- 1. Why is the hyoid frenum short?
- 1.1. Features of
- 1.2. How is the functionality of the language defined?
- 1.3. Types of
- 2. Medical consultation
- 3. Surgical intervention
- 3.1. Indications
- 3.2. Contraindications
- 3.3. Types of Operations
- 3.4. How is the operation?
- 4. Traditional methods of treatment of
- 4.1. Stretching exercises
- 4.2. Logopedic massage
The sublingual bridle is a thin jumper, which is the connecting link between the tongue and the lower oral cavity. It should reach the middle of the tongue, but newborn children also have a short frenum, which can be attached to the tip of the tongue or practically absent( then the tongue almost does not separate from the lower oral cavity).In the photo you can see what the normal bridle looks like.
The bite, diction and health of the teeth depend on the correct arrangement of this small organ. If the problem exist
Why is the hyoid frenum short?
A short frenum of the tongue scientifically called ankyloglossia. Scientists have not yet established exactly why such a deviation in development occurs. Now only a few of the most probable reasons are called:
- The biggest factor in this case is hereditary. If the mother or father was diagnosed with a short frenum, the child's probability increases to 50%.
- Violation of the formation of the sublingual septum can trigger toxicosis in the early stages of maternal or viral and acute respiratory infections. Not the least role here is played by the treatment with medications, especially hormones and antibiotics.
- Mother's abdominal trauma during pregnancy can affect the development of the child.
- Another reason is late pregnancy. At age relatives( after 35 years) children with too short a bridle of language can be born.
- Exposure to chemicals in any form - for example, work in conditions of increased toxicity, contaminated environment, bad habits( smoking, alcoholism, drug addiction).
- The emotional state of the mother during pregnancy is of great importance for the full development of the baby. Frequent stress can also affect the formation of the sublingual frenum.
What is the norm? The newborn child has 8 mm( may be longer, but not shorter).By 5 years of age - up to 17 mm. The free tip of the tongue should be 16 mm in a year and a half. The pathologist will be able to determine the speech therapist.
To find out whether the development of the hyoid part of your baby is right, using some measuring instruments will be problematic. Nevertheless, there are various external signs, by which you can notice the deviations.
Short frenum in the newborn:
- feeding occurs frequently and lasts a long time, while the baby stops to rest;
- when you give a baby a breast, he behaves restlessly - he cries, arches;
- baby does not gain weight;
- the child bites the breast when feeding;
- during eating, the baby "clicks" and snaps the tongue;
- is a great risk that he will completely give up his chest.
Older children and adults:
- bite defects;
- difficulties in fixing implants and prostheses;
- incorrect reproduction of hissing sounds, as well as "p", "l", "d", "t".
Various defects in the structure of the oral cavity can also confirm the fear:
- the lower incisors are inward;
- tip of the tongue is divided in two, when stretched on it noticeably deepening;
- tongue does not get to touch the sky, lips or stick it out;
- the back of the tongue is raised, and the middle is pressed downwards, because of what the tongue looks humpy;
- for swallowing chewed hard food should be moved to the back of the tongue.
How is the functionality of the language defined?
You can determine the length of the jumper by using a special test. According to the indices, the anomaly in development can be of different degree:
- is light - the bridle is longer than 15 mm, there are disturbances in the pronunciation of sounds;
- average - the length of the bridle is less than 15 mm, there are all the signs;
- heavy - length up to 10 mm in the presence of all signs.
The test was offered by the American professor Alison Hazelbaker in the book "Tongue-Tie"( "Bridle of the tongue").In determining the length, it takes into account both the appearance and functionality of the jumper. It also lists the parameters that normal development should match:
- You have to put your finger on the lower lip in the center and draw it from one end of the mouth to the other. In this case, the language should easily move behind the finger.
- The child needs to lift the tip of the tongue to the upper sky. When this action is carried out, there should be no difficulties.
- Place your finger on the lower lip and move it to the child's chin. The tongue should follow the finger and freely touch the lower lip.
- Pull the finger of the finger to the upper sky. When sucking, the tongue will be flat and should shrink from the tip to the sky.
- Touch your finger pad against the upper sky. The language should not be clicked.
- Ask the baby to lift the tongue. In this position, it should acquire a round or square shape.
- Ask the child to press the tab down. If development goes well, he will do it without difficulty.
- The kid needs to pick up the tongue. The length of the bridle must be more than 1 cm.
The short bridle is divided into 5 varieties:
- Thin, transparent. The functionality of the language is only slightly restrained.
- Thin, translucent. If you lift the tongue, its tip splits.
- Thick, opaque. If you push the tongue forward, the back part will be raised, and the tip will be tucked.
- Short. The jumper fuses with the muscles of the tongue.
- Virtually absent. There is an interlacing with the muscles of the tongue.
Undoubtedly, it is necessary to do correction of the deviation. The earlier you start it, the bigger problems you can avoid:
- In a nursing baby, it becomes problematic to feed. The kid does not correctly grasp the chest, he does not suck well, at feeding he makes different sounds with a tongue, gets tired and stops to rest. Nevertheless, the child still remains hungry, becomes restless, weight is practically not added. As a consequence, the mother produces less milk and creates a greater risk that it will completely disappear and you will have to replace the natural food with an artificial mixture.
