Frenulum under the tongue. Should I cut the frenulum of the child's tongue? Causes of incorrect formation

Such anatomical formations are the thinnest mucosal folds that connect the movable lips and tongue with the fixed parts of the oral cavity: the gums and sublingual space.

In total, the baby has three frenulums in the mouth:

Tongue - located under the tongue.
Upper lip - located between the upper lip and the gum mucosa above the level of the central incisors.
Lower lip - connects the inner surface of the lower lip with the gums at the level of the middle of the alveolar process on the lower jaw.

Despite their small size, such mucous folds are of great importance in human life. In a newborn, they are responsible for proper attachment to the mother's nipple. In older babies, the frenulums are involved in the correct pronunciation of sounds and in the formation of a normal bite.

In the photo: a short frenulum of the tongue in a child

Short bridle and why it is dangerous

Shortening of the frenulum is understood as a decrease in its absolute length or its incorrect location, which makes it relatively short (i.e., the length remains normal, but its incorrect localization causes all the symptoms characteristic of shortening).

A short frenulum of the upper or lower lip in an infant can adversely affect the sucking process of the breast. In this case, the child cannot properly position the nipple in the oral cavity and create a sufficient vacuum necessary for sucking and swallowing. Therefore, in order to get enough, the crumbs have to make considerable efforts. The baby quickly gets tired and throws the breast, not satiated properly. Such children behave restlessly, require frequent breastfeeding, but do not gain weight well.

In children older than 3 years, a shortened upper frenulum can cause an increase in the interdental spaces between the upper incisors and their advancement sharply anteriorly. A short lower labial frenulum sometimes causes a malocclusion.

Also, the reduction in size or incorrect location of any of them can have an extremely negative impact on speech function. Children of 2 years of age who have not been diagnosed or corrected in time by such a pathology often do not pronounce individual sounds. Such speech defects can be corrected with great difficulty.

How to check the frenulum in a child?

A shortened frenulum between the lip and gum is diagnosed quite simply even in infants. To do this, you need to gently pull the child's lips and see how pronounced the fold of the mucous membrane is and where it is attached. If it is short, then it will have a thick appearance and its place of attachment will be at the very base of the incisors.

The hyoid frenulum normally has a length of at least 8 mm and is attached approximately in the middle between the root and the tip of the tongue. A small frenulum usually looks like a fold on the mucous membrane, adhering along its entire length to the tongue or sublingual space.

In the photo: a short frenulum of the upper lip in a newborn

How to stretch

It is necessary to immediately make a reservation that, due to anatomical features, only the frenulum under the tongue can be stretched without surgery. This technique is usually taught by a speech therapist and is effective only if all the recommendations are painstakingly followed for several months.

Before carrying out any exercise, it is recommended to do a special massage to stretch the soft tissues. To do this, you need to carefully take the tongue by the very tip and gently move it up, then to the sides and pull it forward a little. A good effect is exerted by gentle stroking from the bottom up along the bridle with the thumb and forefinger of the hand.

The exercises themselves are performed sequentially twice a day:

Relax your tongue as much as possible and put it on your lower lip. Hold for 10 seconds in 3 sets.
Stick your tongue out of your mouth as far as possible. Fix in this position for 10 seconds. Repeat 3 times.
Stretch out your tongue and circle your lips with it.
Click your tongue for 10 seconds, imitating the clatter of horse hooves.
Open your mouth wide. Slowly draw the tip of the tongue across the sky, moving from the teeth to the throat.
Fix the tongue on the palate just behind the teeth. Holding it in this position, open your mouth as wide as possible.

Such fairly simple exercises help both stretch the frenulum on the tongue and correct some speech defects.

Operational correction

If a short frenulum is detected even in the hospital, then its trimming is carried out immediately. This is done so that the baby can properly take the nipple and eat fully. If the shortening is diagnosed at an older age and is not corrected by speech therapy methods, then three options for surgical treatment are possible:

Frenotomy - cutting to increase its length.
Frenectomy - circumcision, when it is almost completely excised.
Frenuloplasty is a plastic surgery during which the place of its attachment in the mouth is changed.

In the photo: the frenulum of the tongue in a child after laser surgery

Although frenulum surgery itself is fairly common, most parents have a lot of questions about the procedure. We will consider the main ones below.

Why cut?

Too small size of such a mucosal fold can cause breastfeeding difficulties in infants, and in older children, problems with the pronunciation of certain sounds and with the position of the teeth in a permanent bite. To avoid such problems, pruning is required.

Should I cut?

Most doctors, including the famous Dr. Komarovsky, are unanimous in their opinion that the short frenulum should be cut if it adversely affects the child's ability to suck milk or make certain sounds.

When a short frenulum does not negatively affect the processes of sound formation and bite formation, then in such cases, surgical intervention is not required.

Which doctor cuts?

Usually, operations to correct the frenulum are within the competence of a dentist.

What is the best age for surgery?

When the bridle should be trimmed is decided individually for each child. If we are talking about a crease on the upper lip, then the correction is done no earlier than 6 years. Usually, the operation is performed only after the eruption of the permanent upper incisors. If correction is required on the lower lip, then this is done more often after 4 years of age.

In most cases, the hyoid frenulum is dissected up to 1 year (most often this is done even in the maternity hospital). But correction is possible at any age.

How are they cut?

The operation of cutting the frenulum is performed on an outpatient basis in the surgical office of the dental clinic. The doctor carefully stretches the fold of the mucous membrane and makes a small incision with a sharp scalpel. After that, small sutures made of threads are superimposed on the edges, which after a while dissolve on their own and do not need to be removed.

A more modern technique is laser dissection, due to which there is no need for suturing, which speeds up the child's recovery process.

Does cutting hurt?

The dissection procedure is performed under local anesthesia, which eliminates the possibility of any pain.

What to do if the child has broken the bridle

Children at any age are quite active and mobile. Therefore, injury is inevitable. Quite often, parents turn to the dentist with such a problem: the baby fell unsuccessfully and tore the frenulum above the upper lip or under the tongue. At the same time, damage to the lower lip is extremely rare due to the fact that normally it is almost not expressed.

If the child has cut the frenulum, then the following signs will be characteristic of such an injury:

Swelling of soft tissues in the oral cavity and above the lip (in case the child has torn on the upper lip).
Pretty profuse bleeding.
Pain in the mouth when talking or eating.

In any case, if the baby has torn the mucous fold under the upper lip or under the tongue, you should immediately consult a doctor. It is he who will decide whether it is necessary to sew up such a gap and carry out the necessary procedures. Self-treatment can lead to negative consequences: the tissues will grow together incorrectly with the formation of rough scars, which will subsequently lead to an incorrect bite and fuzzy pronunciation of sounds.

