When to trim a child's bridle. Up to what age is it possible and at what age is circumcision done? What are the frenulums in the oral cavity

22.05.2019

In medicine, a frenulum is a small piece of connective tissue that is located in the mouth. There are 3 frenulums: tongue, lower and upper lip. They serve as a guarantee of the correct functioning of the speech apparatus, the desired speed and direction of its movement.

In all people, the bridles have their own length, density and elasticity, plus, they are attached in different ways. These factors affect the clarity of pronunciation of sounds, the clarity of speech and the normal intake of food. A very short frenulum of the tongue in a child leads to limited movement of the tongue, which subsequently causes problems with speech development.

Symptoms of a short frenulum of the upper lip and tongue

A short frenulum of the tongue in a newborn is detected immediately after the birth of the little one and is cut if necessary. Not only a pediatrician or dentist can determine the presence of this defect. Parents can understand this on their own by characteristic signs. Symptoms that indicate a problem include:

A peculiar form of language. It becomes heart-shaped, and its tip is slightly pulled back.
Breastfeeding problems. The newborn does not grasp the nipple correctly, as a result of which he is not able to hold the breast for a long time, and the process lasts for a long time.
Poor weight gain. It is the result of malnutrition.
Regurgitation and colic after application to the breast. Also, the newborn may swell the stomach.
Changed appearance of the mother's nipples. Cracks appear on them.

As for the short frenulum of the upper lip, before the central incisors erupt in the child, this defect does not cause noticeable difficulties. However, after eruption, there is a risk that it will fall into the gingival papilla between the teeth. As a result, a gap is formed, called the true diastema. In addition to her, they say about the problem:

Reasons for the formation of a short frenulum

This article talks about typical ways to solve your questions, but each case is unique! If you want to know from me how to solve exactly your problem - ask your question. It's fast and free!

The most common reason for the formation of a short frenulum of the tongue is heredity. If one of the parents was or is the owner of a short lingual strand, then the likelihood of a shortened hyoid frenulum in a child increases greatly. In addition to heredity, the development of pathology is affected by:

The course of pregnancy. If during the period of gestation a woman had early toxicosis, or she took hormonal drugs and antibiotics, then the risk of forming a short tongue in a child is high.
Abdominal trauma during pregnancy.
Age indicators. More often, pathology occurs in children who were born after 35.
Infectious diseases during the period of carrying the fetus.
Bad ecology.

Varieties of a shortened bridle

The pathology of the shortened frenulum is classified into five main varieties:

The jumper is transparent and thin. It practically does not restrain the movement of the tongue.
The cord is thin and translucent. In such a situation, when the tongue is lifted, its tip is bifurcated and it acquires the shape of a heart.
Opaque thick bridle. The protruding tongue has a tucked tip and a raised back.
A short cord that fuses with the muscles of the tongue.
Almost complete absence of a jumper. It is tightly fused with the tongue muscles.

Problem Diagnosis

After childbirth, the neonatologist necessarily conducts a visual examination of the oral cavity of the newborn. The normal length of the bridge at this age is 8 mm. The doctor needs to retract the lower lip a little so that the child opens his mouth, and he can diagnose the problem of a short hyoid band.

In older children, a local pediatrician, therapist or speech therapist can establish the diagnosis of a short tongue. At 2-3 years old, babies begin to talk, and the presence of speech problems indicates a possible defect. In the future, the child is sent for examination to the dentist or orthodontist.

It is possible to diagnose a defect in the short frenulum of the lip or under the speech organ on your own, referring to the forums, the website of the school of Dr. Komarovsky. Photos from the Internet will also help, which show how the hyoid bridge and bands of the upper and lower lips look like in normal and abnormal development.

An adult is able to conduct a simple test. To do this, stick out the tongue as far as possible. If it does not bend down at a distance of two centimeters, then there is no pathology with a frenulum. It is important not to ignore the problem and consult with a specialist to determine the appropriate treatment.

How to fix the situation?

The presence of such a pathology in a child as a short jumper under the tongue, upper or lower lip does not necessarily require surgery. The specialist should decide which method of correcting the defect.

