the fold is cut, and its edges are pulled together from the side with sutures.

Laser surgery

Modern medicine has a large number of new technologies and special equipment. Thus, ordinary scissors and a scalpel can be replaced with a more gentle method of performing the operation, such as using a laser that can trim and simultaneously vaporize tissue areas.

Carrying out the operation in this way eliminates the need for stitches, since the wound is closed at the same time.

The laser is great for preschool children. Often in modern clinics, children are shown cartoons during surgery, during which anesthetic drugs are applied, and glasses are subsequently put on to protect the eyes. Specialists involve the child in an exciting game, which makes the procedure less painful and calmer. Laser surgery has a number of advantages, such as:

Laser frenulum removal

absence of blood when cutting tissue;
the action of the laser promotes coagulation of blood vessels (baking);
the edges of the incisions are sterilized with their simultaneous application;
there are no seams;
rapid healing after surgery;
reduced risks of complications;
easy procedure.

Contraindications

The procedure has virtually no contraindications. But experts recommend not to perform or postpone the operation for a while if there are health problems, such as:

damage to teeth by caries;
infectious diseases;
low blood clotting;
oncological diseases of the oral cavity;
pulpitis, osteomyelitis and other diseases that should be discussed with a doctor.

Are there any complications after surgery?

The trimming procedure is carried out without consequences, which is determined by the simplicity of the structure of the bridle. But complications are possible after the procedure and often arise due to non-compliance with oral hygiene and the prescribed rehabilitation regime. In damaged areas, inflammation and pain may develop.

During the recovery period, it is important to strictly follow the rules of procedures and the diet prescribed by the doctor.

One of the most common problems in children and adolescents can be the formation of a visible and hard scar. In this case, a repeat operation is required. Poor quality surgery can happen very rarely, and this is associated with injuries to the gums and oral mucosa. Normal healing after a successful operation lasts several days, and to shorten the time, you should follow a few simple rules, such as:

Normal healing after successful surgery lasts several days.

refusal of hot drinks and food;
regular compliance with oral hygiene procedures;
avoid frequent conversations;
perform tongue exercises to reduce postoperative scars;
To correct your diction, visit a speech therapist several times.

Complications are possible in children with a thick frenulum after surgery, such as stomatitis, bleeding, infection, which is practically excluded in modern dental centers. It is important to give children and adults pureed food after the procedure to make chewing easier.

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Operation description

Frenum cutting is always performed in a hospital. For pain relief, local anesthesia is used, during which the doctor can calmly talk to the baby. The duration of the operation most often is up to half an hour.

There are three different types of mucosal fold surgery:

Dissection - used when the frenulum is excessively narrow and does not connect with the edge of the alveoli in any way. With the help of competent manipulations, the doctor can cut it across, making almost invisible longitudinal sutures.
Excision - on the contrary, there is a very wide frenulum. The surgeon should make an incision that will slightly touch the top of the stretched mucosa, and then excise the papilla between the teeth, and with it the tissue that is located between the roots of the incisors.
Ordinary frenuloplasty is the name of the method during which the attachment site of the mucous fold is changed.

Such operations are most often carried out when four incisors are completely cut through. After the correction is completed, sutures are carefully applied. They are made from a special material that will later dissolve on its own. The main feature of the operation is that the recovery process will only take a couple of hours.

If the operation was performed on a small infant, the result will be noticeable immediately - the baby will babble and coo more clearly, and will suck the breast more correctly.

The use of innovative methods will help to avoid even minor complications, for example, severe swelling. The child will only need to follow proper rehabilitation.

Trimming the frenulum of the upper lip using a laser

Laser cutting will help avoid hemorrhage during the operation, since the heated rays simply “seal” the vessels that are excised. Anesthesia in this position means the application of a special gel with a strong cooling effect, which is felt instantly.

After this technique there is no swelling, pain or scar, and the procedure itself takes from 5 to 10 minutes. In addition, laser beams under the influence of high temperature completely disinfect the wound, and this helps it quickly recover and heal. The absence of a scar means that there is no need for stitches.

Using a laser will help break up a trip to the doctor into a couple of sessions, which significantly reduces the level of stress for the baby and makes the procedure much more convenient and quick.

Rehabilitation

The recovery period after the procedure may take a couple of days. The baby may experience disorientation for the first couple of hours as the anesthesia wears off, and then quite unpleasant feelings arise.