Such anatomical formations are the thinnest mucosal folds that connect the movable lips and tongue with the fixed parts of the oral cavity: the gums and sublingual space.

In total, the baby has three frenulums in the mouth:

Tongue - located under the tongue.
Upper lip - located between the upper lip and the gum mucosa above the level of the central incisors.
Lower lip - connects the inner surface of the lower lip with the gums at the level of the middle of the alveolar process on the lower jaw.

Despite their small size, such mucous folds are of great importance in human life. In a newborn, they are responsible for proper attachment to the mother's nipple. In older babies, the frenulums are involved in the correct pronunciation of sounds and in the formation of a normal bite.

In the photo: a short frenulum of the tongue in a child

Short bridle and why it is dangerous

In children older than 3 years, a shortened upper frenulum can cause an increase in the interdental spaces between the upper incisors and their advancement sharply anteriorly. A short lower labial frenulum sometimes causes a malocclusion.

How to check the frenulum in a child?

In the photo: a short frenulum of the upper lip in a newborn

How to stretch

The exercises themselves are performed sequentially twice a day:

Relax your tongue as much as possible and put it on your lower lip. Hold for 10 seconds in 3 sets.
Stick your tongue out of your mouth as far as possible. Fix in this position for 10 seconds. Repeat 3 times.
Stretch out your tongue and circle your lips with it.
Click your tongue for 10 seconds, imitating the clatter of horse hooves.
Open your mouth wide. Slowly draw the tip of the tongue across the sky, moving from the teeth to the throat.
Fix the tongue on the palate just behind the teeth. Holding it in this position, open your mouth as wide as possible.

Such fairly simple exercises help both stretch the frenulum on the tongue and correct some speech defects.

Operational correction

Frenotomy - cutting to increase its length.
Frenectomy - circumcision, when it is almost completely excised.
Frenuloplasty is a plastic surgery during which the place of its attachment in the mouth is changed.

In the photo: the frenulum of the tongue in a child after laser surgery

Although frenulum surgery itself is fairly common, most parents have a lot of questions about the procedure. We will consider the main ones below.

Why cut?

Should I cut?

When a short frenulum does not negatively affect the processes of sound formation and bite formation, then in such cases, surgical intervention is not required.

Which doctor cuts?

Usually, operations to correct the frenulum are within the competence of a dentist.

What is the best age for surgery?

In most cases, the hyoid frenulum is dissected up to 1 year (most often this is done even in the maternity hospital). But correction is possible at any age.

How are they cut?

A more modern technique is laser dissection, due to which there is no need for suturing, which speeds up the child's recovery process.

Does cutting hurt?

The dissection procedure is performed under local anesthesia, which eliminates the possibility of any pain.

What to do if the child has broken the bridle

If the child has cut the frenulum, then the following signs will be characteristic of such an injury:

Swelling of soft tissues in the oral cavity and above the lip (in case the child has torn on the upper lip).
Pretty profuse bleeding.
Pain in the mouth when talking or eating.

topdent.ru

Causes of a short frenulum of the tongue in children

In most cases, the pathology of the frenulum of the tongue of infants arises from the influence of a hereditary factor. If any of the parents had such a problem in early childhood, then there is a high probability that the baby will have a shortened sublingual cord. But other causes of congenital ankyloglossia have also been proven. What factors provoke the development of anomalies even in the intrauterine development of the fetus?

The process of formation of the language strand is influenced by the behavior of the mother during pregnancy and its very course. Early toxicosis, taking antibiotics, hormonal agents, especially in the first or last trimester of intrauterine development, often lead to the described fetal pathology.
Abdominal injuries, infections during the formation of the fetus, late age of women in labor (after 40 years), poor environmental conditions, stressful conditions, constant depression are the main causes of a shortened membrane of the oral cavity of newborns.

Signs of a short frenulum of the tongue in infants

Without the participation of the tongue, the full-fledged sucking function of the baby is impossible. The mobility of the tongue, the normal development of the organs of the oral cavity provides optimal nutrition, and hence the development and growth of the baby. If the cord that attaches the tongue to the mucosa of the lower palate of the oral cavity is greatly shortened, the child experiences some discomfort while sucking milk from the mother's breast. He does not manage to lick his lips, and the very extraction of milk causes irritation, causes pain.

Unpleasant, even painful sensations are experienced by the mother when the child does not grasp the breast correctly: the baby presses only the nipple, and not the halo, since the functionality of the lower jaw is limited. As a rule, most of the milk pours out of the baby's mouth, after which the baby is naughty, refusing to eat. The young mother in this case does not know how to help the baby, she begins to panic.

Symptoms and consequences

Each mother is able to independently distinguish whether a newborn has a shortened frenulum. In most cases, the existence of a problem is indicated by the dentist, but also by an experienced pediatrician. Consider the main symptoms of ankyloglossia in infants:

when feeding, the baby "smacks" strongly,
often bites the nipple of the breast before the occurrence of pain in the mother,
requires frequent attachment to the breast,
the baby is nervous, often throws the nipple, does not eat up,
refuses to draw milk, because this action causes him pain, discomfort,
not gaining enough weight due to constant malnutrition.

If parents do not notice the pathology, as the child grows up, the risk of serious complications increases: improper formation of teeth, periodontitis, gingivitis. A short cord has a negative effect on the entire articulatory apparatus. The child lags behind in development compared to peers, does not pronounce individual sounds, his speech is distorted due to limited mobility of the lower jaw. If you miss the time, then after 5 years, even after the operation, there will be no effectiveness from cutting the cord, the person will not learn how to pronounce certain sounds correctly.

How to check the frenulum in a child

The length of the jumper in an infant should be at least 8 mm, while in an adult it should be 2-3 cm. The short frenulum of the tongue of a newborn is easy to diagnose visually. To do this, pull the child's lower lip, let him open his mouth. So you will see where the jumper is attached, how close it is to the row of future teeth. If the frenulum holds the tongue almost at its very tip, and the tip of the tongue barely touches the lips, then this is a sure sign of an anomaly of the hyoid band. Look at the shape of the tongue: if the baby is crying, then the shape of the "boat" also indicates a congenital anomaly.

It is much easier to diagnose the shortened jumper of older children - 2-3 years old, when the baby is already learning to reproduce words. Often, the incorrect pronunciation of individual sounds makes parents turn to a speech therapist. The specialist often confronts the fact - a congenital pathology of the strand or ankyloglossia. But this is not a disease, but a temporary condition of the mucosa, and the problem is completely solvable. This jumper can be stretched with a special massage, articulation exercises, as well as the method of surgical intervention.

