- Why does a child have a short frenulum?
- Types of short frenum in children
- Signs of a shortened bridle
- To what doctor to address?
- Treatment without surgery at home
- At what age do they undercut?
- Types of undercutting
- Laser excision
- Possible complications after undercutting
- Komarovsky about a short frenulum of the tongue
Bridle of tongue- a leathery arch that connects the taste organ to the bottom of the oral cavity, almost entirely consists of connective tissue. If its length does not correspond to the norm, the child has problems with the clarity of speech, and it is impossible to eliminate the problem with medications. Gymnastics and massage can help with minor deviations, otherwise surgery will be required.
Incorrect length of the tongue bridle affects the clarity of the child's speech
Why does a child have a short frenulum?
With the problem of a short sublingual or upper frenulum, parents face sometimes immediately after birth - the babies have problems with sucking. Or at the age of 3-4 years, when the child is difficult to give some words, because the defect prevents the normal movement of the language. The main reason for the development of pathology is the genetic factor.
Why is a short frenum formed?
- intrauterine infection of the fetus;
- serious viral or infectious diseases that the woman suffered during pregnancy;
- abdominal trauma in expectant mothers;
- alcohol abuse during pregnancy, especially in the early stages;
- the birth of a child after 35 years;
- bad ecology, work in harmful production, frequent stress.
The cause of the abnormal structure of the frenum of the tongue may be other factors of unexplained etiology.
Intrauterine infection of the fetus is one of the causes of deviations in the size of the frenum in a child
Types of short frenum in children
Pathological abnormalities in the structure of the frenulum are inherent in nature, may be associated with its incorrect location or length. As the correct and anomalous fold looks, you can see in the photo.
Normal and short frenum of the child's tongue
Ankyloglossia - the wrong location of the hyoid fold, the upper end is too close to the tip of the tongue, while the length of the bridle is normal.
Dysplasia - a bridle less than -3 cm is considered short, depending on the degree of deviation of length from normal indices, the disease is mild, moderate and severe.
Their main features:
- light - the length of the bridle is more than, cm, there may be problems with speech, special logopedic exercises will help to stretch the fold;
- average - less than, cm, for the beginning the doctor will appoint speech therapy, at its ineffectiveness appoint operation;
- heavy - the length of the bridle is less than 1 cm, this form of pathology is treated only surgically.
With a full short bridle, the tongue completely loses mobility, when viewed you can see that the organ of taste is curled into a tube. A partially short sublingual fold is characteristic of infants - connective tissue is only being formed, the bridle looks like a thin film.
Signs of a shortened bridle
In the newborn, there are obvious deviations in the structure of the bridle, which can be determined by a neonatologist in the maternity hospital. The baby has difficulty in grasping the nipple, he can not normally suck his breast, because of what he can constantly cry from hunger.
In children up to one year, the abnormal structure of the frenulum manifests itself in the form of frequent and prolonged feeding; applying to the chest begins to be capricious, arching his back, while there is a small increase in weight. Breasts with short lingual fold produce during the feeding clinking sounds, can bite the breast.
The second common sign of a short frenum is speech defects, which are observed in a child in 3-4 years, and speech therapy exercises do not help improve the situation.
How to recognize the pathology of a bridle:
- the child is difficult to reach the tip of the tongue to the upper palate, and the front teeth on the upper jaw;
- there are difficulties with the rapid movement of the language from side to side;
- the front lower teeth are located at a great distance from each other, the bite is not formed correctly, the incisors turn inwards;
- The tip of the tongue, extended forward, has a square, flat form, or bifurcated in the middle;
- develops periodontitis;
- the child refuses solid food, because it needs to be placed close to the root of the tongue, which provokes a vomitive reflex.
With deviations in the size of the bridle, periodontitis develops
To what doctor to address?
If there are signs of an abnormal structure of the frenum of the tongue, you need to visit a pediatric dentist, if you can not do without surgery, you will need a surgeon's consultation.
Treatment without surgery at home
Conservative restoration of the frenum is possible with an incomplete short frenum, if its length is more than 15 mm. With a fold size of 1 cm, you can try treatment at home, but if the condition does not improve within 2-3 months, you will have to resort to surgery.
To correct the length of the bridle, special exercises and massage are used, the correctness of the exercise will be shown by the speech therapist, but parents will have to deal with the child and at home.
There is a special articulatory gymnastics that helps to stretch a short hyoid fold. The effectiveness of the exercises was already appreciated by many parents, but only on condition of regular classes.
Exercises for a short hyoid fold:
- The tip of the tongue to move from the upper teeth to the throat, the lower jaw must remain in place.
- Repeatedly and accurately pronounce the sound "d the tip of the tongue should rest against the upper teeth, the mouth should be kept wide open all the time. To facilitate the exercise, you can grasp the pencil with your teeth.