The task of adults is to help the wound heal as quickly as possible, and for this purpose it is necessary to do the following:

carefully monitor the child’s constant and high-quality oral hygiene;
prepare special dishes for the baby for a couple of days (liquid, even slimy, in the form of porridge or soufflé, minced meat), and also serve the child only foods and drinks of moderate temperature;
be sure to see a doctor in a couple of days;
Perform basic muscle exercises with your child, which will help to develop the functions of chewing and facial expressions well.

Initially, the baby will still begin to feel severe disorientation due to the appearance of a completely different amplitude and strength of motor activity of the tongue itself. The child’s diction may also change, so you need to train with the correct pronunciation of sounds.

Most often, rehabilitation takes up to 7 days. Within 5 days, wounds usually heal and all discomfort during chewing movements disappears.

Video: plastic surgery of the upper labial frenulum (personal experience).

Consequences

What happens if you don't trim the bridle?

In small children, very short frenulums can significantly disrupt the sucking function, preventing them from correctly taking the mother’s nipple. In this situation, after examination by a doctor, the frenulum can be trimmed in the maternity hospital itself. But if the child quickly gains weight well during feeding, no correction is made;
at an early age, the low position of the frenulum has very little effect on the motor activity of the lips and the facial skeleton. But after cutting through the incisors, the frenulum can strongly fall into the gum papilla between them; this can cause a gap to appear - a real nuisance that will only intensify over time;
protrusion of the incisors from above in the center, and then - a bad bite and severe deformation of the entire row of teeth;
change in the general appearance of the upper lip, its strong upturning, which makes it difficult to properly cover the teeth from above;
too much tension of the gum mucosa, and then its severe recession and complete exposure of the tooth root. Afterwards, frequent inflammation in the area of the incisors in the front is possible: gingivitis, periodontitis.
disturbances in the pronunciation of many sounds.

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History of the problem

Most of you, dear readers, know about a short frenulum of the tongue. It is pruned in infancy or at 5-6 years old to improve the baby’s speech. As for the short frenulum of the upper lip in a small child, parents encounter this phenomenon much less often.

Why is this problem dangerous? In its normal position, the upper frenulum is woven into the gum at a distance of 0.5-0.8 cm from the upper teeth. If the bridge is fixed lower in the area of the gap between the incisors, it does not allow a person to correctly open and close his mouth, speak, or eat.

To diagnose a short muscle bridge, it is enough to lift the upper lip and pay attention to the location of the cord. If it is located at a distance of less than 0.4 mm from the gums, more serious consequences may develop:

the newborn cannot breastfeed normally and therefore receive enough food;
sound pronunciation is disrupted, first of all, the vowels “O”, “U”;
in older people, due to too short a cord, malocclusion may develop;
curvature of teeth, gum pocket formation;
accumulation of food between teeth and the development of inflammatory processes.

In most cases, doctors advise trimming the muscle. This is done not only to improve speech and eliminate these problems. Let's look at why the frenulum is cut and how dangerous the operation is.

Indications

Although the situation may interfere with the baby’s normal development, I think any operation should be performed for a reason, but be a justified action. Bridle trimming is performed for the following indications:

if there is a gap between the central upper teeth;
during bite correction procedures;
for periodontal disease and periodontitis;
in preparation for prosthetics. In this case, plastic surgery of the frenulum is necessary, since if the cord is short, the prostheses will be thrown off;
for speech therapy problems.

If there is at least one indication, dear readers, I advise you to agree to the operation, no matter what age you are. This will save you from many unnecessary problems.

Types of surgery

Modern medical technologies can make any manipulation quick and painless. Doctors consider the optimal age for muscle trimming to be 5 years, although older age is not a contraindication.

Trimming a bridle or plastic is a low-traumatic operation and does not require prior preparation. Only in some cases is it necessary to undergo blood tests and fluorography. It is recommended to feed the infant before the procedure.

There are different types of trimming and plastic surgery:

Frenotomy, or dissection. It is carried out when the bridle is too narrow. The incision is made longitudinally, and the sutures are applied transversely.
Frenectomy, or excision. With a wide frenulum, part of the tissue is excised between the bases of the front incisors.
Frenuloplasty - the essence of muscle plastic surgery is that the place of attachment of the frenulum is transferred. Local anesthetics are used for pain relief. To apply sutures, a self-absorbing thread is used, which does not have to be removed later. The operation lasts about a quarter of an hour and is absolutely painless.
Laser plastic surgery. The operation time is only a few minutes. A special gel is used as anesthesia. The laser device directs a beam of light, under the influence of which the frenulum “disappears”. Then the edges of the wound are sealed. The advantages of this method are the absence of stitches, bloodlessness and a short rehabilitation period.