- With a short bridle of the tongue, the bite will be formed with irregularities. Because of this, the speech function is significantly impaired and speech defects will certainly appear.
- When a child has teeth and goes to a common table, difficulties will arise when chewing and swallowing solid foods. Plus abundant salivation, indigestion, eructation, diarrhea, periodontitis, gingivitis.
- The respiratory system is malfunctioning. Because of this, sleep is affected and apnea manifests( short-term respiratory arrest).The breath begins to predominate, and it, in turn, leads to frequent colds.
- The influence of ankyloglossy on the formation of posture has been scientifically proven. Be prepared for the curvature of the spine.
What does the famous children's doctor Eugene Komarovsky say about the problem? He divides the consequences of this deviation into two groups: sucking and speech. When a pediatrician identifies an incorrect formation of a frenum in a newborn, it is up to him to decide on the need for surgical intervention. At a more advanced age, the speech therapist is engaged.
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A short bridle can be cut. This is a very common way to solve the problem, and often even the only one. Before agreeing or refusing, you need to know how much it is justified, what contraindications it has and how this process is generally carried out. Plus the operation can be done in different ways.
There are cases when the operation can not be avoided:
- a critical situation with natural feeding;
- incorrectly forming bite;
- tooth dislocation;
- speech defects, which can not be solved conservatively.
To confirm the need for surgery, you need to see a surgeon, speech therapist and orthopedist. Only if the situation is hopeless, this decision will be justified.
Surgery with a short frenum is prohibited when any of the diagnoses are confirmed:
- malignant tumors;
- of blood disease;
- any infection in the mouth or in the body;
. As before any operation, it is necessary to undergo a complete examination. If there are no inhibitory factors, surgical intervention is permissible.
Types of operations
There are 3 types of operations. They differ in the way they are carried out:
- Frenulotomy. This is the simplest operation. The sublingual septum is cut with scissors at a distance of 1/3 of the length of the jumper closer to the lower teeth. Dissect the mucous membrane first, and then the strands. Then the edges of the mucosa are reduced and the seam is applied every 3-4 mm.
- Frenulectomy( Glickman's method).Clamp the bridle, then make incisions between the clamp, lip and mucosa from the side of the teeth. Then a seam is applied.
- Frenuloplasty( Vinogradov's method).From the transitional fold to the interdental papilla, two converging cuts are made. The flap is separated in the form of a triangle, and the edges of the wound are sutured. After this, the triangle is sewn to the remaining wound surface.
Of the less common methods can be called Frenuloplasty Limberg and Popovich. Likewise, a trimming of the short frenum of the lip is done. Such an operation is done in the case of orthopedic and orthodontic diseases.
language. How is the operation performed?
If a short frenum was found in the child in the first days of life, the operation is done in the hospital. Frenulotomy can be done before 10 months of the baby's life. Local anesthesia is used. For such a short period, the jumper has not yet been overgrown with nerve endings and blood vessels, so the operation is painless and without blood. Upon termination of the baby it is necessary to attach to the breast, and the healing process will last only a few hours.
Older children are also operated under local anesthesia, but already in the polyclinic. This procedure lasts only 5-10 minutes. Bleeding during incisions is prevented by an electrocoagulator or electroscissors. It takes 1 day to heal the wound.
As practice shows, if the operation to cut a short frenum was carried out no later than 9 months, the child will have no speech defects. In addition, after surgery, babies begin to eat better. Older children will need to practice with a speech therapist and do exercises to stretch the sublingual lintel so that it does not fuse again. I'll have to work on the pronunciation of sounds.
Traditional methods of treatment
After the short frenum has been adjusted surgically, different measures are necessary to fix the result. In this case, these are stretching exercises and a speech therapy massage. By the way, the use of such techniques is also recommended when it is possible to do without surgery.
Classes are held 5 times a day and last 5 minutes. It is better to do them more often, but do not delay. We list the exercises for stretching the short frenum of the tongue:
- pull out the tongue and lead them from one corner of the mouth to the other;
- reach the lower and upper lips with the tip of the tongue;
- click the language, sucking it to the sky and sharply tearing it down( a sound sounds like the clatter of horse hoofs);
- lick tongue drop of jam from the upper lip;
- open your mouth wide and hold your tongue across the sky away from your teeth;
- stretch the mouth in a smile and touch the tip of the tongue with the upper and then the lower teeth;
- close your mouth and in turn rest your tongue in the right cheek, then in your left cheek;
- close your mouth and pull your lips into the tube;
- to close your lips and stretch them in a smile;
- stretch the lips and at the same time smack them;
- to the baby to give a licking spoon.
. Logopedic massage
A good result is provided by a logopedic massage, although it does not deliver pleasant sensations to the child. The doctor conducts the procedure carefully washed and disinfected hands. What is the logopedic massage:
- Bridle clamped with forefinger and thumbs. Then closed fingers should be carried along the bridge from the bottom up.
- With the middle and forefinger, grab the sublingual septum and fix it, and press the front part of the tongue with the big one and slightly pull it outward.
- Tip the tongue with your thumb and forefinger and pull it down then up. Then, with your index finger, pull the bridle upward.
- Put a small ring on the tip of the tongue( you can cut it off from the pipette).Then open the mouth and press the ring to the sky, after which the mouth is closed. Repeat the exercise 3 times a day for 10 approaches.
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