There are two main ways to solve the problem:

Orthopedic. It includes speech therapy gymnastics and a number of exercises aimed at stretching the frenulum.
Surgical. The meaning of the operation is to cut the cord with sterile scissors.

stretching

If a short bridle does not prevent a baby from fully breastfeeding, then the operation can be postponed. For older children, a speech therapist can help correct the defect. Stretching the shortened strand and giving it elasticity is carried out by two methods:

special articulation gymnastics;
logopedic massage.

Part of the exercises that are included in the gymnastic complex, parents can perform with their children at home. Among them:

The positive effect of stretching is possible only in the case of regular exercise every day. They can be carried out several times a day, gradually increasing the duration and complexity.

As for speech therapy massage, such a procedure is quite painful and unpleasant. As a result, the children do not like her very much.

pruning

Not in all cases it is possible to do without surgical intervention. Sometimes only speech therapy exercises are not enough to overcome the problem. Scissors or a laser are used to carry out the operation to cut the frenulum (see also:). There are three ways to perform the procedure:

The ideal time for surgery to correct a short tongue defect is considered to be the first weeks after the birth of a child. During this period, the bridge is still thin and has no nerve endings, so the operation is painless and does not require anesthesia and suturing.

If the baby was not cut the bridle in the hospital, then it is better to postpone such a procedure until the age of 2.5 years. At this time, the milk bite is already fixed, but the formation of pronunciation has not yet been completed.

Another favorable period in which you can trim a short strand is 5 years. Milk teeth are replaced by permanent molars, the bite is formed.

Modern technologies make it possible to carry out operations of this kind at any age. Usually they do not last long and do not lead to serious complications. However, already adult children after them need additional therapy of a speech therapy nature.

Possible complications after the intervention

Usually the cord is cut in the hospital. Indications for surgery are problems with feeding the child. Otherwise, it is not required. The procedure is quick, without causing pain to the baby. After the baby, it should be applied to the chest so that the wound is washed with breast milk. This prevents infection from getting into it.

The operation in adolescents and adults already requires the use of anesthesia and suturing the wound, as the frenulum becomes denser, it already has blood vessels and nerve endings. The older the patient, the longer it takes for the wound to heal. The main complication after surgery is pain. Pain medications, such as Ibuprofen, Paracetamol, or other pain relievers (children are allowed) will help to cope with it.

Another possible complication is the formation of a postoperative scar. In this case, repeated surgery is required.

The fact that the child has a short frenulum, the mother can find out even in the hospital. Such a pathology should be immediately eliminated. Otherwise, problems may arise when sucking the breast or nipples. The bridle is easy to correct. The procedure is well tolerated by all children, almost painless. Pediatric surgeons perform such operations all the time. You should not be afraid of this. Complications will be much more serious in a neglected case of such an anomaly.

Why do you need to cut the bridle?

Any parent wonders if it's really worth trimming the frenulum under the tongue? In children, due to its incorrect size, there may be nutritional problems in the development of pronunciation. The frenulum also affects the bite and the work of the facial muscles.

It is a jumper. Needed to connect the tongue and lower jaw. Thanks to her, the first always remains in the right position.

If the frenulum develops with pathology, then the functionality of the oral cavity may be impaired. Normally, it should be in the center of the tongue and be 2.5 to 3 cm long. In babies who are not yet a year old, its size is 8 mm. The most common anomalies are either that the frenulum is attached to the tip of the tongue or is too short. The latter pathology is called ankyloglossia.

Why is a short bridle so dangerous? Because of it, the bite is disturbed and improper development of the jaw occurs. You can understand that a baby has a small one by the fact that he quickly gets tired when he eats, sucks badly at the breast, and constantly cries. If the child clicks when eating, and milk pours out of the mouth, then you need to cut the frenulum under the tongue. Children with this pathology have problems with weight gain. It hurts them to move their tongue. This situation applies to both infants and artificial babies.