- The tip of the tongue alternately stretch to the nose and upper lip, the tongue should be flat, the jaw to stand still.
- The tip of the tongue is touched alternately to the lower and upper teeth.
- The tongue strongly presses against the right, then the left cheek.
- In a small saucer, pour milk or jam, ask the child to make a kitten.
- Tongue strongly pressed to the palate, open and close your mouth.
- Latch your tongue, pretending to be a horse.
- Press the tip of the tongue against the palate, fix the position for a few seconds.
- As far as possible, stick your tongue out, try to reach the chin.
Special exercises help stretch the hyoid fold
Supplement gymnastics need special logopedic massage, older children cope with this independently after several sessions.
How to wish a massage:
- With fingers of one hand take the tip of the tongue, raise it up, with the fingers of the other hand, with light stretching movements, move from the base of the fold to its end. The child's mouth should be wide open.
- Using two fingers to tighten the bridle, use your thumb to press the tip of the tongue, perform pulling outwards.
- Carefully take the tip of the tongue with your fingers, pull it from side to side and out.
Speech massage helps restore normal speech clarity
During gymnastics and massage in parallel, you need to engage in the production of sounds. While the fold is not stretched, the sounds of h, u, d, t, l are put. After the end of the stretching, you can go over to the sounds x, w, p.
At what age do they undercut?
With a shortened bridle, the lower jaw is incorrectly formed, there are problems with bite and dentition, breathing, swallowing, Due to strong denudation of the gums, dental pathologies develop - all these factors are indications for operative interference.
Some experts insist on carrying out the plastic frenulum before the appearance of speech problems, but sometimes in a place of dissection on a background of active growth of the child there are scars which will be necessary delete.
Other doctors recommend that children undergo surgery after 4 years of age if there are obvious problems with speech. But the problems do not disappear immediately after the intervention, the child will have to continue studying for a long time to talk well.If the baby has problems with sucking, the operation should be performed within a few days after birth.
Types of undercutting
Operations to eliminate bridle defects are carried out in different ways, they are all practically painless, minor traumatism, the child tolerates them well, is quickly restored.
The operation is performed for children over 2 years old, make it under general anesthesia, during the intervention, the crease can cut, remove or change the attachment site. Preliminary it is necessary to make analyzes on coagulability and blood group.
- A small piece of triangular tissue is cut from the fold.
- Then sew it back, forming a fold of the correct length.
- The duration of the operation is 10 minutes.
- The wound heals within 24 hours.
Within a few days, the child can only eat warm, soft consistency, you must strictly follow the rules of oral hygiene.
Before and after the frenuloplasty of the frenulum of the tongue
Frenulotomy - surgery is indicated for young children up to 9 months old, in which the fold is a thin white film, in which there are no blood vessels.
- Make a cut at a distance of a third of the length of the bridle, counting from the lower teeth.
- The edges of the mucosa are brought together and sutured.
- For dissection use a scalpel or surgical scissors, anesthesia is not required. Rarely minor bleedings occur, which stop by themselves when the baby is applied to the chest.
- Rehabilitation is only a few hours.
Frenulotomy procedure of the tongue frenulum
Such an operation is often performed in the maternity hospital, the younger the child, the less in the tissues of the bridle of nerve endings and vessels, which greatly accelerates the recovery process.
Frenulectomy - the essence of the operation is the same, but the sublingual fold is fixed from above with clamps, the tissue is cut under the tongue.
The laser method is considered the most gentle method of plasty of the frenulum of the tongue. The main advantages are absence of bleeding, no need to suture, all manipulations take no more than 5-7 minutes, pain is practically absent, the child is quickly restored.
Laser cutting of the frenum of the tongue is characterized by rapidity and absence of bleeding
During the intervention, the device is guided to the fold, which forms the beam of the desired thickness - the tissues die off under the influence of high temperatures.After the operation, drugs are applied that accelerate the regeneration process, after 2 weeks no child experiences any plastic effects.
Possible complications after undercutting
Usually, the operation to correct the frenum passes for the child without any special consequences. Complications in the form of inflammation, fever and pain appear only if the wound is not properly maintained. If the plastic was done after 6 years, the formation of scars is possible, which will require repeated intervention.
High temperature after the bridle pruning indicates the development of inflammation
Komarovsky about a short frenulum of the tongue
If the therapist or the dentist has diagnosed the diagnosis later, you can observe the baby for up to -3 years, while doing gymnastics and doing massage. If the problem does not disappear, the child has problems with speech, then you need to do the operation.
An abnormal structure of the sublingual ligament occurs in about 30% of children, pathology leads to disruption of the sucking process, problems with speech. Treatment is carried out conservatively and surgically, recommendations about the expediency of the operation are given by the doctor, but the final decision should be made by the parents.
Teeth and Mouth