Tongue frenulum
is the fold of tissue between the lower surface of the tongue and the floor of the mouth. Short frenulum of the tongue otherwise ankyloglossia means such a frenulum, the anatomical structure of which limits the normative movements of the tongue.
ATTENTION PARENT !
The most common symptoms of a short frenulum of the tongue in children are:
1.Difficulty sucking on a bottle/breast
Which, in turn, can lead to a problem in grasping the teat from the bottle, the nipple, insufficient feed intake, pain and trauma to the nipples (erosions, cracks) low weight gain of the baby, long feeding times, food leaking from the mouth, smacking noises, smacking noises during feeding and premature weaning of the baby from the breast.
2.Compensations occurring within the orofacial sphere,
contractures and increased tension of the muscles of the floor of the mouth, sternocleidomastoid muscles and cervicothoracic rim, body asymmetry.
3.Disorders of the diet expansion stage
Difficulty in regurgitating and moving food content within the mouth, effortful swallowing attempts, increased vomiting reflex, food intolerances.
4.Occurrence of malocclusion,
persistent adiposity
5Improper oral breathing pattern,
which largely translates into a disturbed resting position of the tongue.
6.Occurrence of faulty pronunciation of phonemes requiring greater language skills,
These are the following sounds: [r, l, t, d, n, sh, ¿, cz, j, ś, ź, ć, dź
7.Delay in speech development
The disadvantages of a short frenulum can be prevented by undercutting the frenulum, a procedure called frenotomy.
The diagnosis of a functionally short frenulum of the tongue and the qualification for surgery should be established after a careful analysis of the morphological features of the frenulum of the tongue, an assessment of the restrictions in the mobility of the tongue as well as the observation of the child's behaviour during food intake and consumption and the appearance of characteristic symptoms in the mother (if the infant is breastfeeding).
Before treatment frenotomy
It is necessary to prepare the sublingual space for the undercut. The exercises and massages performed are aimed at relaxing the muscle structures of their attachments and separating the oral floor fascia from the frenulum of the tongue. By implementing the appropriate steps prior to surgery, we can cause the muscle structures of the tongue and floor of the mouth to undergo further stimulation and achieve faster improvements in the strength, precision and movement of the tongue muscles.
After phrenotomy
the wound healing process should be supervised and pre-exercise and massage should be implemented so that scarring or adhesions do not develop.
Contraindication to phrenotomy surgery
are blood clotting disorders as well as the Pierre Robin sequence and congenital diseases of the motor units, in which, after frenulum undercutting, the tongue may be displaced deep into the mouth, resulting in respiratory and swallowing disorders.
* Prematurity is not a contraindication to a phrenotomy procedure.