At an older age, in order to check whether the frenulum is in a normal state, you should ask the child to reach out with his tongue to the upper palate. Deviation will provoke bite problems, periodontitis, difficulty in pronunciation, discomfort during chewing and swallowing. Most often, such a disease is diagnosed by a speech therapist, as parents turn to him because of difficulties in pronouncing letters.

Ankyloglossia must be treated, otherwise the child may, in addition to the above problems, develop an inflammatory disease of the mouth, snoring, problems with the functioning of the gastrointestinal tract, scoliosis, and nasal twang.

Pathology is transmitted by a hereditary factor. If relatives have a similar problem, then most likely the child will be born with an anomaly. Also, this defect is formed during pregnancy, if the mother suffered a viral disease, especially in the first and third trimester, toxicosis, exacerbation of chronic ailments, stress. In addition, provoking factors are considered to be a bruise of the abdomen, alcohol, drugs, and chemical poisoning in the first three months of fetal formation. Poor ecology can sometimes cause pathology.

At what age should the operation be done?

Tongue frenulum correction is performed at any age. It can be done by young children, schoolchildren and adults. The operation is quite fast. Doctors advise doing it to a newborn child right away. This is due to the fact that it will be easier for the baby to eat, there will be no problems with weight gain, moreover, at this age, surgical intervention is most painlessly tolerated.

For older children, it is quite difficult to do the operation, since you have to use anesthesia. This is due to the fact that it is difficult to convince a one-year-old baby to just sit still quietly. Therefore, many doctors advise cutting either immediately after birth, or already when the child is 4-5 years old. Children at this age already tolerate anesthesia well and surgery is not contraindicated for them.

But you need to understand that by this time the baby may have problems with speech, which after the procedure will require a long period to correct and eliminate them.

Which doctor should I contact and where is the best place to do the operation?

If ankyloglossia is suspected, the pediatrician will send the child to a dentist, orthodontist, or surgeon. They will either confirm or refute the diagnosis. The orthodontist, speech therapist and surgeon will decide whether to trim the frenulum of the tongue.

There must be a good reason for the operation. These include malocclusion, speech therapy disorders that cannot be corrected by other methods, misaligned teeth, and nutritional problems.

The severity of the anomaly is divided on a 5-point scale. If the deviation is very small, it can be eliminated without surgery using special exercises. The child must be over a year old.

Parents are concerned about the question of where to cut the frenulum of the tongue? The operation is carried out in the hospital. If the child is older, then the procedure is carried out in dentistry. In the case of a severely neglected defect, the operation is performed in surgery in the maxillofacial department.

Operational correction

At the birth of a child, the doctor usually checks the condition of the frenulum. Therefore, the operation is better to do immediately. For children 5 years old, the procedure is performed in the surgical department, or in dentistry. A hospital stay is not required, so you can go home after the operation.

There are some contraindications to cutting the bridle. These include diseases of the blood, oral cavity and teeth, infectious and oncological problems.

Operation types

There are several types of operations during which the shortened hyoid ligament is trimmed:

Vinogradova's method. During the procedure, tissue is cut from the mucous membrane and sutured to the frenulum.
Glickman method. The bridle is cut from the side of the teeth.
Frenulotomy. The frenulum is cut, the edges of the mucosa are sutured.

There are some other types of operations, but they are rarely used. Which version of the procedure will be used should be selected by the doctor depending on the severity of the pathology. In some situations, you can even do without surgery.

Frenectomy

This procedure is also known under another name: the Glickman method. Clamps are used during the operation. They fix the bridle. Next, the surgeon cuts the skin between the lip and the clamp. The edges are sutured. If we are talking about undercutting in newborns, then for them such an operation is painless and fast.

After 2-3 years, vessels and nerves appear in the frenulum. It becomes more dense and fleshy. Therefore, you need to use anesthesia and after dissection, you have to suture.

Frenulotomy

This method is considered the simplest. It allows you to easily increase the length of the frenulum of the tongue. The surgeon must cut the jumper itself at a distance that is 1/3 of the entire length. Next, you need to cut the mucous membrane. The sides of the mucosa begin to converge. Sutures are placed every 4 mm.