Rehabilitation

Proper treatment is only half the battle. Dear parents, it is important to carry out proper rehabilitation after pruning. It consists of following the following rules:

enhanced oral hygiene;
refusal of solid and hot foods;
examination by a doctor on the third day after the procedure.

Complete healing requires only 4-5 days. Almost immediately after the manipulation, the language gains greater freedom, and diction is normalized.

Now, dear readers, if you encounter such a phenomenon as a short frenulum of the upper lip, you will know how to act. Although the word "trimming" sounds threatening, when it comes to the frenulum, it is the only way to correct the situation.

Ulcer on the lip White sore on the lip

At the birth of our child, no one told us that he had a short frenulum under the tongue. None of the doctors noticed this during examinations. And considering that this is my first child, I had never even heard of this; no one in our family had such a problem. And so, during an annual examination by a dentist (apparently more competent than those who examined the child before), we were informed that our son had a very short frenulum, so much so that his tongue did not reach the roof of his mouth. They explained to us that it was necessary to do this (cut it) before 3 months, when the child has no blood vessels there, and this was done in literally 2 minutes, and it was painless for the child. Then I learned that when breastfeeding a child, he experiences discomfort and because of this he suckles for a long time. That’s how it was with us, and I couldn’t understand why he eats for 2 hours, it was especially debilitating at night. But it turns out that the problem was in the bridle. And not one of the pediatricians, even paid ones, at that time told me that the reason for such a long feeding could be a short hyoid frenulum. The dentist also warned us that the child may have burr because of this and the lower jaw may not develop, and if it is not trimmed on time (it turns out there is still such a period) (that is, at 3-4 years), then when the teeth grow, then They will grow crookedly and in two rows. In general, we waited until he was 4 years old, when we could come to an agreement with our son and explain why we needed such an operation. By this time, my son speaks very well, but there is a problem with the pronunciation of the letters “r” and “l”. The speech therapist worked with us for a year, trying to stretch the frenulum, but to no avail. She told us simply - the frenulum is short and you probably still need to go for a consultation with a dental surgeon. So we went. Moreover, they thought that there would only be a consultation, but she insisted on doing this mini-operation right away, she says, then you will delay it again, and later it will be too late and then he, they say, won’t thank you. Of course, we all persuaded our son together. He is obedient to us and agreed. They assured me it wouldn't hurt. He was wrapped in a blanket. And that's when he got scared. Started to cry. We were allowed to stay. For support. I can’t say that it didn’t hurt him. When they injected his tongue, it was very painful for him, he screamed violently, and when his tongue went numb, the operation was done quickly, about ten minutes, they cut it with scissors, and stitched it up. And they released me with recommendations not to eat or drink for 3 hours, then give an age-appropriate dose of Nurofen, and in the morning (we did it in the evening) give more Nurofen. Rinse with chamomile or calendula after meals and immediately treat with miramistin - 7 days. Do not give solid food for 4 days, only liquids and purees. No spicy, no sweet, no salty food for 4 days. Do not jump or run so that the seams do not come apart. The child jumped out of the chair happy. But after three hours the anesthesia wore off and it began... He roared so much. The Nurofen that I gave him numbed him, of course, for 4 hours maximum, we didn’t sleep all night, in general. He cried and slept only in our arms, taking turns with my husband. This is some kind of horror. We waited until morning and gave Nurofen again. When the pain went away, my son perked up, but he couldn’t eat, even in the form of puree, he could only drink. He couldn’t speak, even though he’s a chatterbox among us, but here he couldn’t speak at all. This was torture both for him and for us. I bought him custard porridge, diluted it liquidly, as with the first feeding, and let him drink from a mug, but even drinking it was so painful for him that he cried, complained and refused, they tried to persuade him in all sorts of ways, because he wanted to eat, but was afraid of pain , the pain from the liquid or semi-liquid bothered him. The child was hungry all day. I calmly drank only water and compote. He rinsed his mouth willingly and gave it to him to treat with Miramistin. And this song lasted for 3 days!!! He had lost weight and his ribs could be felt. He was pale. She gave him multivitamins that dissolve in water. And I melted chocolate to give me at least a little energy. We didn’t sleep at night, he went to sleep, periodically woke up in pain and roared. I only gave Nurofen for two days, then they said that I couldn’t take it anymore. It helped that he readily drank milk, especially at night. This is how our first three days passed after cutting the frenulum under the tongue. Excruciating. It was especially painful for my son. On the 4th day he agreed to eat puree, and on the fifth day he even ate cake and pasta. on the fifth day they began to do special gymnastics for the tongue. And drip sea buckthorn oil under your tongue. It's day 10 now. He doesn’t even remember the pain, but he eats carefully anyway. Although everything has healed there, the threads are dissolving. About speech. Improvements became noticeable on the 7th day. It was the first time he said “Leika” clearly. He also pronounces other words with the letter “L” clearly. And he likes it. For comparison, before he said “Eika”, “Yoyka”, etc. But there are no changes with the letter “R” yet. The speech therapist said that in a month she would start talking, she just needs help and work on it. I hope. I want to say that I read a lot about cutting the frenulum of the tongue and everyone writes that it doesn’t hurt (as for children 4-6 years old). I don’t know for what purpose they write this. I say that it is painful for the child and it hurts for the first 3-4 days for sure. It's painful for parents too. And you need to be prepared for this. It is better, of course, to pay attention to the child’s frenulum at birth and solve this problem before 3 months. But if it turns out that you missed this time, you need to trim it from the age of 3, since you understand the consequences may not be very good if you leave it as it is. Again, all this is done on the recommendation of specialists. And if you receive a recommendation, do it, and be prepared for such moments as I described above. I also heard that the frenulum is trimmed with a laser. quickly and heals quickly. But there is one problem with such an operation: it may heal incorrectly, a scar may form, and then they solve it in the usual way. For such an operation you need a proven and experienced doctor. An experienced doctor did it for us, but she does not accept laser cutting; she says that in 90% of cases, after this, children are cut again and in the usual manner precisely because of the formation of scars. I don't know if it's true. I'm not a dentist. But I am inclined to believe the experts. She is a doctor of the highest category and reviews about her are good. I hope our experience will be useful to someone in the same situation. Be healthy.