Treatment of the frenulum under the tongue in newborns

A congenital anomaly of the sublingual lintel is resolved in two ways: by stretching a small cord with articulation exercises, as well as by surgical intervention. For babies, another method is more acceptable - cutting with scissors or a laser. It is good if the doctor sees the problem and solves it during childbirth. Otherwise, everything depends on the attention of parents to the health of their children, timely access to qualified medical assistance. If the jumper is slightly shorter than the norm, and the child takes the breast normally, then surgical intervention is not required.

Frenulum cutting in babies

The incision of the sublingual cord is performed in the first weeks of a baby's life, since later the oral cavity becomes more susceptible to surgery or laser plastic surgery. This is due to the fact that the blood vessels are located deep, closer to the far end of the strand, which is adjacent to the root of the tongue. Mom's milk will help to calm the baby after such a procedure: a few drops quickly heal the wound. As a result of surgical treatment, there are no complications, and the cut bridge allows the articulatory apparatus to develop correctly.

The operation should not scare the parents. Surgical intervention takes only a few minutes, the child does not need anesthesia (anesthesia): he does not hurt, blood is not noticeable. This is explained by the still unformed nerve endings in the tissues of the mucous gums, sublingual cavity. A day later, a small incision heals, the baby develops normally, gaining weight. The threads with which the incision was sewn up dissolve, and the microscopic suture will not interfere with the child.

When is the best time to have surgery

The operation is best done before the child is one year old. During a routine examination of the baby, the task of the pediatrician is to timely recognize the cause of the anxiety of the baby, prescribe the appropriate treatment. If time is lost, and parents see a jumper defect after 3 years, you need to contact an orthodontist or pediatric surgeon. When the baby is 5 years old or older, the surgeon explains the inexpediency of the operation, since the child has already developed the skills of pronunciation of the scale. Even a good outcome of the operation does not mean that the child will not lisp in the future.

Photo - frenulum of the tongue in newborns

We bring to your attention a selection of photos that demonstrate a congenital anomaly of the frenulum under the tongue. If you suspect that your baby has the same problem, verify this by comparing the picture in the baby's mouth with the attached images of typical pathologies. Ankyloglossia is shown here, which is more or less pronounced, depending on the place of attachment on the lower gum.

mosmama.ru

Difficulties associated with a short bridle

Every person has a bridle in his mouth. In appearance, these are thin folds of the mucous membrane connecting the moving parts of the oral cavity (lips and tongue) with the fixed ones (gums and space under the tongue). There are three of them: one is located directly under the tongue, the other two are connected to the upper and lower lip, respectively.

When talking about a shortened bridle, they mean either its short length or its incorrect location (the length is normal, but locally it is attached so that it keeps the tongue “on a short leash”). In medicine, the defect is called ankyloglossia or congenital cord pathology.

The first difficulty is that the correct process of grasping and sucking the breast is disturbed. After all, normally, during attachment to the breast, the baby's mouth is wide open, so that the lower lip turns outward, and the tongue itself is located on the gum of the lower jaw. As a result, the areola of the nipple is completely captured, the necessary vacuum is created, and the tongue begins to work.

A short bridle does not allow you to properly capture the nipple, and in the process of eating, the baby quickly gets tired. Throwing the breast ahead of time, he does not receive proper nutrition, gains weight worse, is restless during feeding and requires frequent attachments.

Another problem becomes apparent closer to the 2nd year, when the child has speech disorders. The kid cannot pronounce individual sounds and you have to work hard to eliminate such defects. A shortened frenulum of the lower lip provokes the formation of a malocclusion.

Causes and symptoms

A short fold is formed during fetal development in the presence of pregnancy pathologies. However, most often its small size is explained by a genetic predisposition. That is, when the next of kin had similar problems, the likelihood of frenulum correction in the heir increases.

Symptoms that may suggest that something is wrong with the sublingual fold are as follows:

the child “hangs” at the chest for more than 30 minutes, but does not eat up;
gaining weight poorly;
the baby smacks while eating, bites the nipple with his gums or cannot keep it in his mouth for a long time;
often burps, he is tormented by flatulence (a consequence of air ingress);
milk in the breast stagnates.

At an older age, ankyloglossia causes such problems:

speech defects;
formation of malocclusion;
early occurrence of caries (in case of a defect in the frenulum above the upper or lower lip);
the formation of a crooked dentition;
profuse salivation;
sleep difficulties, sleep apnea.

Diagnostics

The hyoid frenulum is easy to check. Normally, it is attached somewhere in the middle between the root and the tip of the tongue, and its length is at least 8 mm. Professor Alison Hazelbaker developed a special test that takes into account the ability of the tongue to stretch forward, rise to the upper palate, turn in different directions, evaluate the sucking reflex, how elastic the frenulum is, etc.

Visually, with ankyloglossia, the tongue takes on the shape of a heart due to a fold pulling from below. This is clearly seen during crying. If you show your baby your tongue, he will not be able to copy you and do the same.

Cut or stretch?

If the defect under discussion is diagnosed, there are two ways to eliminate it:

try to stretch the bridle with the help of special exercises;
cut her.

In fairness, it should be said that you can do without surgical intervention and try to stretch only the hyoid frenulum, provided that the child is already able to independently perform the necessary exercises under the supervision of an adult. The stretching technique is usually shown by a speech therapist, and the exercises are done at least twice a day for several months.

However, such procedures are not suitable for a newborn. And if we are talking about the possibility of further normal breastfeeding, it is better to agree to cutting. As we will see below, such an operation does not bear any negative health consequences.

When to cut?

How do you know when is the best time to cut the bridle? If the problem was noticed immediately after birth, the pruning will be offered to be done right at the maternity hospital in order to forget about further unpleasant consequences once and for all.

If the child is more than 9 months old, then there were no difficulties with nutrition, and the bridle did not bring any particular inconvenience. Therefore, it makes sense to wait until the child speaks. Perhaps the frenulum of the tongue will not affect the speech ability of the baby, or it will stretch. In principle, correction with surgery can be carried out at any age. Only the older the patient, the greater the likelihood that it will be necessary to apply anesthesia (though in the vast majority of cases, local) and stitches.

In addition, at school age, when a speech therapist or orthodontist sends a surgeon for pruning, the operation will “free” the tongue only mechanically, but it remains to be learned how to use it correctly. An operation at the age of 6 does not guarantee that the child will stop lisping, as pronunciation skills have already been firmly established. Correcting a crooked dentition will also take time.

As for the trimming of the fold on the lower lip, it is advised to carry it out from the age of 4, and on the upper one - not earlier than reaching the age of 6. The frenulum of the tongue is in most cases trimmed in infants under one year old.