Frenuloplasty

This method is called the Vinogradova method. During the operation, the location of the frenulum is changed. The procedure is carried out in three approaches.

First, a flap is cut in the form of a triangle. The wound is closed with sutures.
Next, an incision is made from the septum to the papilla, which is located between the front teeth.
A triangle is sewn to the wound.

After that, the operation is considered completed.

How is the pruning procedure?

If the child is already more than 2 years old, then he will have to explain why the frenulum is cut under the tongue. So you can avoid severe stress in the baby. The operation will be performed under general anesthesia. The manipulation time is no more than 5-10 minutes. At this age, there are no nerve endings and blood vessels in the frenulum, so you should not feel much concern.

If the child is older, then lidocaine or an anesthetic gel is applied to the site of the future incision. After - the doctor makes an incision with a scalpel or scissors. Seams are not always applied.

Treatment with a laser

Many are interested in whether it hurts to cut the frenulum of the tongue with a laser? This procedure is considered completely safe and refers to microsurgery. Complications after such an operation are excluded. Seams are not applied. The rehabilitation period lasts two days.

The operation is carried out with a laser for no more than five minutes. Doctors often use this method to cut the frenulum of young children, as it is painless, accurate and does not allow the attachment of infections.

Rehabilitation

The rehabilitation period depends entirely on the age at which the frenulum of the tongue is cut. If the child is less than 9 months old, then after a few hours it can be applied to the breast. In older children, rehabilitation lasts about a day. If the operation is performed with a laser, then the period is halved.

Immediately after the operation, it becomes easier for newborns to eat, milk helps the wound heal quickly. Babies immediately begin to gain weight. If the frenulum was cut in a newborn, then he will not have problems with speech. Older children will have to undergo corrective therapy with a speech therapist. The doctor will tell you what exercises to do.

After the operation, it is forbidden to eat for two hours. The first three to four days should not be given salty, spicy, sour and hard crumbs. Too hot food and drink should be avoided. At first, it is better to eat mashed food. Too much talking is forbidden. After eating, you need to rinse your mouth with special antiseptic preparations. It can be infusions of chamomile or calendula, a solution of "Furacilin". If the child is already at least five years old, if there is pain, he can be given pain medication. It is necessary to apply sea buckthorn oil or Solcoseryl on the seam. The doctor will definitely tell you what exercises to support speech should be done, they should be observed. If necessary, regularly visit a speech therapist.

Complications after surgery

If a child needs to trim the frenulum of the tongue, then parents should not worry. With proper postoperative treatment, no complications will arise. Surgical intervention is well tolerated by the child, therefore, in addition to the fact that for a while the child will lose the opportunity to speak for a long time and eat ordinary food.

If the wound is poorly treated, then pain and inflammation may appear. If the child has a scar, it is necessary to do a second operation.

Can the bridle be stretched?

If the child does not pronounce hissing, it is not necessary to immediately go to cut the bridle. You can try to stretch it. For this, exercises are carried out and performed.

You should stretch out the tongue, and then move around. It is necessary to reach its tip to the lower lip, then to the upper. You can click your tongue. To do this, you need to hold it near the sky and lower it down. Between the cheeks should be driven with the tongue, while the mouth should be closed. Also stretch the tongue with a tube and smack.

If the child is small, he can often be allowed to lick the spoon. Another way helps: you can drip jam on your lip, and then ask the child to lick it.

Summing up

It is best to trim the frenulum of the tongue when the child is not yet a year old. What is it connected with? There are no vessels or nerves in the area to be dissected. Therefore, the baby will not be hurt. Doctors do not have to use anesthesia or pain medication.

If the parents had no desire or reason for trimming the bridle at an early age, it is better to wait until 5-6 years. This is due to the fact that children at this age tolerate anesthesia well. The operation is carried out quickly for both infants and adult children. The only difference is the recovery time. In the first case, it takes only a few hours. In the second - a few days.

What kind of operation the surgeon will perform depends on the indications and reasons. If the child has a mild stage of pathology, it is enough to make a small incision. Stationary monitoring is not required, so you can go home immediately after the procedure. Above in the article it was described what is prohibited in the first days after the operation. You need to carefully choose a diet, food should not be hard or irritating to the mucous membranes (spicy, smoked, and so on).