When a child is born, in the maternity hospital he is immediately assessed according to the Angar scale. This scale was invented to evaluate the functioning of human organs. is also assessed, and an important part of it is the bridle. There are many expert opinions expressed on this matter.

The importance of language

The tongue is one of the unique human organs. If we consider it as a muscle, then this muscle is capable of stretching more than any other. The tongue is capable of taking on a variety of shapes and consists of striated muscle tissue. The child begins to use this organ first and continues to actively use it throughout life. When starting to eat, the baby learns to use it while still in the maternity hospital. Using the principle of vacuum, he sucks the mother's breast, while actively using the organs in his mouth. Miniature nipples of different types are directly located. They contain receptors responsible for the perception of tastes. In order for the organs to function correctly, the tongue is divided into four parts accordingly:

sour (base of tongue);
sweet (tip of tongue);
salty (sides);
bitter (root).

The difference between a child’s tongue and an adult’s is that, in comparison, a baby’s tongue takes up more space in the mouth than an adult’s. Covering the tongue with an epithelial layer causes the tongue to quickly recover from injury, be it a burn from something hot or a cut. This tissue is one of the fastest healing tissues in the human body. A day later, not a trace of the injury remains.

What is a frenulum of the tongue

This is a ligament that connects the lower part of the tongue to the oral cavity. Despite its apparent insignificance, it is an important organ in the human body. After all, if there is the slightest pathology, that is, a frenulum of irregular shape or size, then it interferes with normal eating and conversation. Often the problem is that the frenulum in the child's mouth is too short. This condition can lead to problems such as:

inability to move the tongue freely in the mouth;
makes it difficult, and sometimes makes it absolutely impossible, to suck the breast;
difficulties in conversation: having a frenulum that is too short, the baby cannot pronounce sounds correctly;
incorrect formation of the dentition, and, consequently, crooked teeth, which will subsequently lead to even greater problems;
the formation of diseases such as gingivitis or periodontitis, as well as malocclusion.

The presence of a problem must be determined in the maternity hospital during an examination of the oral cavity.

Should the bridle be trimmed?

