These small mucous bands can affect the clarity of speech, the aesthetics of a smile, in infants, the frenulum of the oral cavity can affect the quality of attachment to the breast, or the ability to suck a bottle. It is on this occasion that parents should pay attention to these anatomical formations.

If the frenulum(s) of the oral cavity is short, then the baby will not be able to eat properly, attach to the breast, therefore, it will get tired faster, remaining hungry. There can be no talk of any increase in the weight and height of the child. Parents should be aware and aware of such a problem and be able to notice alarming symptoms. According to statistics, a large percentage of short frenulums are recorded in children, on average, every 14 children. If the problem is diagnosed in time, then it is possible to avoid those complications that can provoke short frenulums.

Oral Anatomy

There are three frenulums in the child's mouth, and not one, as many parents believe. After all, more famous» frenulum of the tongue, which has an attachment on the underside of the tongue and sublingual space. The frenulum of the tongue is rightfully considered the most insidious, but at the same time practically the most important.

In addition to the frenulum of the tongue in the baby's mouth, there are also frenulums of the upper and lower lips, which also have certain functions. The frenulum on the upper lip should be woven into the upper lip and into the mucous membrane of the gums, just above the level of the front incisors. The frenulum on the lower lip is woven in by analogy with the upper one.

To diagnose a short frenulum in the mouth, as a rule, they can still be in the maternity ward, this is more true for a short frenulum of the tongue. As for the rest of the frenulum of the oral cavity, the diagnosis mainly takes place in the dentist's chair at a random appointment. There are cases when the frenulum of the tongue is not immediately diagnosed, and the frenulum in no way interferes with the feeding of the baby. But in the future, the child may pronounce incorrectly defined sounds, and then the question of a short frenulum of the tongue pops up again, which, as a rule, is diagnosed at a speech therapist's appointment.

frenulum of the upper lip

When diagnosing a short frenulum, there are usually no difficulties, even for parents. To do this, you just need to gently pull the upper lip at rest, and see at what level the mucous cord is attached. Normally, attachment should occur 5 to 8 mm from the neck of the child's incisors. If the bridle is attached lower or its attachment is not visible at all, then we can talk about a short bridle.

What threatens the presence of a short frenulum?

In a newborn baby, a short frenulum on the upper lip can affect the attachment of the breast, the baby simply cannot properly position the upper lip, and properly embrace the mother's breast. Only in this case, the frenulum of the upper lip can be corrected even in the maternity hospital. Fortunately, this happens quite rarely.
At an older age, a short frenulum in the oral cavity can affect the aesthetics of a smile, as a gap is formed between the front teeth of a child - a diastema (trema). Usually babies are embarrassed by such diastemas, especially teenagers, and try to smile or talk less.

Such gaps between teeth are considered defects in the dentition that require orthodontic treatment, sometimes in combination with surgery. But it is worth remembering that an aesthetic defect is not the only problem that a short frenulum of the upper lip can provoke, the most formidable complication is problems with bite, namely, the advancement of the front incisors forward.

The extension of the anterior incisors occurs as a result of pressure. The fact is that when talking or eating, the lips are involved, and the frenulum connects the lip and the alveolar process and pulls it along, while mechanically acting on the jaw in the region of the incisors, contributing to their advancement. The solution to this problem is orthodontic, and requires a fairly large investment of time and money. In fairness, it is worth noting that such a scenario can only develop in babies with permanent incisors, if the baby still has a milk bite, then you should not worry.

Excessive tension of the mucous membrane of the gums can provoke inflammatory diseases in the area of ​​the anterior incisors - gingivitis, periodontitis. As a result, the child may develop increased sensitivity of the teeth. Speech defects can also be characteristic of a short frenulum, the little one cannot correctly pronounce some sounds, in the pronunciation of which the baby's lips are involved, for example, "o", "u", etc.

In addition, inflammatory diseases in the gums can provoke caries in the necks of the teeth. Due to the low attachment of the frenulum, a large amount of plaque accumulates in the area of ​​​​the incisors, and it is quite difficult to remove it.

How is the correction going?

Correction can take place exclusively surgically, but it is worth remembering some features. Correction of the frenulum on the upper lip is indicated only after or during the eruption of the permanent incisors! Usually it is 6 - 8 years, until this age, parents should not worry.

It is not recommended to carry out the operation before this time, with the only exception in the maternity hospital. Otherwise, such actions may result in bite pathology. A shortened and thick frenulum of the upper lip in a milk bite is not a pathology, but a variant of the norm; as the jaws grow, the frenulum can independently correct itself, i.e. stretch and change its place of attachment.