Do I need to trim the frenulum of the tongue? This question worries many parents. Doctors advise to do this either immediately after childbirth, or look at the situation. Many children do not experience any discomfort with a mild form of pathology when eating, talking, and so on. Experts in this case recommend waiting for 5-6 years to check whether the child can pronounce words and sounds correctly. If there are any defects, for example, the baby cannot say "r", then he is sent for an operation. In other cases, you can not worry and do only exercises to stretch the frenulum. They will facilitate the daily life of the child and help prevent pathological changes.

You need to understand that the anomaly does not get worse over the years. The frenulum does not shorten, therefore, if they have not been identified before a year, this will not lead to serious complications. Pronunciation can always be corrected, and the operation is allowed to be done even in adulthood.

- this is a fold in the oral cavity connecting the bottom of the cavity and the tongue itself. Need a bridle to fix the tongue, preventing it from sinking. This is true for newborns during periods of strong crying. Tongue tie is one of the most famous minor anomalies among newborns. Most often, this anomaly is caused by heredity, but information is also known about intrauterine trauma to the oral cavity.

Physiological features

With a feature, like a short frenulum of the tongue in a newborn, it is not uncommon. In medicine, the term "bridle" is known as the hyoid ligament, and the usual name has received a figurative character due to the fact that when the tongue is raised up, the ligament holds it. From the ligament descends almost to the base of the gums of the lower incisors, located in the center. With this arrangement, the ligament does not interfere with the movement of the tongue, and the length is considered the norm. Sometimes the newborn is not in the middle, but at the very tip, when the tongue is raised up, the ligament pulls it up and it takes the form of a gutter, such a ligament is called a short one. Weak mobility of the tongue makes it difficult to pronounce the sounds p, l, s.

You should not make quick decisions, consult with several doctors, a pediatrician, dentist, surgeon will help you make a decision. If this problem is inherited, ask your relatives for their opinion, in what ways they solved it and how this feature affects human health and the functioning of the speech apparatus. Your family who refused surgery can recommend exercises or a speech pathologist who can give you advice on how to improve your speech.

Ignoring the problem leads to the development of malocclusion, which impairs speech, and in newborn age prevents the mother's nipple from being properly grasped when sucking.

Problems and symptoms of tongue tie

A short frenulum of the tongue in a newborn can cause problems and trouble when feeding a baby. The uvula of the newborn is located not at the bottom of the mouth, but in the cavity. With normal development, the frenulum is elastic and flexible, so it does not interfere with sucking. If attempts to properly latch on to the breast fail and the baby does not get enough milk, and does not stimulate lactation. The less the child sucks out milk, the weaker the new one comes. The impossibility of making a full-fledged movement does not allow the child to fully enjoy milk and suck out the required amount of liquid, with such feeding, the child and mother experience discomfort.

Being in the maternity hospital, the pediatrician is able to determine the short frenulum of the child's tongue - and the mother herself can notice a change in the child's behavior and talk about discomfort during feeding. At the first symptoms, the mother should consult a doctor and talk about problems with sucking. Significant symptoms for the mother may include:

long, persistent sucking, but the flow of milk does not go away;
with normal external sucking, the child begins to act up;
in the middle of feeding, the child may abruptly throw the breast;
refusal to suck;
weight loss with active sucking.

After consulting with the pediatrician, the baby should be shown to the pediatric dentist, if the diagnosis is confirmed that the newborn has a short frenulum under the tongue, he can prescribe circumcision of the frenulum of the tongue. If for some reason a visit to the dentist is postponed, you should not panic and switch to artificial feeding. It is possible to wait out the period of refusal of the breast due to the fact that the frenulum of the newborn is short, using pumping. Expressed milk can be given from a bottle, such feeding will not cause difficulties for the child and will preserve the mother's lactation.