If, after examining a child’s tongue, a specialist stated that he observed a shortened frenulum of the tongue, or you yourself noticed symptoms indicating such a problem, then something needs to be done about it. There are two known ways to treat this disease:

surgically: perform an operation and trim the frenulum of the tongue;
conservatively: perform special exercises that promote stretching.

The conservative method is used in cases where the deformation is minor, does not cause serious problems and does not lead to disruption of other processes in the body. Then, under the supervision of a specialist, you can undergo a course of treatment, perform a set of exercises and correct the problem. The surgical method is mainly used.

There are many opinions expressed about whether a child's frenulum should be trimmed. Some experts trim the frenulum under the tongue at the age of six years, when active school life begins. Others advise doing this in the maternity hospital.

The decision about whether to cut the frenulum of the child’s tongue, whether to operate on the child or not, when to do it and in what way is made by the parents. But this must be done based on the comments of experts. Take your child to several specialists before making a decision, listen to the doctors' recommendations, and then do what's best for the child.

There are cases when a child’s short frenulum is inherited from his parents. In this case, it is necessary to know how this problem was solved for them, how the frenulum of the tongue was corrected. If such a defect does not cause any serious disturbances or inconveniences for parents, then it is worth considering choosing a conservative method of treatment. Contact your doctor and he will show you exercises that will help improve your child’s diction without surgery. diction? Yes, because usually this defect forces parents to go to the hospital. As sad as it is to admit, other signs that a baby has a short frenulum of the tongue often go unnoticed. And only later, when the problem grows and leads to other complications, do parents pay attention to the defect.

How not to miss such an important moment in the life of a baby? Monitor your child's behavior. Symptoms that will tell you that you need to think about trimming the frenulum of the tongue:

Problems with breastfeeding. A child whose frenulum is too small takes the breast incorrectly, constantly loses the nipple, characteristic clicks of the tongue are heard while eating, the child fidgets, gets nervous and quickly gets tired of eating. For this reason, the baby does not eat the required amount of food, and, consequently, slowly gains weight. Sometimes he even starts to lose weight. In this case, trimming the frenulum of the tongue in children should be done as early as possible. Basically, at this age, the frenulum under the tongue is cut because they do not want the child to become malnourished.
In the case when, without looking at the problems with the frenulum, the child eats normally and is full, then the weight is gained well and the problem cannot be seen immediately. And the first alarming symptoms appear when the baby begins to speak. A short frenulum prevents the child from pronouncing sounds such as “r” or “l”, hissing “sh”, “sch”, “zh”, “ch”, as well as the upper sounds “t” and “d”. Having noticed that the baby’s speech is illegible and incomprehensible to others, you need to take him to a doctor for an examination.
Additional symptoms include excessive salivation, heavy snoring, increased swallowing of air when eating, and periodic cessation of breathing during sleep.

Any of the symptoms should be an alarm bell for parents. Do not be afraid of the examination results, visit a specialist. Otherwise, this threatens huge problems in the future.

Trimming procedure

A child’s tongue frenulum can be trimmed at different ages, depending on the need:

While breastfeeding. If it is difficult for a baby to eat, and he begins to lag behind his peers in weight, while he is healthy and there are no other reasons for malnutrition, then it is worth resorting to circumcision of the frenulum already at this age.
Stage of speech development. When a child begins to speak, you may notice that he does not pronounce some sounds. This indicates that the child's frenulum is too short. The sooner the surgery is performed, the easier it is to correct the damage already caused to speech.
The period of bite formation. A sublingual defect leads to incorrect formation of the bite, and, as already mentioned, to crooked teeth. If you notice any abnormalities, you should consult a doctor and, if necessary, have surgery to trim the frenulum.

If it is not possible to correct the defect using exercise, then the only option is to resort to the surgical method. How is a child’s tongue frenulum cut? The method of pruning depends on the age of the person. If it is a baby, then its frenulum is thin and does not contain blood vessels. This greatly simplifies the correction process. In private clinics you can give anesthesia to even a small child, but in dentistry they will do this procedure without anesthesia. Immediately after the frenulum has been cut in infants, they are applied to the chest and given something to eat. This helps distract the child and promotes rapid healing of the wound. The older the baby, the more difficult it is to perform such an operation, since more blood vessels appear.

