Indications for plastic surgery or trimming of the frenulum of the upper lip in a child. Trimming the short frenulum of the tongue in a child

Why is the frenulum under the tongue trimmed?
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A sign of a short frenulum in a newborn baby is difficulty sucking the breast, while the baby bites the nipple and very quickly refuses the breast. Most often, a short frenulum occurs in boys than in girls. Very often this phenomenon is typical for children whose parents had a similar problem.

A slightly shortened frenulum in a newborn child is not a disease, it is only a defect in the oral cavity, which doctors often discover in the maternity hospital. In this case, the trimming procedure is carried out immediately, although there are cases when doctors send the mother and newborn child to the dentist.

The procedure for cutting the frenulum is practically painless, because the newborn baby’s membrane is still completely small quantity blood vessels and no nerve endings. Therefore, a newborn baby’s frenulum is cut without the use of anesthesia using special scissors.

In order to stop the bleeding, after the procedure the baby is immediately put to the breast or given a bottle. The operation of cutting the frenulum is quite simple, the wounds after it heal the next day. After the procedure, newborn babies begin to breastfeed much better and their appetite improves.

This procedure is indicated only if there is difficulty breastfeeding. If a defect exists, but the procedure for cutting the frenulum was not carried out, after discharge from the maternity hospital, the parents themselves begin to notice that the child has deviations in the movement of the tongue. The baby cannot stick his tongue out of his mouth due to the fact that the frenulum pulls his tip down. The baby's tongue forms a groove, and this is accompanied by a certain sound.

As a result of difficulty in moving the tongue during conversation, an older child has difficulty pronouncing the letter p, as well as hissing sounds. Sometimes there is a violation of diction - the child speaks unintelligibly or unclearly.

A short frenulum can also lead to a displacement of the center of the tongue and cause problems in the formation of the lower jaw. Which subsequently contributes to the development of gingivitis and periodontitis of teeth.

When a child aged 5 years incorrectly pronounces the letter r and hissing sounds, and also has great difficulty lifting his tongue up, it is necessary to check his frenulum. In a stretched state, for a 5-year-old child, the characteristic length of the frenulum is at least 0.8 centimeters. When lifting the tongue upward, it should not bifurcate and take the shape of a heart.

The anterior edge of the frenulum is normally attached a few millimeters above the base of the gingival papilla, but not quite close to the tip of the tongue. To more accurately recognize a short frenulum, you can ask the child to lick the saucer with his tongue or click with his tongue.

When a child performs these actions without difficulty, the cause of speech defects is not the length of the frenulum. For children over 4 years old, surgery to cut the frenulum will not help correct speech defects, so it will be necessary to contact a speech therapist.

The need to trim the frenulum under the tongue in children

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

What are bridles and why are they needed?

The frenulum is normally capable of lengthening and shortening 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 area of the lower front incisors. Its main purpose is to ensure mobility of the tongue and normal pronunciation of sounds.

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

What are the dangers of a short frenulum?

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 normal control of the tongue, swallowing and even breathing. Usually a pediatric neonatologist helps to detect pathology, but there may be mistakes on the part of some doctors.

A short frenulum prevents the child from normal control of the tongue, swallowing and even breathing.

A clear sign of pathology is that the baby has difficulty sucking the breast during feeding, as a result of which he is poorly satiated, behaves restlessly, is capricious, often requires latching to the breast, and does not gain weight.

This is important! In children over three years old, 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 move sharply forward. An anomaly of the lower lip most often leads to improper formation of the bite.

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

Genetic predisposition - it is not necessary for the baby’s parents to have the same problems. Often the anomaly is inherited from a close relative.
Pathology can occur during pregnancy, in the first and third trimester. Various determining factors: consumption narcotic substances during gestation, somatic or infectious diseases, unfavorable natural conditions, abdominal injuries and much more.
In some cases, an incorrectly developed frenulum of the upper lip is diagnosed in children who already have other congenital anomalies, which cause various kinds deformation.