Another problem that awaits a child with a delay or refusal to cut the frenulum at a newborn age arises with the onset of speech activity. The baby will not be able to correctly pronounce sounds and letters, this may change speech and bite. At an older age, a short frenulum can be signaled by:

lower incisors turned to the other side;
deepening in the tongue when stretched;
the child cannot reach the palate with his tongue, lick his upper lip;
problems chewing hard foods.

In an attempt to avoid surgery, parents turn to speech therapists for help. Classes with a speech therapist will give a small result, but without surgery it will be difficult to achieve a good effect and speech will not be complete. The younger the child, the easier the operation is tolerated. There is no need to be afraid of the cutting procedure, since for a specialist the operation to cut the ligament is simple, and the consequences of refusing such a procedure bring difficulties in the development of the child and the correct formation of the baby's speech apparatus.

A short frenulum in adults makes it difficult to speak, brings its own difficulties. There are problems with the use of dentures. Fixation of the prosthesis makes it difficult to chew and gives complications to the condition of the teeth and digestion.

Possible operation methods in language

In surgery, there are two main methods of frenuloplasty:

Surgical.
Laser.

The surgical procedure must be carried out by a professional doctor. A doctor can cut the frenulum of a newborn using surgical instruments (scissors or a scalpel), as well as using a laser method.

Trimming the frenum of the tongue in newborns is an almost painless procedure, the frenum of the tongue in an infant is elastic and thin, it takes only a few seconds to cut it. A newborn baby may not even experience acute pain from the procedure itself. An older child can be stressed and scared, so doctors recommend and cut the frenulum at a very early age, when the possibility of pain, fear and postoperative care is minimal.

The laser method in surgery is used more often and has several significant advantages:

no blood;
absence of pain;
sterility of the procedure, no contact with instruments;
lack of anesthesia.

Sometimes surgeons continue to use a medical scalpel, as not every circumcision problem can be solved with a laser. When using surgical instruments, local anesthesia is used.

The frenulum of the tongue of the baby is thin, so immediately after circumcision, the baby is allowed to suck on the breast in order to stretch the frenulum and the tip of the tongue becomes more mobile. The process of sucking stabilizes the condition of the baby and soothes.

Older children are prescribed classes with a speech therapist in a week or ten days. After assessing the child's condition and the possibilities of the speech apparatus, the speech therapist will prescribe exercises for the muscles that help in the movement of the tongue. A healthy oral cavity restores all speech capabilities in a short time. If the parents postponed the operation and did not cut the frenulum of the newborn's tongue, in adulthood the operation also gives results, but the postoperative period becomes longer.

Several indicators serve as a criterion for a well-performed operation:

absence of edema in the oral cavity;
lack of prolonged pain;
no increase in body temperature.

After the procedure, the patient's speech improves, and the movements of the lips and tongue become smoother and softer.

Oral hygiene

The frenulum in newborns after surgery heals quickly and painlessly, and the oral cavity does not need additional care. The frenulum after circumcision in older children heals more slowly; with the surgical method of circumcision, pain may occur with the completion of anesthesia.

The main rule after the process of excision of the ligament is oral hygiene. Try not to eat hard, spicy and hot foods. No need to load the muscles of the tongue unnecessarily. A week later, a patient of any age returns to his usual mode of life and does not feel discomfort.

The main contraindications for surgery

Despite the simplicity of the operation, not everyone can carry it out. There are several reasons why pruning is not recommended:

Blood diseases: hemophilia, risk of proliferation of epithelial tissue.
Chronic diseases of a viral nature.
Oncology.
Diseases of the oral cavity: caries, pulpitis, chronic diseases of the oral cavity.

Before the operation, seek advice from your doctor, tell us about your concerns or illnesses. The choice of method and the duration of the operation should be appointed by a professional.

A short frenulum of the tongue in infants is a common problem. The doctor must determine the need for an operation. The frenum of the tongue in newborns is thin and easily amenable to surgical intervention without the consequences of prolonged healing. Dentists recommend performing such an operation as early as possible. A newborn baby will be able to immediately enjoy sucking without discomfort. He does not experience fear before and after the procedure, unlike adults and preschool children.