Speaking about the operation, there are several types of procedures for cutting the frenulum under the tongue in children:

Frenulotomy. This is the process of cutting the frenulum with scissors without using any stitches. This type of surgery is performed on young children.
Frenuloplasty. This is the process of rearranging the place where the bridle is attached. To do this, it is cut off with a scalpel at one point and secured with a suture at another.
Frenulectomy. A wedge-shaped incision followed by suturing.
. Lately it has become popular to trim a child’s tongue frenulum with a laser. This modern method is easily tolerated by both children and adults. The incision site is smeared with gel, and then the laser is directed.

After the operation, it takes seven days for the oral cavity to recover. At this time, it is better not to strain your mouth muscles and talk less. The patient is prescribed antiseptics. A diet is followed, and it is better to eat soft food.

Contraindications

It is impossible not to mention the options when the patient is contraindicated to trim the frenulum. Contraindications for surgery:

a blood disease in which the blood has poor clotting ability;
there is a risk of epithelial tissue growth;
viral diseases that must first be cured and only then undergo surgery;
dental diseases.

You need to get tested and the doctor will make a conclusion. And only after the doctor approves the procedure, you can agree to the operation.

Anatomy has six frenulums on the human body. Three of them are in the mouth: the ligament of the upper and lower lips and the frenulum of the tongue. The sublingual membrane is responsible for the position of the tongue in the mouth, the formation and pronunciation of sounds. It is an elastic strip of fabric that starts from the middle of the inside of the tongue and attaches it to the bottom of the mouth. Has the shape of a triangle. If the ligament is located almost at the tip of the tongue or it is excessively short, then this is considered a pathology. In most cases, trimming the frenulum of the tongue eliminates the unpleasant consequences associated with it.

Reasons for the formation of frenulum pathologies

Despite the fact that the reasons leading to the formation of a short frenulum are not fully understood, there are several factors influencing its development:

Hereditary predisposition. Doctors have noticed the fact that children whose parents have undergone cutting of the frenulum of the tongue also need correction of the tongue membrane.
Problems during pregnancy. A shortened ligament can develop in the embryo if it is adversely affected in the first three months of pregnancy. The formation process can be affected by viral diseases, taking medications, stress, working with harmful working conditions (paints, varnishes, chemicals).

Types of pathologies

The following types of pathological changes in the formation of the frenulum are distinguished:

The hypoglossal ligament is represented by a thin transparent membrane, but the mobility of the tongue is limited.
A thin frenulum, the anterior edge of which is closely attached to the end of the tongue. When it is lifted, the tip bifurcates into a heart shape.
The hyoid membrane is short and dense, attached close to the end of the tongue. Lifting the organ is difficult. When the tongue protrudes from the mouth, its tip turns inward and the back rises.
The frenulum is short and dense, fused with the muscles of the tongue. The mobility of the organ is severely limited.
The hypoglossal ligament is inseparably intertwined with the muscles of the tongue, which practically does not move.

A defect of the short hypoglossal ligament is detected almost immediately in infants. Trimming the frenulum of the tongue in newborns can be done right in the maternity hospital. After all, a baby with such a pathology will not be able to attach to the breast correctly and will often lose it during feeding. The volume of milk that he can absorb will be insufficient to satisfy him, and as a result, the baby will slowly gain weight.

Trimming the frenulum of a newborn's tongue will not cause the baby severe pain. It is performed without the use of anesthesia because the ligament has no nerve endings. To calm the baby and stop bleeding, it is applied to the chest. After surgery, there will be improvement in sucking and swallowing and normal weight gain.

What are the consequences of ignoring the problem?

For many parents, cutting the frenulum of the tongue sounds like a death sentence. But if you delay the operation, then in the future you will have to deal with the following problems:

improper development of the lower jaw;
bite distortion (open anterior or lateral, cross, oblique);
displacement of the dentition;
failure of speech breathing, disturbances in physiological breathing, which leads to mouth breathing and recurring colds;
speech dysfunction (problems with the articulation of hissing, sonorant and other sounds of the upper row), as a result, inexpressive speech.

Trimming the ligament will relieve older children and adolescents from constant injury and tears to the frenulum, excessive salivation during speech, snoring and sleep apnea syndrome. This defect can cause emotional and behavioral problems.

Most often, short frenulum in children aged 3-6 years is diagnosed by a speech therapist or pediatric dentist. Advice should be sought if parents notice that the child is unable to lick the lips with the tongue, raise the tip of the tongue to the roof of the mouth, or run the tongue along the gums. You can try to stretch a slightly shortened frenulum with regular special exercises and massage. If exercises do not bring results, then after consultation with specialists, surgical correction may be prescribed. The operation is often performed before the age of 9 years (before the replacement of milk teeth with permanent ones).