Clinical picture

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

the baby has difficulty sticking out his tongue or is unable to do so;
the baby cannot extend the tongue, because in this case it takes the shape of an arch;
the child is unable to raise his tongue to the palate, since in this case its tip bifurcates.

There may be other symptoms that your baby's frenulum is too short. A doctor can make an accurate diagnosis after a thorough examination.

When the parents' suspicions are confirmed, it is recommended to perform an operation - plastic surgery 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 sucking at the breast during feeding, you should contact your pediatrician for an examination. The operation itself is performed 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 it is treated with minimal bleeding.
From 4 years. If the child has not undergone plastic surgery before this age and has speech defects, and massage and various exercises do not help stretch the tongue, it is recommended to undergo plastic surgery. This 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, trimming the frenulum of the upper lip already causes discomfort and pain. That's why surgery performed using local anesthesia. After this, the child receives stitches.

You can see in the photo short bridle language.

Note! The most suitable age for plastic surgery is selected by the doctor depending on the individual characteristics child. Trimming before the age of 1 year causes the least amount of trouble and discomfort. In some cases, the doctor may recommend surgery immediately after the baby is born.

The sooner parents take care of eliminating this anomaly, the faster baby can begin to live fully.

Why is plastic surgery required?

A short tongue frenulum in a newborn causes a lot of difficulties. Therefore, experts recommend making corrections in early age to minimize the consequences. Most often, difficulties arise during breastfeeding:

Can't attach baby in the right way to the chest.
The baby has difficulty sucking in milk.
During feeding, the baby swallows too much air, which subsequently leads to belching and abdominal pain.
Insufficient consumption of mother's milk leads to the fact that the baby does not grow fast enough.

If surgery is not performed at an early age, an abnormally developed frenulum of the upper lip in a child leads to the following consequences:

growth retardation and abnormal development of the jaw;
the child develops an abnormal bite;
the lower central teeth may turn inward;
cervical caries appears at an early age;
the lower row of the frenulum can be injured by the incisors;
there are problems pronouncing many sounds;
The child begins to snore.

Which method should I choose to correct a short frenulum?

Surgical dentistry offers two methods of correction:

With a scalpel. In this case, the operation takes at least 20 minutes. The doctor makes a small incision and then stitches it. After this, the child may experience slight swelling or pain. The scar that appears as a result of correction heals within approximately 10 days. It will be difficult to see in the future.

In order for the intervention to proceed without complications, it is recommended to rinse the child’s mouth with a special solution prescribed by the doctor during the postoperative period. It is advisable to eat soft foods.

With laser. The operation takes no more than 15 minutes. Correction using this method does not cause pain and occurs with virtually no bleeding. The doctor makes an incision using a special laser, which immediately seals the wound. This avoids discomfort during surgery and eliminates the need for stitches.

The dental gel used in this case has an anesthetic effect. Within a few hours after plastic surgery, the child will not feel any discomfort. The postoperative period does not take more than 2 days.

To avoid any complications, you should strictly adhere to the specialist’s recommendations. Sometimes children develop a fever after correction, which is an individual reaction rather than the norm.

If a scar appears after plastic surgery, which is usually observed in older children, the doctor may prescribe a repeat operation.

Chesnachki.ru

Good afternoon, dear readers! A tongue tie can be a serious problem for babies and their parents. Because of this defect, breastfeeding suffers, and subsequently the speech of babies. Trimming the frenulum under the tongue in children is one of the ways out of the situation when other means do not help.

In today's article we will look at whether pruning is necessary, at what age, which doctor does it, and what pruning methods exist.

Should my child's tongue frenulum be trimmed?

In half of the cases, ankyloglossia (short frenulum) is a hereditary defect. But this does not mean that absolutely all children need pruning. Many people live well with a short frenulum and at the same time speak correctly and do not experience any discomfort.