The hyoid frenulum is a thin membrane that connects the tongue to the lower jaw. Sometimes this membrane is not long enough, which limits the mobility of the tongue, in this case they speak of ankyloglossia - a shortened frenulum of the tongue. With such an anomaly, the child is not able to stick out his tongue - he bends to the lower lip or takes the form of a heart.

A short hyoid frenulum can cause sucking problems at the mother's breast because the membrane prevents the baby from tightly grasping the mother's nipple. Such a baby will not be able to eat breast milk normally, it will be difficult to gain weight and often act up. A short frenulum makes it difficult to move the tongue in the mouth. It is difficult for the child to raise the tongue and touch it to the upper palate, he cannot stick the tip of the tongue out of the mouth. This can lead in the future to various speech defects, for example, to the so-called lisp. A shortened hyoid frenulum can also contribute to the formation of a malocclusion in a child and displacement of the dentition.

Doctors still cannot name the exact cause of this anomaly, but it has long been noted that the defect is most often inherited.

A neonatologist can recognize the problem and solve it immediately even in the maternity hospital in the first days of a child's life. If the defect is not too strong, then the specialist can postpone the issue of cutting for a while, during which the frenulum can stretch a little and return to normal.

If, however, parents still begin to notice that the baby does not suckle well and is constantly naughty, does not eat up, then you should contact a surgeon or dentist.

If your child is already large and you suspect that he has such a defect, do the following: ask him to lift his tongue and touch it to the upper palate. If he can do it without difficulty, then everything is in order. And if this causes difficulty, and you see that the membrane is strongly stretched and does not allow the tongue to rise up, then your baby still has a short hyoid frenulum.

How and when to cut the bridle

It is best to cut the bridle at a very early age, up to a year. This is an extremely simple and almost painless procedure. It is carried out either in the surgical department of the polyclinic at the place of residence or in the dental clinic. In infancy, the operation is performed without anesthesia, with special scissors, and mother's milk will help stop the blood. The procedure itself will take 5-10 minutes. At an older age, frenuloplasty is performed under local anesthesia, if necessary, sutures are applied. At an older age, this procedure can also be performed with a laser using an anesthetic gel. In any case, cutting the frenulum does not cause any complications, and the sooner you carry out this procedure, the better for your baby.

Ankyloglossia is a pathology characterized by a shortened membrane that attaches the tongue to the lower jaw. Such an anomaly limits the movement of the tongue, which causes problems with speech. The formation of a short frenulum of the tongue in infants occurs even before birth.

The formation of an abnormal membrane can be caused by the following reasons:

What does a short bridle look like: signs

A short frenulum of the tongue in a child is easily detected by a doctor during an external examination of the baby. With such a pathology, the tongue resembles a heart with a slightly elongated tip.

Signs of an anomaly of the frenulum in infants:

smacking during feeding;
chest bites;
the frequency of feeding increases;
the baby rests for a long time when feeding;
underweight;
breast rejection;
whims during feeding.

A short frenulum of the tongue in a child, a symptom is whims during feeding.

Signs of frenulum pathology in children after a year:

speech disorder;
incorrectly formed bite;
periodontitis;
the central teeth are bent inward from below.

External signs of an anomaly:

The tongue does not protrude beyond the mouth.
The child is unable to lick his lips.
The tongue does not reach the sky.
When protruding, the tip of the tongue bifurcates.
A notch forms in the middle of the tongue when it is pulled forward.
The lower incisors are curved.

How to independently identify the problem in newborns

The length of a normal child's ligament is 8 mm or more. You can identify the pathology yourself. To do this, you need to pull the bottom sponge so that the baby opens its mouth. If the tongue joins at the tip and does not reach the lip, then the frenulum is short.

You can also identify this pathology in newborns according to the following criteria:

Classification of pathology

A short frenulum of the tongue in a child has 5 main types:

Diagnosis of a short frenulum of the tongue in newborns

A frenulum defect can be identified by specialists such as a pediatrician, surgeon, pediatric dentist, orthodontic specialist, speech therapist. Diagnosis of this anomaly occurs by external examination of the baby. It also helps to identify a frenulum defect by conducting the E. Hazelbaker test, which determines the size of the membrane and the degree of tongue mobility.

