Saturday, August 19, 2006

Tongue Tied

Everyone has this little connection from the floor of the mouth to the underside of the tongue. This is called a lingual frenum. Sometimes it is quite thick and tight, or it may have a connection point close to the the tip of the tongue. If it is too tight or too thick it may interfere with proper tongue movement or speech development. This is called being Tongue Tied. (You can see why they call it that).

Treatment: If the tongue moves pretty well and speech is developing normally, no treatment is indicated. However, sometimes we will recommend surgically clipping the frenum to allow more natural movement, especially if it is really tight or in some other way interfering with normal movement. Now just clipping the frenum will not necessarily correct a speech problem. However, a tongue that is free to move properly will at least reduce one complicating factor. Infants may have a frenum that concerns a parent who is having nursing problems. Most of the time a frenum is not the problem in these cases.

I usually wait till a child is old enough to cooperate a little in the dental office, usually around four years of age. Then it is quite easy using an electrosurge (bovie type) instrument that easily cuts the area with little or no blood involved. The kids do quite well for this. Usually no sutures are needed, although in more extensive cases they may be needed. If I think the case is more severe I will refer to an oral surgeon who can do a more extensive procedures utilizing some sort of general anesthesia. Again, most children don't need a frenum clipped. Each case should be evaluated on an individual basis. This one is pretty tight with a high attachment:



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