It is for these reasons that the most optimal time for correction is the time when all the permanent incisors in the upper jaw have erupted, and active eruption of the canines begins, or when the anterior permanent incisors erupt, and when the lateral ones actively erupt. The fact is that when the frenulum is corrected at this time, the erupting teeth will move the teeth towards each other and the gap between the teeth will close on its own, and there is no need for orthodontic treatment.

If it was not possible to correct the frenulum in time, it is necessary to use orthodontic treatment, when the doctor puts a “screed” on the front teeth, which will bring the incisors closer together.

Surgery

Dentists can use 3 types of surgical treatment:

Frenotomy - dissection;
Frenectomy - excision;
Frenuloplasty - moving the place of attachment of the frenulum.

Kids can dissect the frenulum on their own, and cases of such injuries are quite frequent. For example, when falling or chewing toys too hard, a frenulum rupture can occur, which is accompanied by bleeding and hematoma. In case of injury, it is necessary to immediately contact the dentist to decide the fate of the injured frenulum. Frenectomy solves this problem, and even with an injury to the oral cavity, frenulum ruptures, as a rule, do not occur.

The operations themselves are performed in a polyclinic surgical room, using local anesthesia, and the procedure usually does not take more than 30 minutes. After dissection of the frenulum, the doctor sutures from a special biomaterial that dissolves on its own, which avoids the unpleasant procedure for their removal. The recovery period after the procedure is not long, and takes from several hours to several days. And as soon as the swelling subsides after the operation, parents note that the child begins to pronounce sounds more clearly, or grabs the mother's breast more freely.

The operation can be performed using various instruments - surgical scissors or a scalpel, or using a laser. The use of the latter technique is most acceptable, as it allows you to avoid suturing and significantly reduce the recovery time for the baby. Most often, the bridle is corrected in young children with a scalpel, the amount of time spent is reduced, and an indispensable condition for this is instant attachment to the chest.

Frenulum on the lower lip

The frenulum of the lower lip may not be present or it may be bifurcated. In order to diagnose a short frenulum on the lower lip, it is necessary to pull the lower lip. At the same time, the frenulum itself becomes noticeable, which goes from the middle of the alveolar process of the lower jaw, weaving below the area of ​​\u200b\u200bthe lower incisors, and attaching to the lower lip.

Under normal conditions, the frenulum should be thin and almost invisible, and it should be flush with the center line. If the baby's frenulum is thick, short and is attached at the base of the lower incisors - the frenulum is short.

What is the danger of a short frenulum of the lower lip?

By analogy with the bridle on the upper jaw, the sucking function may suffer in a toddler. When sucking, the short frenulum pulls the lower lip along with it, thereby breaking the vacuum that is formed during sucking. The baby needs more effort, the baby quickly gets tired, remaining hungry and throwing the breast. In this case, frenuloplasty can be performed even in the maternity ward.

A short frenulum can also provoke malocclusion, inflammatory and carious diseases in the region of the lower anterior incisors. The formation of spaces between the lower anterior incisors is quite rare, but can still be diagnosed if the frenulum is woven into the region of the gingival papilla between the anterior incisors of the mandible.

Treatment

The operation can be performed on children of different ages, but most often these are children with fully erupted permanent incisors. No less often, the frenulum can be dissected already in adulthood, when it comes to prosthetics of the lower jaw.

The operation itself is carried out in a polyclinic, using local anesthesia, and 2 operations can be used to correct the frenulum - frenotomy, frenectomy.

Frenulum of the tongue

It is this frenulum that is able to influence the movement of the tongue, most often it limits these movements. The tongue is the most important organ in the oral cavity, which is involved in many functions - speech production, nutrition, breastfeeding and much more.

Normally, the mucous cord is woven from the inside of the tongue approximately in the middle, and connects to the sublingual space. The normal length of the frenulum is about 8 mm. If the little bridle is attached almost to the tip of the tongue, then this is a clear indication for correction.

Such a classic sign of a short frenulum of the tongue is not always found, there are other symptoms by which its shortening can be diagnosed. Doctors usually use a simple test that parents can use as well. With the baby's mouth open, you need to ask her to touch the very sky, and if the baby gets it without difficulty, everything is normal. But if the child has a pain reaction, or the baby simply cannot do this operation, this is a reason to contact the doctor.