How is pruning

The operation to cut the frenulum of the tongue is called a frenotomy. It is performed by a pediatric surgeon or dental surgeon. The child's face is fixed, after which cutting is carried out with special scissors or a laser. In infancy, the procedure is painless, since the nerve endings in the gingival mucosa have not yet formed. After the bridle has been cut, the child is recommended to be immediately attached to the chest.

Even if the baby is crying, know that this is not because he is in pain. It's just that no one is pleased when for some reason they hold their faces tightly and climb into their mouths, and even under the light of a lamp. The procedure itself lasts a matter of seconds - nothing compared to the relief that the baby then experiences.

There are two more ways of surgical treatment:

frenectomy - when the frenulum is excised almost completely;
frenuloplasty - an operation due to which the place of fastening of the fold in the oral cavity changes.

Special postoperative care is not required. The blood vessels are still deep, so a few drops of blood are all the consequences. However, over the next week, scar formation occurs, and the uvula must move to avoid regrowth. The doctor will show special exercises for its promotion.

If the child has broken the bridle

Little fidgets are often in search of adventure, sometimes unsafe. What to do if, having fallen, the baby cut the frenulum in his mouth? Of course, you should immediately seek medical help, especially in cases where it is constantly bleeding, it hurts the child to talk or eat, the soft tissues in the oral cavity are swollen.

The doctor will decide if the tear needs to be stitched up and tell you how to care for the wound. Do not try to treat the baby yourself. With improper fusion, rough scars are formed, which negatively affects the formation of bite and articulation.

Summarize. Too short frenulum of the tongue directly affects the quality of life of the child. Cut it or not - you decide, dear parents. Just do not reject the opinions of doctors on this matter. After all, sometimes you need to make small sacrifices in order to save your baby from the physical and emotional problems associated with speech defects in the future.

mladeni.ru

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….. But time has shown that the surgeon was right, my daughter has no problems with speech therapy, the frenulum has stretched. The son had a more vivid case, the fact that the bridle is short was pointed out to us back in the maternity hospital. He sucked well, but gained a lot of air and sometimes choked. At 3 weeks old, we cut his bridle and forgot about this problem. We turned to a regular pediatric dental clinic for a consultation, as a market study of commercial clinics showed that almost none of them have a license to serve babies. The operation consists in cutting the frenulum with surgical scissors and lasts literally seconds. Before cutting, the incision site is lubricated with a local anesthetic. During the operation, the mother sits on a chair, the baby holds a column in her arms ...

... The first time the baby can be shown to the dentist in the hospital - he will check the correct development of the jaws and the condition of the mucous membranes. Plan your next visit to the dentist at 4-5 months, when the first teeth appear. The doctor will assess the condition of the enamel and see if the frenulum under the tongue is shortened. By the year when the upper and lower incisors usually appear, the baby should be shown to the doctor again, especially if the teeth are dull and dull, covered with plaque. At this stage, dental problems can still be solved by adjusting the diet. In the future, show the child to the dentist twice a year: in autumn and spring. If the child is often sick for a long time, it makes sense to visit the doctor 4-5 times a year. So that the baby is not afraid of the dentist, introduce him to him, ask him to talk, take a “tour” around the office ....

… But already now there are district consultative and diagnostic centers, so small residents of some areas still undergo screening studies. There are similar centers at regional hospitals. Parents themselves can contact the center for a comprehensive ultrasound diagnosis. It is in 1-1.5 months that deviations that are not visible in the first days of life can be noticed and revealed. As already noted, ultrasound is absolutely harmless, so the number and frequency of ultrasound is not limited, and one organ can be examined up to several times during the day, for example, in case of trauma to internal organs. Later, if...

What to do about a cough? We treat a cough in a child. Diseases…

... It multiplies in the nervous system. A person with whooping cough can cough from everything - from a loud sound, bright light, anxiety. Cough with whooping cough is very characteristic - it starts with a loud whistling breath, lasts paroxysmal for several minutes, the child just coughs. He often protrudes his tongue in such a way that there are tears in his frenulum. With whooping cough from terrible tension, hemorrhages can occur in the sclera of the eyes and the skin of the chest. In young children, bouts of whooping cough (reprises) may be accompanied by respiratory arrest. Leaving aside the prevention and treatment of whooping cough, I can only say that drugs that thin sputum and increase ...

... It is urology that deals with most of those diseases that can lead to problems with conception or even to its complete impossibility. Examination by a urologist should identify or exclude these diseases. A thorough questioning of a man allows us to draw conclusions about the possible presence of any diseases or a predisposition to them. During the examination, the urologist pays attention to the structure of the external genital organs, checks the size, shape and condition of the testicles, and also performs a rectal examination.

... As a result, the baby's body during pregnancy does not receive a lot of useful substances. Including calcium - the main building material for teeth. On average, 80 percent of young children in Russia suffer from rickets. What can we say about children's teeth. - What should I pay attention to immediately after the birth of a child? - On the frenulum of the tongue. In the days of Soviet medicine, orthodontists went to an appointment on an infant's day and checked congenital anomalies in children: a cleft palate, shortened frenulums of the tongue and lips. A shortened frenulum of the tongue is quite common. The tongue becomes immobile. The operation is very simple: the bridle must be trimmed, and it must be done within the first two months of life. Now, unfortunately, there is no such practice. - How is the frenulum of the tongue related to dental health? - It is associated with the health of the whole organism in ...

the bridle on the upper lip was torn! what to do?. Children's medicine

Yesterday Ilya stayed with his dad, they played very well and were furious. Ilya fell and broke his lip, and then I noticed that the bridle on his upper lip was torn. What to do with it? Which doctor should I go to? And what will the doctor do?

Physiological phimosis in boys and other anomalies in the development of the penis

2vtta about the bridle. Other children

The topic has already crawled away and I can write to you here. we are not cerebral palsy, but literally at the end of summer we cut the frenulum under the tongue for the second time, so the memory is still fresh. in simple cases, you can use ordinary pediatric dentistry for free, you can also contact paid dental centers (not all have such a service - this needs to be clarified), both for children and adults (although the amount can be voiced very different, it does not depend on the professionalism of the surgeon , but from the requests of the center, sometimes ...

Short bridle. Children's medicine

The first time they paid attention to the bridle at 3 months. They said to wait. Now 7 months, but the frenulum is still short. Does she need to be cut? What doctor does this? Thanks in advance.

conf.7ya.ru

What is a frenulum of the tongue

The frenulum of the tongue outwardly resembles the thinnest membrane, consisting mainly of connective tissue, the function of which is to attach the tongue to the bottom of the oral cavity.