Operation: types, how it is performed

If cutting the frenulum of the tongue in newborns is a painless process and does not require anesthesia, then at the age of 5 years the same intervention will require local anesthesia and suturing using self-absorbing materials. Abnormal frenulum placement can be corrected by one of three types of surgery:

Private clinics practice cutting the frenulum of the tongue with a laser. To do this, the sublingual membrane is treated with an anesthetic gel and an LED is directed at it, focusing a beam of light that literally dissolves the frenulum. This operation is seamless, since the laser, evaporating the tissue, immediately sterilizes the wound.

Postoperative period

Usually, there are no unpleasant consequences after cutting the frenulum. The sutures may cause some discomfort if the operation was performed without the aid of a laser. For several days, the child should talk as little as possible and limit his intake of solid food. After a week, nothing will remind you of the surgery.

However, parents should understand that cutting the frenulum of the tongue in children will not solve problems with speech and articulation of sounds. A subsequent course of speech therapy and massage cannot be avoided anyway. The child must be re-taught to speak the language and strengthen his muscles. A visit to the dentist will help correct bite problems.

Timely identification of a short ligament and subsequent trimming of the frenulum of the tongue will help to avoid undesirable consequences associated with the health and development of the child. Parents, be vigilant. The beauty and health of children is in your hands.

Often parents are faced with the problem of an insufficiently long frenulum under the tongue of their babies.

Pathology, as a rule, is noticed immediately after the birth of a child, but such a defect is not always diagnosed at such an early age.

Dentists recommend that parents immediately, if a problem is discovered, undergo surgery to trim the frenulum under the tongue. The correct length and location will prevent possible unpleasant consequences associated with violation of the position of the tongue and its mobility.

In medical language, the pathology is called ankyloglossia and is diagnosed quite often. Experts identify several reasons for the problem. These include:

genetic predisposition;
pathologies during pregnancy;
defects at birth that cause deformation of the head and face.

A hereditary factor is considered the most likely cause of ankyloglossia.

Genetic predisposition is more often diagnosed in boys.

The formation of the frenulum is influenced by the mother's lifestyle during pregnancy. A huge percentage of children whose mothers took drugs developed this problem.

Symptoms

Doctors do not always immediately notice a discrepancy in the length of the frenulum under the tongue in a child. But based on a number of signs, parents can identify disorders on their own already in the first days after birth.:

the baby’s tongue does not extend outside the mouth;
breastfeeding takes a long time and intermittently;
biting the breast, refusing it, whims when applying.

A short frenulum in infancy leads to impaired breast sucking reflex, poor weight gain, breast refusal and, accordingly, developmental and growth retardation.

At an older age the child:

when the tongue is extended, it becomes an arch;
when you bring your tongue to the upper palate, the tip of the tension resembles a heart in shape;
if you fold your tongue, you hear a clicking sound;
visible malocclusion;
problems with pronunciation of a number of letters;
frequent periodontitis.

If you notice one or more of these symptoms, you should consult a pediatric dentist for joint decision-making.

Optimal age for surgery

Parents do not dare to cut the frenulum under the tongue in infancy and postpone the operation until a later period. Although it has been proven that infants tolerate surgery much easier.

Trimming the frenulum under the tongue for up to a year is carried out by a dentist after examination by a pediatric neonatologist. There are practically no nerve endings and blood vessels in the structure of the membranes of newborns.

This makes it possible to operate even without the use of anesthesia. In addition, the procedure will take place with little blood loss.

Sometimes a rough scar forms after the procedure in infancy. In this case, repeated frenuloplasty will be needed, but at an older age.

If trimming has not been done before one year of age, then until the age of 4 years, parents observe whether the short frenulum affects the child’s speech, nutrition, and bite.

Work begins with a speech therapist who solves the problem of a short frenulum through special exercises, massage and tongue stretches.

If all actions fail, the speech therapist recommends surgical intervention. But the operation will be performed under local anesthesia with sutures at the incision sites. In older children, the structure of the frenulum changes. It thickens and fills with blood vessels.

The optimal age for frenulum correction is obvious. The best option is to carry out the procedure in the maternity hospital.

Preparation for the procedure

Correcting the length of the frenulum under the tongue is a low-traumatic operation, so no special preparation is required.