The only drawback of such a test is the age restrictions in babies, such a test can only be carried out in children older than 3 years. If the baby is younger, then he can simply refuse to carry out such manipulation. For younger children, there are also their own set of tests, usually doctors ask or provoke a child to show his tongue. And at the same time, the doctor evaluates how much the baby's tongue can come out of the oral cavity.

What is the danger of a short frenulum of the mouth?

Every mother should pay attention to feeding the crumbs, monitor his reaction, pay attention to the sounds that the baby makes, and weight gain. With a short frenulum of the tongue, the baby simply cannot properly lay the tongue under the mother's nipple, it turns out that the baby cannot properly grasp the breast, and “clattering” sounds may occur during feeding.

In addition to inadequate attachment to the breast, and problems for the mother, the baby spends more effort to get enough, the baby's sucking activity gradually decreases, and the feeding time itself increases, during which the baby takes a short break. The baby tries to compensate for more effort by clenching the jaws, and often when feeding, babies bite their mother's breasts.

Often such children set their own feeding schedule, since full saturation occurs over a longer amount of time, usually babies eat about every two hours. Weight gain is carried out at the lower limit of the norm, or even lags behind.

A frenulum in infancy may not be diagnosed, and may be detected during the period when the baby begins to actively talk. Toddlers with a short frenulum of the tongue cannot correctly pronounce quite a lot of sounds, namely those sounds in which the tongue should touch the sky or upper incisors - “p”, “sh”, “u”, “h”, “p”, etc. Diagnosis of the frenulum often occurs at the reception of a speech therapist, from where parents receive a referral to the dentist.

Treatment

Treatment can take place in two ways - surgical, or speech therapy, often there is a combination of these two methods. Parents should remember that the choice of treatment method lies entirely on the shoulders of the dentist, and not a speech therapist.

Surgical correction of the frenulum

The frenulum can be corrected even in the maternity hospital, the operation is carried out in the obligatory presence of the mother, and after the operation, the baby must be immediately applied to the chest. There are no nerve endings in the frenulum itself, but there are blood vessels, in the place where the dissection takes place there are none, therefore, there is no pain and bleeding. Babies can just get scared, and breastfeeding is more of a soothing maneuver.

In young children, the correction is most often carried out with a laser, which eliminates the need for stitches and reduces recovery time.

In older children, namely school children, it is carried out under local anesthesia. In this case, the doctor dissects the frenulum and sutures using a classic set of tools. It is better to use a laser scalpel. When using it, the time of the operation itself is reduced, there is no need for suturing.

After rehabilitation, the baby must follow a special sparing diet, and perform those exercises that the dentist or speech therapist recommends. These exercises are aimed at training the bridle. If the frenulum is not very shortened, then it is possible to solve the problem without surgical intervention, but only if the baby is less than 5 years old.

Speech therapy exercises

Exercises can be different, and the choice will depend on the age of the child. For the smallest, you can offer game exercises where the baby’s tongue will be involved, for example, the “kitten” exercise - the baby is offered to lick the saucer like a kitten.

You can use the exercise horse”, ask the baby to click like a horse, while the tongue rises to the sky, the bridle is stretched and stretched, which trains it.

At the reception, a speech therapist can massage the frenulum with special tools or with the help of hands. It is worth remembering that the child gets tired pretty quickly, and there may be discomfort up to pain. That is why the load must be increased gradually, and it is precisely with this fact that speech therapy treatment does not give quick results, and in most cases it is impossible to do without surgical intervention. And when diagnosing a short frenulum, you need to get

Very often, parents of non-speaking children come to a speech therapist, and the first thing they ask is: “Look, please, maybe his frenulum is short, so he doesn’t speak?” This is one of the biggest myths. Dear parents, a short hyoid frenulum does not prevent the child from starting to speak, it can affect diction, but not the appearance of speech itself.

Let's take a closer look at this issue. In the oral cavity there are three mucous flagella, or strands, called frenulums. Their condition is checked in the first days after the birth of the child, since the child's ability to perform the act necessary for the life of the child - sucking - depends on their condition. In the maternity hospital, if necessary, they are cut. Occasionally, a speech therapist tells you about the condition of the hyoid frenulum, because it often affects the sound pronunciation of the child.