Any discrepancies in the test are abnormal and are indicative of ancoglossia.

With a normal length of the ligament, the baby can easily reach the tongue to the lips and palate.

Treatment Methods

There are several methods for correcting the pathology of the frenulum:

correction exercises;
laser operation;
surgery.

Types of surgical operations:

Method	Description	Contraindications
Frenulotomy	The operation is performed with mild and moderate anomalies. This is a cut of the membrane with suturing of the edges of the mucous membrane.	Small amount of tissue for dissection.
Frenuloectomy	The same operation as a frenulotomy. The difference in the implementation of the incision from the side of the incisors.	Hemophilia (blood clotting disorder)
Frenuloplasty	This technique is performed for severe anomalies. The tissue is cut out of the triangular mucosa with further sewing.	Presence of oral infections.

Correction exercises

In children with a mild degree of pathology, with the help of special exercises, it is possible to correct the defect at home. Speech therapists have developed a whole range of highly effective exercises that help stretch the shortened frenulum of the tongue. With their systematic implementation and compliance with all recommendations, it will be possible to avoid surgery.

A set of exercises:

When performing such gymnastics, you can use additional items (a teaspoon, tubes, pencils) to help the baby achieve results faster.

Operation

A short frenulum of the tongue in a child is easily corrected surgically. Before the operation, the specialist pays attention to the age of the child, the degree of complexity of the pathology and its location.

The defect is removed under local anesthesia. The surgeon makes an incision with a special instrument and then sutures it. There may be slight bleeding. In time, this procedure takes about 30 minutes.

The recovery process after the operation lasts up to 10 days. At this time, the child will have swelling, pain, discomfort.

In this case, it is necessary:

exclude hot and spicy foods from the diet;
carry out oral hygiene;
perform special exercises for the rapid resorption of scars;
observe speech peace;
consult with a speech therapist to eliminate speech defects.

laser treatment

To correct the pathology of the frenulum, laser cutting is also used. This treatment method is more gentle and therefore more suitable for younger children.

Advantages of laser surgery:

fast healing;
sealing of the wound;
lack of seams;
no bleeding;
sterilization of incisions;
duration of the operation (10 min.).

Laser treatment goes without complications. After the procedure, you must follow all the doctor's instructions (the same as after surgery with a scalpel).

Is an operation necessary?

The decision on the need for a surgical operation to eliminate the defect should be made by doctors such as an orthopedist, speech therapist and surgeon. It depends on when ankyloglossia was detected (the age of the child), as well as on the individual characteristics of the anomaly.

Often, doctors prescribe an operation 1-2 years after the discovery of a defect, since during this time the frenulum can stretch to the desired size as the baby grows.

Optimal age for surgery

Doctors recommend performing an operation to eliminate the pathology of the frenulum for children under 1 year old. The younger the baby, the easier the procedure will be for him. At this age, the membrane is weak, has no capillaries and nerve endings. The operation is performed without anesthesia.

If a child older than 4 years has speech impairments, and exercises to stretch the frenulum do not help, it is necessary to solve the problem surgically. At this age, the procedure causes discomfort as well as pain. The operation is performed using local anesthesia and suturing.

Consequences of ankyloglossia

A short frenulum of the tongue in a child leads to the following consequences:

The prognosis for a short frenulum of the tongue in children

With the timely detection of ankyloglossia and the operation, the prognosis for children is positive. After the procedure, breathing, nutrition, weight gain are normalized. Early treatment of frenulum pathology prevents malocclusion and speech defects.

If surgery is performed on older children, then to eliminate speech problems, it is necessary to attend speech therapy classes.

Correcting the pathology of the frenulum with exercises to stretch the membrane requires regular performance and patience. This technique is effective at the age of 5 years. What method of treatment to choose for a shortened frenulum of the tongue in children is decided by parents. The main thing is to eliminate the anomaly in a timely manner so that the baby develops normally.

Article formatting: Lozinsky Oleg

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