In other words, a short frenulum of the tongue in a child is some kind of defect in the oral cavity that interferes with the consolidated movement of the tongue.

In some cases, the bridle does not look thin at all, which greatly exacerbates the situation. Almost half of all parents face this problem. And although a short frenulum can be seen by a specialist even in newborns, parents learn about it when the baby begins to talk.

The concepts of complete and partial short frenulum of the tongue in a child are also divided. The type of pathology depends on the level of discomfort of the child, the type of treatment chosen (surgery or corrective exercises).

With a full short frenulum, the child's tongue is practically immobilized, which greatly complicates the pronunciation of most speech sounds. With this type of pathology, the formation of muscle strands occurs. In the case of partial pathology of the frenulum of the tongue, the connective tissue plays the role of muscle strands.

What is dangerous short bridle

A short frenulum is a congenital pathology in which the development and functionality of the ligamentous connection of the tongue and lower jaw is disrupted. At the same time, the mobility of the tongue in the oral cavity is limited to such an extent that it causes speech problems in the child.

Problems with the frenulum of the tongue in a child can be realized in two ways. Young children who are breastfed or bottle-fed and have this pathology may have problems with suckling. This is due to the fact that the frenum of the tongue is so short that it simply does not allow the tongue to function adequately.

With a short frenulum of the tongue, the baby cannot be fully breastfed, due to the fact that it is difficult for him to suck out enough breast milk. Therefore, in this case, immediately after the birth of the baby, he has real difficulties with feeding.

The second option for implementing the problem associated with the pathological frenulum of the tongue is speech defects and they occur much later. Partial immobility of the tongue leads to the fact that the child is not able to correctly pronounce certain sounds, his speech remains similar to babbling, "lisping".

Causes of the development of the pathology of the frenulum of the tongue in a child

The formation of an anomaly associated with a short hyoid membrane is laid even before the birth of a child. This is preceded by negative factors, which include:

genetic predisposition;
infection of the fetus during pregnancy;
viral and infectious diseases suffered by the mother during pregnancy;
mechanical injuries of the abdomen of the expectant mother;
the age of the expectant mother is over 35;
adverse environmental conditions;
the influence of other factors of unknown etiology.

How to recognize a pathology in a child

A neonatologist, a pediatrician, or the mother herself can recognize a pathological frenulum of the tongue in a newborn. If during the first and subsequent breastfeedings the child experiences difficulties, cannot properly grasp the nipple, then there is a reason to see a doctor.

The second common sign of a pathological frenulum of the tongue in children is the occurrence of a speech defect when they begin to speak in phrases, namely at 3-4 years old. Most often, with this anomaly, children do not pronounce several letters: “zh”, “sh”, “u”, “h”, “z”, “l” and “r”. Moreover, the sound “l” is easy to pronounce if it is followed by a soft vowel, for example, “i”, “u”, “e”, “e”, “I”, in other cases it is simply “swallowed”. If there is an incorrect pronunciation of sounds, then an examination by a speech therapist is necessary.

The most common symptoms of a tongue tie in a child are:

the child is not able to reach the front teeth of the upper jaw, palate with the tip of the tongue;
the child may have difficulty moving the tip of the tongue from one side to the other;
the front teeth of the lower jaw may have a gap between each other;
when the tongue is pulled forward, its tip remains flat, square or heart-shaped (that is, the front edge of the tongue seems to bifurcate);
feeding problems in newborns.

In what cases is it necessary to cut the bridle

The operation of trimming the frenulum of the tongue is called frenulotomy. It belongs to the category of simple and requires only local anesthesia.

Abundant bleeding during frenulotomy is a rarity, after a couple of hours the child will be able to return to the usual rhythm of life.

If a short frenulum prevents a newborn baby from receiving nutrition, it must be cut. The decision on the operation is made by the pediatric neonatologist.

Infants, as a rule, are operated on without anesthesia, since only the sublingual film of connective tissue is dissected, which has practically no blood vessels or nerve endings.

For children aged 3-5 years, the operation to dissect the frenulum is performed under local anesthesia. The decision on whether surgery is necessary is made by the dentist, and the speech therapist writes the referral.

Before the operation, the child needs to donate blood for a detailed analysis, which will display numerous indicators, including the number of platelets and the rate of blood clotting.

There are a number of indications for frenulotomy, and restriction of tongue mobility is not the only one. The formation of a malocclusion in a child, displacement and disturbances in the formation of the dentition, the low effectiveness of speech therapy and articulatory gymnastics, as well as the need to install dental implants or orthodontic structures for a child.

The pathology of the frenulum of the tongue does not always require surgical intervention. If the child does not experience discomfort during breastfeeding, and the pronunciation of sounds is satisfactory, then it is likely that a speech therapist will help solve the problem. In this case, the baby attends special classes, performs speech therapy exercises, articulatory gymnastics, and so on.

Treatment Methods

Problems associated with a short frenulum of the tongue can be solved with medication and non-pharmacological methods.

Medical methods involves surgical intervention of varying degrees.

If the hyoid membrane requires dissection, but it is thin and elastic enough, then the doctor dissects it right at the reception. Anesthesia in this case is not provided, since the procedure belongs to the category of lungs.

More complex types of dissection of the frenulum of the tongue include frenulotomy, which is indicated for children with thicker frenulums. Frenulotomy is performed under local anesthesia with tissue dissection and subsequent suturing.

Complications of this operation can be stomatitis, prolonged bleeding from the wound, infection in the wound, and so on. After the frenulotomy, the child should receive pureed food for some time, as chewing can be painful.

Non-drug methods treatments include special types of massage, exercises for correcting the frenulum of the tongue, individual sessions with a speech therapist.

Non-drug methods are recommended when the condition of the frenulum of the child's tongue is not critical and allows the refusal of the operation. The decision on this is made by the speech therapist, pediatrician and dentist. Classes with a speech therapist include performing various exercises, articulatory gymnastics, tongue twisters and poems.

Massage aimed at stretching the frenulum of the tongue includes a list of special exercises. It is important that the classes are systematic in order to give a positive result.

Massage instead of cutting the frenulum is recommended for children in two cases: if the condition of the frenulum is not so critical and the problem can be solved by non-drug methods of treatment; if the dissection of the frenulum falls on the older age of the child (over 5 years old) and the operation will not solve problems with a speech defect.

Exercises for the correction of the frenulum of the tongue and in the postoperative period

Postoperative exercises for stretching and correcting the frenulum are aimed at developing new muscle movements of the tip of the tongue inside and outside the oral cavity. Regular exercise will increase the range of motion of the tongue.