The first is the frenulum of the upper lip; it attaches the upper lip to the gum of the upper jaw. Finding it is very simple; move the child's upper lip, you will see a thin flagellum that connects the upper lip and gum. As a rule, the frenulum is attached to the gum 1 cm from the neck of the anterior incisors. It happens that the bridle is attached below, and perhaps it goes beyond the front incisors, such a bridle is considered short. This defect can provoke malocclusion, namely, to the advancement of the front incisors forward. But most often, the frenulum of the upper lip wears a cosmetic defect when you see the gap between the two front teeth of the child. Very rarely, but there may be defects in the sound pronunciation of labial sounds.

Treatment of this defect is only surgical, after consulting an orthodontist. Moreover, cutting the bridle is done only after the appearance of permanent incisors, as a rule, this is during the period of changing teeth.

The second - this frenulum is located on the lower lip, it attaches it to the gum of the lower jaw.

It is interesting, but there are cases when this bridle does not exist at all, or, on the contrary, there may be several of them. To find it, pull back slightly on the lower lip, you will see a slimy flagellum that comes from the lower jaw and connects to the lip. The bridle should be thin and barely noticeable, be sure to coincide with the center line. The frenulum is thick, and weaves in at the base of the lower central incisors. Treatment is always surgical after the child has permanent teeth. The condition of this frenulum does not affect the pronunciation of the child.

If the first two frenulums practically do not affect the pronunciation of the child, then the third frenulum has a very big impact. Since our diction depends on the mobility of the language.

The third - the frenulum of the tongue - is the main one, it is attached to the tongue and the sublingual space. The hyoid frenulum is attached to the inside of the tongue approximately in the middle and connected to the hyoid space, its length should be about 8 mm. To find out if the frenulum is short, ask the child to open his mouth and stick out his tongue, reach for the upper teeth. The frenulum is considered shortened if the child's tongue does not reach. When the child pulls the tongue, the frenulum will stretch, sharply marked, protrude under the tongue. If the tip of the tongue is not stretched enough and you see that the hyoid tourniquet seems to be stretching the tongue, then the frenulum is short.

A short frenulum of the tongue is not always diagnosed in the hospital, more often it is detected during the period when the child begins to talk. A child with a short frenulum is not capable of clearly pronouncing the "upper" sounds of hissing and sonorants. There are several ways to treat this defect - surgical intervention and performing special articulatory gymnastics to stretch the frenulum. Speech therapists are currently trying to the last to stretch the frenulum, not wanting to injure the child at the dentist. Parents, remember that it may take a sufficient amount of time to stretch the frenulum of about 3-7 months, it all depends on the individual characteristics of your child's frenulum. And only in case of failure send the child for a consultation with the dentist.

Good luck to you and your child!

Cutting the frenulum under the tongue in children is a common procedure in surgical dentistry. The operation is recommended at any age and is performed in order to eliminate congenital pathology. The sooner plastic surgery is performed, the faster and better the correct speech, jaw and bite of the child will begin to form.

The frenulum is normally able to lengthen and contract in the mouth. This is an elastic fold of mucous membrane that stretches from the middle of the tongue to the very base of the gums, approximately in the region of the lower front incisors. Its main purpose is to ensure the mobility of the tongue and the normal pronunciation of sounds.

The fold may have some deviations, in particular related to its elasticity, length and attachment area. They are found in early childhood when a child is examined by a doctor.

What is the danger of a short bridle?

This pathology has the scientific name ankyloglossia, which means "curved tongue". Most often this phenomenon is observed in boys. An abnormally short frenulum prevents the child from properly controlling the tongue, swallowing and even breathing. Usually, a pediatric neonatologist helps to detect pathology, but there may be oversights on the part of some doctors.

A short frenulum prevents the child from properly controlling the tongue, swallowing and even breathing.

A pronounced sign of pathology is that the baby hardly sucks the breast during feeding, as a result of which it is poorly saturated, behaves restlessly, is naughty, often requires attachment to the breast, and does not gain weight.

It is important! In children older than three years, a short frenulum of the upper lip can lead to improper development of the interdental spaces, which are located between the upper incisors, as a result of which they are pushed forward sharply. The anomaly of the lower lip most often leads to incorrect bite formation.

A short frenulum in a newborn is a congenital pathology. The reasons may be different:

1. Genetic predisposition - it is not necessary that the parents of the baby have the same problems. Often the anomaly is inherited from the next of kin.
2. Pathology can be during pregnancy, in the first and third trimester. The determining factors are different: the use of narcotic substances during the period of gestation, somatic or infectious diseases, adverse environmental conditions, abdominal trauma, and much more.
3. In some cases, an incorrectly developed frenulum of the upper lip is diagnosed in children who already have other congenital anomalies that cause various kinds of deformities.