If the doctors at the maternity hospital did not indicate ankyloglossia in your child, you can find out for yourself how to identify a short frenulum.

Normally, in a newborn, the length of the muscular septum (the frenulum is the muscular septum) should be 8 mm. By the age of five it grows to 17 mm. There are three degrees of impairment:

easy – the length of the septum is more than 15 mm, but the child has difficulty pronouncing individual sounds;
medium – the length of the jumper is from 10 to 15 mm, all symptoms are present;
severe - the length of the frenulum is up to 10 mm, the baby experiences difficulties with pronunciation, feeding, there are all signs of a disorder.

Reasons for pruning

The reasons for pruning are directly related to the symptoms that appear if the baby has a defect:

difficulties in breastfeeding (the baby often rests, does not latch on to the nipple correctly, is capricious and arches while eating, or cannot latch onto the breast at all);
at an older age, problems arise with the pronunciation of sounds and diction in general;
the bite is formed incorrectly.

If these signs are present, there is an 80-90% chance that doctors will advise you to trim the bridge.

Other signs that parents can easily notice without outside help may indicate ankyloglossia:

frequent diseases of the oral cavity, caries;
problems with chewing solid food in older children;
copious secretion of saliva;
a quiet voice with a nasal tinge;
frequent stomach problems;
low mobility of the tongue (ask the child to reach the palate with his tongue, move it from side to side. If these actions cause difficulties, you should consult a specialist).

What happens if you don't prune?

A short tongue frenulum in a child can have significant consequences:

difficulties with pronunciation of individual letters;
sensitivity of the gums and teeth, which causes frequent dental problems in adulthood;
mouth breathing, which causes frequent respiratory diseases;
Unaesthetic appearance of the front teeth due to malocclusion.

However, many of these consequences can be eliminated using conservative methods. For example, to learn how to pronounce sounds, you need to do exercises to stretch the frenulum. In 90% of cases, diction can be improved using speech therapy techniques. Malocclusion can be perfectly corrected with braces adolescence.

Decide whether to cut the bridge if there are difficulties with breastfeeding, or doctors do not see other solutions to existing problems. Then surgery may be necessary.

Where to trim a child's tongue frenulum?

When parents are faced with the question of which doctor decides whether pruning is required, the first thoughts are transferred to dentistry. Absolutely right: the operation itself is performed by a surgeon.

However, before making a decision, it is necessary to consult with specialists in other fields:

pediatrician or lactation consultant (if there are problems with feeding),
speech therapist (if there are difficulties with pronunciation);
an orthodontist (if a malocclusion is formed).

If no others are offered for your problem effective solutions, take a referral to a surgeon in pediatric dentistry.

At what age is a child’s tongue frenulum cut?

The operation to trim the muscular septum in a newborn is performed in the maternity hospital, if the problem was noticed in time and the parents do not mind. It is believed that this is the best time to fix the problem.

The baby has no blood vessels in the frenulum, so the whole procedure takes a matter of seconds, and the consequences are minimal. To make healing faster, the baby is immediately put to the breast.

The next age at which the surgeon considers it necessary to perform the operation is between five and six years. At this time, the baby’s speech is formed and defects are identified, as well as the possibility of eliminating them using conservative methods.

An orthodontist can predict how a child’s bite will develop. If there are real problems, he will point it out to his parents.

At 5-6 years of age, the procedure is longer and is performed under anesthesia, since the bridge becomes overgrown with vessels. However, the operation does not require hospitalization: after it the child can go home.

Surgical trimming

There are several methods for trimming a bridle:

Frenulotomy

This method is used if the baby’s age does not exceed 9 months. It consists of using scissors to make an incision closer to the teeth. The mucous membrane is dissected first, and then the muscle strands. At the end, stitches are applied.

Frenulectomy

A clamp is used to secure the septum, then an incision is made between the lip and the clamp. Stitches are placed on the wound.

