Undercutting of the frenulum under the tongue in children: plastic frenulum of the tongue
A child is born with well-developed muscles of the tongue. The gap feature of the mucosa between the tongue and the bottom of the mouth is called the frenulum. The degree of development of the structure depends on the child’s ability to get enough food and say the sounds. In a short length of this connection is the language is not capable to perform designated functions. And because the child’s development slows down. Let’s look at this issue in more detail.
Age category for the transaction
What age is recommended to prune is it necessary? The lingual frenectomy in children perform the relevant indications. Normally, when the natural feeding the child seizes the nipple with tongue and sipped it, remove the milk. When making these oscillatory action of the bridle helps him to maintain fixation of the nipple and make muscular contractions. In case of a short length of the frenulum language will be limited in their actions that will result when feeding to frequent loss of the nipple and therefore does not saturate. The baby with the effort of sucking, applying considerable efforts. If the child does not eats, he becomes restless and Moody. The child is crying, feeding combined with a clatter, but the background of muscular effort may receive tremor of the jaws. The changes also affect sleep. The child may opt out of breastfeeding. With the decline of the food consumed, the child is not gaining weight adequately and so the development starts to slow down. Therefore, the main criterion for undercutting of the frenulum in newborns will be a problem in sucking. Recommendations for intervention given by the pediatrician, the dentist after examination.
If the child is growing and developing according to age and body mass index was normal, the frenulum pathology may manifest as violations of articulation. The child will not clearly pronounce some syllables and words. For a start, the doctor-the therapist assigns to perform a number of exercises for stretching and massage of the frenulum of the tongue. If the complex of measures did not yield results, the indication for intervention by a doctor-a speech therapist is determined by the age of 4 years. In General, the meaning of cutting the frenulum under the tongue in children is calculated individually. As we evaluate not only the main indications (power and articulation), but also additional (susceptibility of the nervous system). It is believed that the early is performed, the better for the child.
The causes and options
To determine the origin of the short ligament is capable of the following factors:
- Genetic predisposition;
- The negative influence of factors of the first trimester of pregnancy: infectious diseases, professional diseases, use of some medicines, stress;
- Is calculated more often in children of parents over 35.
A bridle provides the formation of occlusion, articulation, nutrition, expressions of the facial muscles.
There are the following options ankyloglossia:
- Lingual ligament is a thin, transparent, blocks the mobility of the tongue;
- Translucent, thin and secured at the tip of the body;
- Short and thick ligament blocks the movement of the tongue;
- Compact and short, fused with the organ of touch;
- Almost imperceptible bundle, the mobility authority strongly blocked.
Thickening of frenulum occurs over time. Worse, the child pronounces hissing sounds, the letter «P», increases salivation. Abnormal condition of the bridle leads to regular disruption, snoring during sleep, the swallowing of air and regurgitation.
Tests and examinations
To identify ankyloglossia (short bridle of language) able specialist, usually a dentist. In normal mucosa, the film must be attached to the middle underside of the tongue is in length of 25-30 mm (adults). Improper development of the bridle attached to the face of the language and when picked up it forms a groove or heart. If the child will stick his tongue out of his mouth, the tip bent downwards. Before making the intervention you need to perform several surveys. Why do you think? This is necessary to prevent the development of complications in the idea of anaphylactic shock and other pathologies. Performed examinations of urine, blood (total forms). Checked for blood clotting . Complete the survey by fluorography. To cut the frenulum of the tongue of the child is considered to be less traumatic operation, but it is better to conduct all the necessary examinations before the intervention.
If the assessment performed in children of older ages, it is necessary to give them a number of tasks: clicked his to lick the plate, the tip of his tongue to reach to the sky. If you completed all the tasks without difficulties or with slight confusion as the frenulum is estimated as normal. Initially undertake a number of activities for stretching the muscles of the tongue and frenulum and in the case of their ineffectiveness proceed to surgery.
Methods of intervention
You need time to cut the frenum of the tongue and the child will be easier. The child should be fed prior to the manipulation, because the lingual frenectomy in newborns will determine the origin of the stress, and hunger additionally aggravate the condition of the body. Circumcision lingual frenulum operates in two methods: using scalpels and laser. The newborn may use manicure scissors, because mucosal layer is thin and, as a rule, without blood vessels and nerves. What is plastic surgery of the frenulum of the tongue in infants is reflected in a small bloodletting. Immediately after surgery, the baby put to the mother’s breast to soothe and stop the bleeding. In the case of artificial feeding takes formula from a bottle.
Plastic frenulum of the tongue with a scalpel has its own characteristics:
- The tongue-tie to clip under the tongue of the child will require approximately 20-30 minutes;
- If the child is older than 4 years doing anesthesia;
- Produce the mucosal incision, remove the excess tissue and suturing;
- The healing of the seam occurs in 7_10 days, over time, visual changes in the mucosa disappear;
- In the period after the operation may cause swelling of tissues and scar;
- Recommend rinsing solutions, relieving inflammatory symptoms in the course of the healing and not to take solid food.
Plastic frenulum of the tongue laser is a more modern method of intervention:
- Cut the frenulum under the tongue in the sequel 10_12 minutes;
- Tongue-tie at undercutting does not cause severe pain and bleeding;
- Before the intervention is carried out following application of the anesthetic spray or gel;
- Especially the predominant laser application are that when cutting tissue under the action of the device takes place simultaneously coagulation. Thereby minimizing the manifestation of blood, all this leads to the absence of the need for stitches.;
- In continuation of hours the child’s condition returns to normal and he can begin fulfilling their duties;
- Heal tissue after the intervention for 2-3 days.
How to cut the frenulum under the tongue, will decide the parent. Each method of intervention for their own good and has a number of differences not only in execution but also in price. It is important to evaluate the child’s condition and come to a common doctor method of manipulation.
General advice after the operation
- 2-3 hours after intervention;
- To exclude solid products;
- 3-4 days to withdraw from food stomach irritating foods (spicy, salty, sour and otherwise);
- A week after the meal to carry out rinsing with antiseptics;
- After rinsing lay in the wound means wound healing: solkoseril, sea buckthorn oil;
- Restore the mobility of language exercises from a speech therapist.
Child care and complications
Plastic frenulum of the tongue, though low-impact intervention, however, requires adjustments in the child’s condition.
May include the following changes in the condition of the baby soon after the procedure:
- Pain in the area of intervention after falling anesthesia;
- Hyperthermia as a variant individual reactions to the intervention.
If plastic frenulum of the tongue was performed in the older child, on the venue, you may receive a scar, which will restrict mobility of the tongue. It is necessary in such cases, repeat the plastic.
Other complications will emerge in the period after the operation in the range from 2 to 7 days. The occurrence of complications provoked by the background of violations of wound care. Baby are recommended to gargle with herbal decoctions and anti-inflammatory, antiseptic and analgetic action. In case of insufficient holding of swelling and pain in the wound can be maintained. And produces a correction in the diet: recommend that you eat, the consistency of sour cream and cream. In violation of this paragraph occurs injury the wound with particles of food, causing deterioration of inflammatory changes and the possible accession of microbes. It is recommended to thoroughly carry out the oral hygiene and less talking, because this can lead to a gradual divergence of seams. After a week of observation, the child may return to normal rhythm of life.
After complete closure of the wound speech therapists give advice on a number of stretching exercises and massage of the language. Gradually the doctor in combination with the patient carry out the production of sounds, syllables and words in the right direction.