Clinical picture

If such a problem occurs, then the following are observed complications:

• the baby hardly sticks out his tongue or is not able to do it;
• the baby cannot stretch out the tongue, because at the same time it takes the form of an arc;
• the child fails to raise the tongue to the sky, as in this case its tip bifurcates.

There may be other symptoms that the baby's frenulum is too short. An accurate diagnosis can be made by a doctor after a thorough examination.

When the suspicions of the parents are confirmed, it is recommended to perform an operation - plasty of the frenulum of the tongue in children. Surgical intervention has a number of features depending on the age of the child:

• Up to 1 year. If your baby has difficulty suckling while breastfeeding, you should contact your pediatrician for a checkup. The operation itself is carried out by a dentist. At this age, babies still have a small membrane, in which nerve fibers and blood vessels are completely absent. Plastic surgery is performed without the use of local anesthesia. Most often with minimal bleeding.
• From 4 years old. If before this age the child has not had plastic surgery and he has speech defects, and massage and various exercises do not help stretch the tongue, it is recommended to perform plastic surgery. Such a diagnosis is usually made by a speech therapist, and the operation is performed, as in the previous version, by a dentist.

During this period of life, cutting the frenulum of the upper lip already causes discomfort and pain. Therefore, surgery is performed under local anesthesia. After that, the child is stitched.

The photo shows a short frenulum of the tongue.

On a note! The most suitable age for plastic surgery is selected by the doctor depending on the individual characteristics of the child. The least trouble and discomfort is pruning at the age of up to 1 year. In some cases, the doctor may advise surgery immediately after the baby is born.

The sooner the parents take care of the elimination of this anomaly, the sooner the child will be able to begin to live fully.

Why is plastic needed?

A short frenulum of the tongue in a newborn causes a lot of difficulties. Therefore, experts recommend that correction be carried out at an early age in order to minimize the consequences. Most often, difficulties arise already during breastfeeding:

1. Unable to attach the baby in the right way to the breast.
2. The child has difficulty sucking milk.
3. In the process of feeding, the baby swallows too much air, which further leads to belching and pain in the abdomen.
4. Insufficient intake of mother's milk leads to the fact that the baby does not grow fast enough.

A short frenulum is a common diagnosis in babies, which a mother can hear even in the maternity hospital. In the same place, this pathology must be immediately eliminated, because the newborn baby will experience difficulty in sucking the mother's breast or when feeding from a bottle. The frenulum can be successfully corrected, the procedure is quick, almost painless and well tolerated, so do not worry if this happened to your baby. This is a common operation in the practice of pediatric surgeons. Much more dangerous are the consequences that this anomaly can cause in advanced cases.

An abnormally short frenulum occurs in many newborns, but if surgery is performed on time, the child will not remember this problem in the future.

Why is the bridle cut for a child, and is it really necessary?

The frenulum of the tongue is a webbed bridge that connects the tongue and the lower jaw (see also:). Thanks to its presence, the tongue is held in a normal position. It is responsible for many important functions in the human body:

• nutrition, in infancy - breast sucking;
• correct pronunciation;
• normal bite;
• work of the facial muscles.

When the frenulum has developmental pathologies, the normal functioning of the oral cavity is disrupted. Normally, it is located in the middle of the tongue and has a length of about 2.5-3 cm, in babies up to a year - 8 mm. Usually frenulum anomalies consist in shortening the length or attaching it to the tip of the tongue. This deviation is called ankyloglossia, or a short frenulum. The location of the frenulum in the mouth, characteristic of this anomaly, is shown in the photo.

Why is ankyloglossia dangerous for a baby? It causes deviations in the development of the jaw and malocclusion. You can understand that the baby has a short frenulum immediately after birth. The baby does not suck well at the breast, gets tired quickly, cries and is often applied to the mother's breast. During feeding, characteristic clattering sounds are heard, and milk pours out of the mouth. Such babies grow slowly and gain weight, because their tongue is inactive, and sucking causes discomfort, it hurts to move the tongue. The same is observed in artificial babies.

At an older age, a simple test is used to determine ankyloglossia: if the child can reach the upper palate with the tip of the tongue, the length of the frenulum is normal. A specialist may suspect a deviation when a child has malocclusion, periodontitis, speech pathology, discomfort when chewing and swallowing food. Usually this problem is diagnosed by a speech therapist, who is contacted for help with incorrect pronunciation of sounds and words.