To check the condition of the baby’s body, a general blood test and hemosyndrome test are taken, as well as a urine test. Fluorography is required.

Contraindications

Despite the ease of correcting the length of the frenulum, there are still contraindications. The procedure cannot be carried out if:

oncological diseases;
blood diseases;
infectious diseases of any kind;
oral infections, stomatitis.

If oncology and other incurable diseases are absolute contraindications, then after the infectious diseases have been cured, surgery can be performed.

Methods

Correction of the length of the frenulum is carried out using traditional surgical methods or laser. The choice of cutting method is determined by a specialist depending on the general condition and age of the child.

Classical

Classic operations include:

frenulotomy (cutting the frenulum) carried out with surgical scissors at a distance of a third of the total length of the frenulum closer to the bottom. The first incision is used to dissect the mucosa, and then incisions are made in the cords. After this, sutures are placed on the mucous membrane every 3 - 4 mm;
frenuloplasty used for complex forms of ankyloglossia and is a more serious type of frenulum cutting operation. It is done by cutting out tissue and applying sutures.

Frenuloplasty is performed in several ways:

Removal- a triangular incision is made, the frenulum is clamped, and the wound along the edges is sutured with self-absorbing material;
Changing mounting locations– a strip of tissue between the transitional fold and the interdental papillae is transferred to the edges of the wound, previously reduced by sutures;
Cutting– the fold is cut and tightened with sutures, capturing deeper layers of tissue.

You can learn more about frenuloplasty from the video.

The entire plastic process includes:

duration – about half an hour;
the postoperative period is often accompanied by swelling and discomfort in the area of the operation;
a postoperative scar remains, but it heals over time and disappears;
The period of scar tightening requires special care and avoidance of solid food.

During the procedure, monitoring of the condition of the salivary glands is required to prevent damage to them during cutting and suturing. Injuries to the excretory ducts can disrupt the flow of saliva.

Laser

Carrying out the laser procedure

In medicine, methods are used using modern technologies, which include lasers. The peculiarity of the laser method is to burn out excess tissue, seal and sterilize the edges. That is, sutures are not placed on remote parts of the frenulum.

The operation lasts no more than 15 minutes and after an hour the child can return to his normal lifestyle. The entire scar heals within 1 to 2 days.

The main advantages of the laser method are:

absence of blood when cutting;
sealing and sterilization of tissues;
no stitches are required;
cuts heal faster;
minimum risk;
high speed of the procedure;
low pain sensations;
easier to tolerate for small patients.

Doctors prefer the laser method for correcting the length of the frenulum.

To avoid postoperative complications, you should follow some rules for caring for your baby.:

The child should not be fed for 2 hours after the procedure;
For 4 days, exclude from the diet foods that irritate the mucous membrane, namely salty, sour, spicy, and solid foods;
do not allow the child to talk a lot;
rinse your mouth with antiseptic solutions for a week after eating;
Do special exercises with your baby to restore tongue mobility.

Sometimes after surgery some problems may arise that you can correct on your own.

What to do if the child does not eat?

Does your baby refuse food after surgery? This may be due to both discomfort in the mouth and fear. In this case, you should try to feed him from a syringe without a needle or in another way so that he does not bother himself in any way.

Painful sensations

When the anesthesia wears off, your baby may feel pain. They may continue for several days while the stitches are tightened. The doctor prescribes painkillers that are harmless to the child’s body.

Inflammation and pus

After the procedure, a coating may appear on the tongue, which indicates the formation of new mucosa. Over time, it disappears on its own. Some parents confuse it with pus.

If pus does appear, you should consult a doctor to identify the cause and treat the inflammatory processes. Most often they arise due to failure to comply with the norms and rules of oral hygiene.

The temperature has risen

If 2 - 3 hours after the operation the child’s temperature rises, do not panic. This may be the body's response to intervention. The child will benefit from gentle antipyretics.

In case of longer duration of high temperature, the help of specialists is required. There is a possibility that an infection was introduced during the frenulum correction process.

The seams have come apart

There are unforeseen situations when the baby’s stitches come apart. This may be the result of an injury, a fall, or other factors. With such a problem, you should immediately seek help from a doctor for re-suturing. Otherwise, the cut may heal.

Correction of the frenulum of the tongue is the only procedure that allows you to completely restore the functions of proper nutrition and speech. The sooner the pathology is detected, the more painless and simpler the operation will be.

The video tells in detail about the tongue frenuloplasty procedure.

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