The most common and universal exercises for stretching and correcting the frenulum of the tongue are given here in the article. Following them, you can practice at home with your child on your own:

Stretch the tongue forward, then stretch the tip up to the nose, then down to the chin. Relax, repeat the exercise several times (at first, up to five repetitions are enough, gradually the number of repetitions must be increased, bringing them to twenty).
The exercise is performed by analogy with the previous one, making tongue movements to the left and right. The number of repetitions is also gradually increased to twenty.
Mouth open wide. Touch the upper incisors with the tip of the tongue and try to press on the teeth with all your might, preventing the mouth from closing. During each execution, mentally count to ten. The number of repetitions is similar to the previous ones.
The exercise is performed in front of a mirror. The mouth is wide open. When performing the exercise, it is important to follow the movements of the tongue. Pronounce the syllables “dar-dar-dar”, “nar-nar-nar”, “tar-tar-tar”, etc.
Sticking your tongue out as far as possible, alternately “lick” the upper and lower lips.
Closing your mouth, move your tongue from right to left and back, forcefully pressing on your cheeks from the inside with the tip of your tongue.

To achieve good results, exercises should be performed daily, in several approaches, for 15-20 minutes. The articulation of specific sounds can be gradually corrected.

Speech therapy classes should include exercises to improve the functioning of the speech apparatus and oral kinesthesia, without which it is difficult to claim significant improvements in the development of a child's speech. Many young patients after the dissection of the frenulum begin to speak more quietly and more quickly, trying to "drown out" speech problems.

Many people have heard about such an operation as cutting the frenulum under the tongue in children, but not everyone understands why and when this is necessary. The problem with the imperfection of the structure of the hyoid frenulum can manifest itself at different ages and parents really should pay due attention to this. Despite the fact that this part of the body seems quite insignificant, it is associated with the process of eating and reproducing speech. Its anomaly can indirectly affect vital phenomena in the body.

The essence of the problem

Photo: this is what a normal frenulum looks like in a child's mouth

The tongue is attached to the base of the mouth with its root part. Between the tongue and the lower edge of the mouth is a small fold of skin - the frenulum. Normally, it should be of such length that a person can easily move his tongue, protrude it slightly beyond the lips, touch the front surface of the teeth, and make sounds.

A shortened frenulum of the tongue severely limits its mobility, speech capabilities and the ability to eat normally, especially in children. The same problems arise when it is attached incorrectly, when it is in close proximity to the tip of the tongue.

The consequences are:

The frenulum in newborns is normally about 8 mm long. and more, and in five-year-old children it increases to 17. But it is far from always possible for mothers to take measurements at home, especially if the baby is very active. And to understand whether everything is correctly located in the oral cavity, only specialists can do it.

You can determine if a child has a short frenulum by some external signs:

If parents suspect a problem, you should contact your pediatrician or dentist. But in many cases, the defect is established by a neonatologist in the maternity hospital.

Reasons for the defect

A short frenulum of the tongue in a newborn is a congenital anomaly, which is laid down in the first months of fetal development, when all organs are formed. There are several reasons for its appearance:

The presence of a hereditary predisposition: if the parents had such a feature, it can be inherited.
The older the mother-to-be, the more likely her child is to have a shortened frenulum due to an increased risk of developing anomalies.
A defect can develop if a woman has had an infection during pregnancy or suffers from chronic diseases.
Severe early toxicosis can lead to a lack of nutrients, due to which the organs of the fetus are formed incorrectly.
Exposure to any teratogenic factors: radiation, toxic substances, heavy drugs for the body, alcohol, tobacco and drugs.
Accidents involving injuries to a pregnant woman.

Some of these reasons do not depend on the actions of future parents, especially genetic predisposition. Other risk factors should be avoided: a pregnant woman should not work in hazardous industries, drink, smoke, self-medicate, expose herself to the risk of falls when playing sports.

Ways to solve the problem

At the moment, there are several ways to correct:

Cutting the frenulum in children with a scalpel.
Cutting the frenulum under the tongue with a laser.
Stretching through exercise.
Defect removal with massage.

Surgical interventions can be performed in different ways, the main methods are:

In more modern clinics, pruning is performed using a laser. The dissection is carried out after treatment with an anesthetic: gel, spray. For patients, such pruning is less traumatic, damage to blood vessels is minimal - the laser simultaneously cuts the mucosa and causes adhesion of the affected capillaries.

Tissue regeneration after laser cutting takes place within a few days, you can return to your usual lifestyle an hour after the procedure. But how long you need to stay in the clinic, the doctor decides. Complications are less common than after the removal of the defect with a scalpel.

Optimal age for surgery

Is it worth it to manipulate the frenulum under the tongue and at what age it is better to cut it - such decisions depend on when the anomaly was discovered, what are the individual characteristics. If a neonatologist determines in the maternity hospital that the baby has a defective hyoid frenulum, it is better to do the cutting right away.

The baby is not yet so mobile as to interfere with the procedure, and the membrane itself is small, thin and does not contain blood vessels. Thanks to these factors, local anesthesia will be sufficient for manipulations, and you can calm the baby by applying it to the chest after the operation.

Trimming the frenulum of the tongue in children over the age of 6 months is associated with some difficulties. The kid becomes mobile, and parents cannot discipline him with persuasion. Due to careless movements, surgical intervention may occur incorrectly, that's why surgery is delayed until the age of five.

During this period, the children are talking, the doctor can determine if there are speech defects, whether the frenulum under the tongue interferes with the child, whether it needs to be cut or stretched with gymnastics.

If the baby did not perform a dissection of the frenulum of the tongue, and after many years he developed speech defects, developed problems with breathing and digestion, then it is necessary to perform circumcision in adulthood. But the older a person is, the denser his membrane becomes, it becomes overgrown with capillaries and nerve endings - that is why it is much more painful to dissect it than in the case of a baby. The incision requires anesthesia.

Examinations before surgery and contraindications

Any surgical actions in the oral cavity are a risk to the body. In order to prevent complications after the operation, it is necessary to undergo preliminary examinations prescribed by the doctor. The most significant are blood tests, urine tests, determination of blood coagulation and fluorography.

Contraindications for frenuloplasty are infections of the throat, oral cavity, inflammatory processes in any part of the body, since pathogenic microorganisms can get into the incision of the mucous membrane. That is why a mandatory examination is carried out before the intervention. It is impossible to operate on patients with oncological diseases, reduced blood clotting.

Postoperative period

The mucous membrane in the mouth recovers quickly. But circumcision of the frenulum can cause complications:

The formation of a hard scar in the place where the incision was made.
The development of the inflammatory process due to infection.
Temperature rise. It manifests itself as a sign of the development of an infectious process or a kind of reaction to the operation.