Ankyloglossia must be treated, otherwise it leads to serious disorders:

• chewing food;
• bite;
• pronunciation;
• nasality;
• snoring (apnea);
• inflammatory diseases of the oral cavity;
• frequent colds due to mouth breathing;
• disorders of the gastrointestinal tract;
• scoliosis.

Often ankyloglossia occurs for hereditary reasons. If relatives had such a pathology, the probability of having a child with the same disorder is quite high. In addition to the genetic predisposition, a short frenulum is formed with pathologies of the mother's pregnancy and other factors:

• viral diseases (the first and third trimesters are especially dangerous);
• toxicoses;
• exacerbation of chronic diseases;
• psychotraumatic situations;
• taking alcohol, drugs, chemical poisoning in the first 3 months of pregnancy;
• poor environmental situation in the region of residence;
• bruising of the abdomen or other injuries.

At what age do such an operation?

There are no age restrictions on plastic surgery, it is done for the smallest patients, school-age children, and adults. Mom is practically not separated from the child, because the plastic of the frenulum itself passes quickly.

Plastic frenulum of the tongue is easier to tolerate in the first months of life. It is best to make it for a newborn so that the baby can eat comfortably and grow well.

In older children, it is more difficult to carry out a correction, since it is performed under general anesthesia, and convincing a one-year-old child to sit still for several minutes is much more difficult than operating on a baby. That is why doctors recommend in some cases to postpone the intervention until the age of 4-5 years.

However, during this time, persistent speech disorders may appear, which subsequently require long-term corrective work and constant exercises. Other experts recommend cutting the membrane between the tongue and jaw during the growth of the upper teeth.

Where is frenuloplasty done and which doctor should I contact?

If ankyloglossia is suspected, the child will be referred for a consultation with a dentist, orthodontist or maxillofacial surgeon, who will confirm or refute the preliminary diagnosis. The decision on the need for surgery will be jointly made by the orthopedist, surgeon and speech therapist.

3 degrees of pathology: mild, moderate and severe

There must be good reasons for this:

• serious nutritional problems in a newborn baby;
• speech therapy disorders that cannot be eliminated by conventional means;
• malocclusion;
• violation of proper food intake;
• displacement of teeth, inclination of the incisors inward.

Experts share the degree of pathology on a 5-point scale. Small deviations are successfully eliminated without surgery at the age of over 1 year by performing special exercises.

The operation is performed in the maternity hospital or in dental clinics for older children. If the case is complicated, they operate in the maxillofacial departments.

Surgical correction of a short frenulum

A newborn baby can be operated on even in the maternity hospital, because at birth a neonatologist will check him for the presence of this pathology. In older children, the procedure is carried out quickly, it does not require a stay in the hospital, after it you can immediately go home.

Contraindications to cutting the bridle may be:

• oncological diseases (including the oral cavity);
• blood diseases;
• acute infectious diseases;
• diseases of the oral cavity and teeth (caries, pulpitis, osteomyelitis).

Bridle cutting is carried out if the child is completely healthy; in the presence of caries or other disease, the operation is not possible

The main types of operations for ankyloglossia

It is up to the specialist to decide which type of surgery is appropriate. Usually this:

• frenulotomy - cutting the frenulum and suturing the edges of the mucosa;
• frenuloectomy, or the Glickman method, when the frenulum is cut from the side of the teeth;
• frenuloplasty, or Vinogradova's method, in which a layer of tissue is cut off from the mucosa and sutured to the frenulum.

There are other ways - it all depends on the specific case. The specialist will advise how best to proceed in this situation, perhaps circumcision of the frenulum is not required.

How is the procedure for trimming the bridle?

A child over 2 years old needs to be explained why it is necessary to cut the jumper between the tongue and jaw. It is necessary to calm him down so as not to cause severe stress.

The operation is performed under local anesthesia. There are no nerve endings and blood vessels in a newborn child in the frenulum. That is why her pruning does not cause much concern to the baby and parents. The operation time usually takes 5-10 minutes.

For an older child, a lidocaine spray or gel is applied to the site of the future incision. Then the doctor performs cutting with a surgical scalpel or scissors. Sutures are not always required.

Treatment with a laser

Laser correction is considered the safest method of surgery and belongs to microsurgery. It practically does not cause complications. There are no stitches after laser surgery, this is not necessary, and the postoperative period lasts 2 days.