Frenuloplasty

The essence of the method is that a flap in the shape of a triangle is excised from the jumper. An incision is then made and the flap is sutured to the desired area to lengthen the frenulum.

The last two methods are suitable for children over 5 years old. For them, the operation begins with the administration of anesthesia. Frenuloplasty is rarely used. The main indications for it are serious orthodontic defects.

Wound healing occurs within 24 hours. IN rehabilitation period It is not allowed to eat too hot or cold food. Special attention You need to pay attention to oral hygiene.

Another important question, which worries readers about how much such a procedure costs. The cost starts from 500 rubles and can reach up to 5 thousand depending on the age of the child, the level of the clinic and doctor, and the chosen method.

Trim a child's tongue frenulum with a laser

The latest achievement in dentistry is laser cutting of the bridge. It has many advantages:

no risk of infection, since the laser has disinfecting properties;
minimal risk of bleeding, since the laser beam seals the vessels;
no stitches required;
minimal undesirable consequences;
accuracy of the cut;
fast healing;
absence of pain;
reasonable price.

Laser frenulum cutting surgery has received excellent reviews from parents as children tolerated it easily and side effects were minimal.

The procedure is very simple. Before starting, local anesthesia is administered, and the dosage of painkillers is much less than with traditional methods.

The surgeon focuses the laser beam on the desired area of the septum and dissolves it. A bandage soaked in healing solutions is applied to the wound. The entire procedure takes up to 5 minutes. Rehabilitation lasts no more than 2 days.

How much such an operation costs is easy to find out if you look at the website of any dental clinic. The average cost is 4 thousand rubles.

We have considered possible ways trimming the frenulum of the tongue and the need for the procedure. How appropriate it is for your child is up to you to decide.

How and at what age do children have their frenulum cut under the tongue and why do they need plastic surgery?

A short frenulum is a common diagnosis in infants, which mothers can hear even in the maternity hospital. There, this pathology must be immediately eliminated, because the newborn baby will have difficulty sucking the mother’s breast or feeding from a bottle. The frenulum can be successfully corrected, the procedure is quick, almost painless and well tolerated, so don’t worry if this happens 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 surgical intervention is performed in time, the child will not remember this problem in the future

Why does a child have a bridle cut, and is it really necessary?

The frenulum of the tongue is a membranous bridge that connects the tongue and the lower jaw (see also: what to do if a baby sticks out his tongue?). Thanks to its presence, the tongue is held in its normal position. She is responsible for many important functions in the human body:

feeding, in infancy - breast sucking;
correct pronunciation;
normal bite;
work of 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 under one year old it is 8 mm. Typically, abnormalities of the frenulum consist of shortening the length or attaching it to the tip of the tongue. This deviation is called ankyloglossia, or short frenulum. The location of the frenulum in the mouth, characteristic of this anomaly, is shown in the photo.

How is ankyloglossia dangerous for a baby? It causes abnormalities in jaw development and malocclusion. You can understand that a baby has a short frenulum immediately after birth. The baby sucks poorly, gets tired quickly, cries and often latches on to the mother’s breast. During feeding, characteristic clicking sounds are heard, and milk pours out of the mouth. Such children grow slowly and gain weight, because their tongue is inactive, and sucking causes discomfort; it hurts to move the tongue. The same thing 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 therapy pathologies, discomfort when chewing and swallowing food. Usually this problem diagnosed by a speech therapist, who is consulted 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.

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

viral diseases (the first and third trimesters are especially dangerous);
toxicosis;
exacerbation chronic diseases;
psychotraumatic situations;
drinking alcohol, narcotic drugs, poisoning with chemicals in the first 3 months of pregnancy;
bad ecological situation in the region of residence;
abdominal bruise or other injuries.

At what age is this surgery performed?

There are no age restrictions for plastic surgery; it is performed on both the youngest patients and children school age, and adults. The mother is practically never separated from the child, because the frenuloplasty itself takes place quickly.