The baby can respond to complications with constant anxiety, refusal of food. Children three years and older can tell themselves what is bothering them. If you feel any discomfort, you should consult a doctor, only a specialist will correctly assess the condition of the baby and prescribe the best treatment.

To avoid complications, you need to monitor the cleanliness of the oral cavity. Five-year-olds are already brushing their teeth and can rinse their mouths with water. Within a few days after the defect was removed, you can not chew solid food and talk a lot how much exactly the restrictions should be observed, you need to ask your doctor. After the follow-up examination, the attending physician will recommend special exercises to develop the elasticity of the frenulum.

Correction with the help of gymnastics for the tongue

Only a doctor is able to determine whether it is worth doing an operation on a short frenulum of the child's tongue or whether it is better to remove the defect with the help of exercises. Therefore, even if parents are not set up for surgery, they still need to go to a pediatrician, dentist for a consultation and surgery or the correct individual selection of exercises.

The possibility of conducting gymnastic classes appears when the baby can already repeat some given actions. But there are simple exercises even for newborns: they are given a silver spoon to lick, milk is dripped onto their upper lip, which is why they try to lick it, at a slightly older age they smear jam.

When the baby is able to understand the mother's requests to repeat certain actions, you can do more complex gymnastics:

Close your mouth and feel the side walls of the tongue, the palate and the lower part of the mouth.
Open your mouth and reach as far as possible to the outer surface of the lips.
Click your tongue.
Put the tongue on the lower lip and hold in this position for 10 seconds.
Stick out your tongue as far as possible and hold for 10 seconds. You can also ask the baby in a playful way to show what a long tongue he has.

Frenulum tear

Some children with an unsuccessful fall have a rupture of the frenulum of the tongue. Such injury can be obtained due to close contact of the septum with the lower teeth. If the child has cut the frenulum, he may start bleeding and swelling in the oral cavity, it becomes painful for the baby to chew and talk.

You can not rely on self-medication, you should immediately consult a doctor. Sometimes it is necessary to sew up the formed wound because of the danger of heavy bleeding.

The importance of such a part of the body as the bridle cannot be underestimated. There are many ways to lengthen a small septum to free up the tongue for free speech and eating. Before taking certain measures, it is necessary to consult with a specialist and do preoperative tests if it is necessary to cut the frenulum.

If the anomaly causes disturbances in the functioning of the organs, then frenuloplasty is necessary, and it is better to carry it out at the age that the doctor advises. Ignoring such a problem means exposing the child to the risk of frequent respiratory and digestive diseases, a problem in the pronunciation of sounds.

Video: short frenulum of the tongue

A short frenulum is a common diagnosis in babies, which a mother can hear even in the maternity hospital. In the same place, this pathology must be immediately eliminated, because the newborn baby will experience difficulty in sucking the mother's breast or when feeding from a bottle. The frenulum can be successfully corrected, the procedure is quick, almost painless and well tolerated, so do not worry if this happened 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 surgery is performed on time, the child will not remember this problem in the future.

Why is the bridle cut for a child, and is it really necessary?

The frenulum of the tongue is a webbed bridge that connects the tongue and the lower jaw (see also:). Thanks to its presence, the tongue is held in a normal position. It is responsible for many important functions in the human body:

nutrition, in infancy - breast sucking;
correct pronunciation;
normal bite;
work of the 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 up to a year - 8 mm. Usually frenulum anomalies consist in shortening the length or attaching it to the tip of the tongue. This deviation is called ankyloglossia, or a short frenulum. The location of the frenulum in the mouth, characteristic of this anomaly, is shown in the photo.

Why is ankyloglossia dangerous for a baby? It causes deviations in the development of the jaw and malocclusion. You can understand that the baby has a short frenulum immediately after birth. The baby does not suck well at the breast, gets tired quickly, cries and is often applied to the mother's breast. During feeding, characteristic clattering sounds are heard, and milk pours out of the mouth. Such babies grow slowly and gain weight, because their tongue is inactive, and sucking causes discomfort, it hurts to move the tongue. The same 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 pathology, discomfort when chewing and swallowing food. Usually this problem is diagnosed by a speech therapist, who is contacted 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.

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

viral diseases (the first and third trimesters are especially dangerous);
toxicoses;
exacerbation of chronic diseases;
psychotraumatic situations;
taking alcohol, drugs, chemical poisoning in the first 3 months of pregnancy;
poor environmental situation in the region of residence;
bruising of the abdomen or other injuries.

At what age do such an operation?

This article talks about typical ways to solve your questions, but each case is unique! If you want to know from me how to solve exactly your problem - ask your question. It's fast and free!

There are no age restrictions on plastic surgery, it is done for the smallest patients, school-age children, and adults. Mom is practically not separated from the child, because the plastic of the frenulum itself passes quickly.

Plastic frenulum of the tongue is easier to tolerate in the first months of life. It is best to make it for a newborn so that the baby can eat comfortably and grow well.

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

However, during this time, persistent speech disorders may appear, which subsequently require long-term corrective work and constant exercises. Other experts recommend cutting the membrane between the tongue and jaw during the growth of the upper teeth.

Where is frenuloplasty done and which doctor should I contact?

If ankyloglossia is suspected, the child will be referred for a consultation with a dentist, orthodontist or maxillofacial surgeon, who will confirm or refute the preliminary diagnosis. The decision on the need for surgery will be jointly made 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 eliminated by conventional means;
malocclusion;
violation of proper food intake;
displacement of teeth, inclination of the incisors inward.

Experts share the degree of pathology on a 5-point scale. Small deviations are successfully eliminated without surgery at the age of over 1 year by performing special exercises.

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

Surgical correction of a short frenulum

A newborn baby can be operated on even in the maternity hospital, because at birth a neonatologist will check him for the presence of this pathology. In older children, the procedure is carried out quickly, it does not require a stay in the hospital, after it you can immediately go home.

Contraindications to cutting the bridle may be:

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

Bridle cutting is carried out if the child is completely healthy; in the presence of caries or other disease, the operation is not possible

The main types of operations for ankyloglossia

It is up to the specialist to decide which type of surgery is appropriate. Usually this:

frenulotomy - cutting the frenulum and suturing the edges of the mucosa;
frenuloectomy, 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 off 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 circumcision of the frenulum is not required.

How is the procedure for trimming the bridle?

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

The operation is performed under local anesthesia. There are no nerve endings and blood vessels in a newborn child in the frenulum. That is why her pruning does not cause much concern to the baby and parents. The operation time usually takes 5-10 minutes.

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

Treatment with a laser

Laser correction is considered the safest method of surgery and belongs to microsurgery. It practically does not cause complications. There are no stitches after laser surgery, this is not necessary, and the postoperative period lasts 2 days.