The duration of laser surgery is only 3-5 minutes. This method is suitable for babies, because it does not cause bleeding, complications in the form of secondary infections, it is accurate and almost painless.

Recovery period

For babies up to 9 months, the rehabilitation time is only a few hours, after which the baby can be attached to the breast. In older children, the recovery period lasts about a day. After laser surgery, rehabilitation is even faster.

Immediately after the operation, the babies begin to eat normally without experiencing discomfort, and mother's milk will help the wound in the mouth heal faster. Babies quickly gain weight and grow well. Speech therapy disorders in babies under one year old are not diagnosed, and older children will need corrective work with a speech therapist. What exercises are recommended in the presence of pathology, you can see on the video.

In the presence of pathology, it is recommended to regularly perform simple exercises.

After frenuloplasty, you should:

• do not eat for 2 hours;
• 3-4 days do not eat irritating foods - salty, spicy, sour and too hard;
• refuse hot food and drink;
• for some time it is better to eat food in a pureed form;
• do not load the language with conversation;
• after eating, it is imperative to rinse the oral cavity with antiseptic agents (chamomile decoction, calendula tincture, Furacilin solution);
• do special exercises developed by the doctor;
• lay sea buckthorn oil, Solcoseryl on the site of surgical intervention;
• visit a speech therapist as prescribed by the attending physician;
• if there is pain, the child is given pain medication (Nurofen, Ibuprofen).

Are there complications after the operation?

Usually, no consequences, except for a short-term restoration of the normal function of the oral cavity and tongue, do not occur. Everything passes quickly, almost painlessly and is well tolerated by the child.

With poor postoperative wound treatment, improper hygiene, inflammation and pain may occur. In school-age children, scarring sometimes forms, in which case a second dissection will be required.

The pathologies of the human body present at birth include a small frenulum, expressed by an anomaly in the development of connective tissues (ankyloglossia), which fix the tongue to the lower part of the oral cavity. The tongue does not perform normal movement due to obstacles created by the strand of muscles and connective tissue.

Children have a complete or partial frenulum. The first case is expressed by the immobilization of the lingual organ and during the examination it is seen how the tongue folds into a tube from two sides. With a partial short frenulum, there is a thin film in which there are no nerve endings. You can see what a full short frenulum looks like in a newborn in the photo to identify signs in your baby.

Tongue frenulum

According to statistics, an anomaly of the frenulum under the tongue in a child is noted in most cases in male children, as well as in those who were inherited from one of the parents who had a problem. The elimination of a defect in modern medicine is not a rather complicated procedure, it does not cause any special reasons for unrest.

Many young parents who are faced with a problem often ask the question of what factor could affect the formation of a short frenulum. This component of the body is formed in the womb during the development of the fetus. The main reasons include:

• hereditary phenomenon transmitted from one of the parents;
• harmful, bad habits in a future woman in labor;
• unfavorable ecological situation;
• taking medications during gestation;
• the age of the mother carrying the child has exceeded 35 years;
• getting abdominal injuries during pregnancy;
• fetal infections during fetal maturation;
• somatic diseases of the expectant mother;
• viral diseases in a pregnant woman (first, last trimester).

Based on a series of pictures, a short frenulum of the tongue in a photo in newborns invites parents to familiarize themselves with the anomaly and compare the picture of the oral cavity in their crumbs.

How to determine a short frenulum of the tongue in a child

Pathology is detected most often even in the maternity hospital by neonatologists, but later you can be examined by a surgeon, dentist. In addition, most of the symptoms allow parents to independently determine the presence of a short frenulum in the child's oral cavity. Feeding is difficult, incomplete, the baby constantly asks for breasts and is constantly in a restless state from the lack of nutrition.

A short frenulum is most often found in the hospital by neonatologists

The first signs are considered when the baby after birth has difficulty sucking the breast, with its normal grip. He practically refuses to suck at the breast at the very beginning of feeding, as it constantly slips out.

The baby often acts in the process of feeding with gums, lips, which creates chewing, biting the nipple and, accordingly, pain in the mother's chest. At the same time, the child and mother get tired, and the constant tension of the jaw muscles can give them trembling (tremor). Therefore, it takes enough patience, skill, to feed a baby with a short bridle.