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

However, during this time, persistent speech disorders may appear, which will subsequently require long-term correctional work and constant exercises. Other experts recommend trimming the membrane between the tongue and jaw while the upper teeth are growing.

Where is frenuloplasty performed and which doctor should I contact?

If ankyloglossia is suspected, the child will be referred for consultation to a dentist, orthodontist or maxillofacial surgeon, who will confirm or refute the preliminary diagnosis. The decision about the need for surgical intervention will be made jointly 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 corrected by conventional means;
malocclusion;
violation of proper food intake;
displacement of teeth, incisor inclination.

Experts divide the degree of pathology on a 5-point scale. Minor deviations can be successfully eliminated without surgery after the age of 1 year by performing special exercises.

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

Surgical correction of a short frenulum

A newborn baby can undergo surgery as early as maternity hospital, because at birth the neonatologist will check him for the presence of this pathology. In older children, the procedure is carried out quickly, it does not require a hospital stay, and after it you can go home straight away.

Contraindications to cutting the frenulum may be:

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

Trimming the frenulum is carried out if the child is completely healthy; If there is caries or other disease, surgery is not possible

Main types of operations for ankyloglossia

The decision about what type of surgical intervention will be appropriate is made by a specialist. Usually this is:

frenulotomy - cutting the frenulum and suturing the edges of the mucosa;
frenulectomy, 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 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, cutting the frenulum will not be necessary.

How is the frenulum trimming procedure performed?

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

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

Treatment with laser

Laser correction is considered the most in a safe way operations and refers to microsurgery. It causes virtually no complications. Sutures are not applied after laser surgery, this is not necessary, and the postoperative period lasts 2 days.

The duration of the laser operation is only 3-5 minutes. This method is suitable for children because it does not cause bleeding, complications such as secondary infections, it is accurate and practically painless.

Rehabilitation period

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

Immediately after the operation, babies begin to eat normally without experiencing discomfort, and breast milk will help the wound in the mouth heal faster. Breasts quickly gain weight and grow well. Speech therapy disorders babies under one year of age are not diagnosed, but older children will need correctional work with a speech therapist. What exercises are recommended to be carried out in the presence of pathology can be seen in the video.

After frenuloplasty you should:

do not eat for 2 hours;
Do not eat irritating foods for 3-4 days - salty, spicy, sour and too hard;
refuse hot food and drink;
For some time it is better to eat food pureed;
do not load your tongue with conversation;
after eating, you must rinse your mouth with antiseptic agents (chamomile decoction, calendula tincture, Furacilin solution);
do special exercises developed by your doctor;
apply sea buckthorn oil and Solcoseryl to the surgical site;
visit a speech therapist as prescribed by the attending physician;
if there is pain, the child is given an anesthetic (Nurofen, Ibuprofen).

Are there complications after surgery?

Usually no consequences other than short-term recovery normal function mouth and tongue does not occur. Everything goes quickly, almost painlessly and is well tolerated by the child.

With poor postoperative wound treatment and improper hygiene, inflammatory processes and pain may occur. School-aged children sometimes develop scars, in which case repeated incision will be required.

In today's article we will look at whether pruning is necessary, at what age, which doctor does it, and what pruning methods exist.

If the doctors at the maternity hospital did not indicate ankyloglossia in your child, you can find out for yourself how to identify a short frenulum.

Normally, in a newborn, the length of the muscular septum (the frenulum is the muscular septum) should be 8 mm. By the age of five it grows to 17 mm. There are three degrees of impairment:

easy – the length of the septum is more than 15 mm, but the child has difficulty pronouncing individual sounds;
medium – the length of the jumper is from 10 to 15 mm, all symptoms are present;
severe - the length of the frenulum is up to 10 mm, the baby experiences difficulties with pronunciation, feeding, there are all signs of a disorder.