Older children with the pronunciation of individual sounds, hissing, the letter P with difficulty and inexpressive diction should also be examined for the presence of a short frenulum. It can be determined visually. In some cases, the frenulum can be fixed at the very tip of the tongue, leaving little room at the bottom. With normal fastening, it is possible to limit the movements of the tongue due to its small length. In this case, the child's tongue hard reaches the lower lip, cannot lick the lips, and it is difficult to pass along the upper gums from the inside. Children often hear involuntary clattering sounds, clicks. When a child sticks his tongue out of his mouth, it takes on a hunchbacked shape, or is folded like a groove.. If you ask a child to specifically create clattering sounds, he will not succeed in this process. Also, at the age of five, in children in a stretched state, the frenulum is on average 0.8 cm, and when lifting up, the tongue should not form a bifurcation in shape, resembling a heart.

For comparison, in an adult, the length of the frenulum is no more than 3 cm. The anterior part of the frenulum is attached several millimeters above the gingival papilla

Treatment

Currently, experts offer two types of treatment, both surgical undercutting and a conservative method. The method of treatment is determined by the doctor, and also prescribes the time of treatment, the importance of taking measures. For surgical treatment, doctors such as a dentist, a surgeon, an ENT doctor take part, and a speech therapist takes part in conservative treatment.

Excision of the frenulum of the tongue with a laser

Cutting the frenulum of the tongue in newborns is carried out immediately when problems with sucking are detected. In this case, anesthesia is not used, since the connection contains a small number of blood vessels, and there are no nerve endings, and therefore there is no pain. The specialist uses surgical scissors, a scalpel designed for this type of operation. The procedure is painless and simple.

Recovery, rapid healing, as well as stopping the blood is carried out by applying the baby after the operation to the mother's breast for sucking. If the baby is already several months old, then the frenulum is trimmed using local anesthesia, and for older children, general anesthesia with suturing can be used. The terms for the procedure are set by the doctor, but in the absence of normal breast sucking by the baby, the operation is performed promptly urgently.

The operation is performed surgically, but recently it is preferable to use the laser method - electrocoagulation. Experts recommend cutting babies up to a year. During a routine examination of the baby, the pediatrician prescribes treatment, and if an anomaly is detected after 3 years, the parents turn to a pediatric surgeon or an orthodontist. At the age of 3 to 5 years, the procedure is carried out in the case of obvious problems with speech, as well as in the future with a noticeable displacement of the teeth, an incorrectly formed bite.

The operation is considered safe, takes several minutes, complications are excluded. If the procedure is performed on an older child, speech therapy should be additionally carried out.

You can see what a short frenulum of the tongue looks like in a child in the photo before and after the operation. After the procedures, anatomical defects gradually disappear in the child, breathing improves. Babies begin to gain significant weight. It increases the likelihood of preventing malocclusion and getting rid of speech problems.

Contraindications for treatment

The presence of certain diseases in a child may cause a contraindication for treatment.

The manipulation of cutting can be prevented by the presence of certain diseases in the child, such as hemophilia (non-coagulability of the blood), the risk of epithelial growth. In these cases, it is necessary to take additional measures for blood clotting so that the wound healing process proceeds normally. A contraindication may be infectious diseases in a child that need to be treated, as well as bad teeth. During the examination, the specialist warns about them and makes the optimal decision on the treatment process.

Effects

In addition to the fact that a short frenulum of the tongue in a newborn does not make it possible to receive adequate nutrition during breastfeeding, the baby loses weight, growth is stunted, and the mother’s milk disappears, the child does not pronounce certain sounds in further development, speaks poorly, there may be other problems . Incorrect language work has the effect of:

As a result, if the problems are not eliminated in a timely manner, the child will have to conduct classes with a speech therapist. He will constantly experience profuse salivation, a gap may form between his front teeth, and apnea is likely to occur - difficulty breathing, reduced oxygen supply and other problems.

Speech therapy methods of treatment

Speech therapy techniques include massage stretching procedures with a tongue with a short bridle. In most cases, experts recommend contacting speech therapists:

Speech therapy programs include articulatory gymnastics, which improves the elasticity of the frenulum with its stretching.

Often, speech therapists recommend that parents train with babies at home. For example, the child opens his mouth and tries to move his tongue towards the tip of the nose, chin alternately. With the next simple exercise, the child pulls the extended tongue up and down, then moves from side to side along the upper lip with the lower jaw stationary. The use of special speech therapy massage procedures by a speech therapist creates unpleasant, painful sensations for children. Not everyone can endure the process calmly, and often refuse to comply.

Achieving a positive result can be achieved by conducting regular classes with gymnastic exercises every day several times with an increase in time.