The duration of laser surgery is only 3-5 minutes. This method is suitable for babies, because it does not cause bleeding, complications in the form of secondary infections, it is accurate and almost painless.

Recovery period

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

Immediately after the operation, the babies begin to eat normally without experiencing discomfort, and mother's milk will help the wound in the mouth heal faster. Babies quickly gain weight and grow well. Speech therapy disorders in babies under one year old are not diagnosed, and older children will need corrective work with a speech therapist. What exercises are recommended in the presence of pathology, you can see on the video.

In the presence of pathology, it is recommended to regularly perform simple exercises.

After frenuloplasty, you should:

do not eat for 2 hours;
3-4 days do not eat irritating foods - salty, spicy, sour and too hard;
refuse hot food and drink;
for some time it is better to eat food in a pureed form;
do not load the language with conversation;
after eating, it is imperative to rinse the oral cavity with antiseptic agents (chamomile decoction, calendula tincture, Furacilin solution);
do special exercises developed by the doctor;
lay sea buckthorn oil, Solcoseryl on the site of surgical intervention;
visit a speech therapist as prescribed by the attending physician;
if there is pain, the child is given pain medication (Nurofen, Ibuprofen).

Are there complications after the operation?

Usually, no consequences, except for a short-term restoration of the normal function of the oral cavity and tongue, do not occur. Everything passes quickly, almost painlessly and is well tolerated by the child.

At the birth of our child, no one told us that he had a short frenulum under the tongue. None of the doctors noticed this during the examinations. And I, given that the child is the first, did not hear about this at all, no one in our family had such a problem. And when examined by a dentist a year (apparently more competent than those who examined the child before), we were told that our son has a very short frenulum, so much so that his tongue does not reach the sky. They explained to us that it was necessary to do this (cut it) up to 3 months, when there are no blood vessels in the child and this is done literally for 2 minutes, and it is painless for the child. Then I found out that it turns out that when breastfeeding a child, he experiences inconvenience and because of this he suckles for a long time. So, however, we had it and I could not understand why he eats for 2 hours, it was especially debilitating at night. And it turns out that it was in the bridle. And none of the pediatricians, even paid ones, at that time told me that the short hyoid frenulum could be the reason for such a long feeding. The dentist also warned us that the child may have burr because of this and the lower jaw may not develop, and if you do not cut it in time (it turns out there is still such a period) (that is, in 3-4 years), then when the teeth grow, then grow they will grow crooked and in two rows. In general, we waited exactly 4 years, when we can already agree with our son and explain why we need such an operation. by this time, the son speaks very well, but there is a problem with the pronunciation of the letters “r” and “l”. The speech therapist worked with us for a year, trying to stretch the frenulum, but to no avail. She told us simply - the bridle is short and probably you still need to go for a consultation with a dental surgeon. We went. Moreover, they thought that there would only be a consultation, but she insisted on immediately doing this mini-operation, she says, then you will tighten it again, and later it will be too late and then he won’t say thank you. Of course, we all persuaded our son together. He is obedient with us, and agreed. They made sure it didn't hurt. They wrapped him in a blanket. And this is where he got scared. Started crying. We were allowed to stay. For support. I can't say that it didn't hurt him. When they cut off his tongue with an injection, he was in great pain, he screamed loudly, and when his tongue went numb, this operation was done quickly, for about ten minutes, they cut it with scissors, stitched it up. And they let me go with recommendations not to eat or drink for 3 hours, after giving Nurofen an age dose, in the morning (we did it in the evening) give more Nurofen. Rinse with chamomile or calendula after meals and immediately treat with miramistin - 7 days. 4 days do not give solid food, only liquid, puree. Neither spicy, nor sweet, nor salty, too, for 4 days. Do not jump or run so that the seams do not come apart. The child jumped out of the chair happy. But after three hours, the anesthesia went away and it began ... He roared so much. Nurofen, which I gave him anesthetized, of course, for 4 hours maximum, we didn’t sleep all night, in general. He cried and slept only in our arms, taking turns with her husband changed. This is some kind of horror. They waited for the morning and gave Nurofen again. When the pain passed, the son revived, but he could not eat, even in the form of mashed potatoes, he could only drink. He could not speak, although he was a talker with us, but here he could not at all. That was torture for him and for us. I bought him custard porridge, diluted it liquidly, as at the first feeding, and gave him to drink from a mug, but even drinking it hurt so much that he cried, complained and refused, they persuaded him in all sorts of ways, because he wanted to eat, but the fear of pain , pain from liquid or semi-liquid interfered with it. The child was hungry all day. Quietly drank only water and compote. He rinsed his mouth willingly, gave Miramistin to treat. And this song lasted 3 days!!! He lost weight, his ribs were palpable. Pale was. Gave him a multivitamin that dissolves in water. And melted chocolate to give at least a little energy. They didn’t sleep at night, he went to sleep, periodically woke up from pain and roared. Nurofen gave two days in total, then they said that more could not be. It saved me that I drank milk willingly, especially at night. This is how our first three days passed after cutting the frenulum under the tongue. Painfully. It was especially painful for my son. On the 4th day he agreed to eat mashed potatoes, and on the fifth day he even ate a cake and pasta. on the fifth day they began to do special gymnastics for the tongue. And drip sea buckthorn oil under the tongue. Now the 10th day. He does not remember the pain of that, but he eats carefully all the same. Although everything has healed there, the threads dissolve. About speech. Improvements were noticeable on the 7th day. It was the first time he said "Lake" clearly. He also pronounces other words with the letter "L" clearly. And he loves it. For comparison, he used to say “Eyka”, “Yoika”, etc. But with the letter "R" there are no changes yet. The speech therapist said that in a month she would speak, she just needed help, work on it. I hope. I want to say that I read a lot about cutting the frenulum of the tongue and everyone writes that it doesn’t hurt (as for children 4-6 years old). I don't know what the purpose of writing this is. I say that it is painful for the child and it hurts for the first 3-4 days for sure. It's painful for parents too. And you have to be ready for this. It is better, of course, to pay attention to the child's frenulum at birth, and solve this problem up to 3 months. But if it turned out that you missed this time, you need to cut it from the age of 3, since the consequences, you know, may not be very good if you leave it as it is. Again - on the recommendation of experts, all this is done. And if the recommendation is received, do it, and be prepared for such moments as I described above. I also heard that the bridle is cut with a laser. quickly and heals quickly. But there is one point in such an operation, it may not heal properly, a scar will form, and then they already solve it in the usual way. For such an operation, a proven and experienced doctor is needed. An experienced doctor did it for us, but she does not accept laser cutting, she says that in 90% after that, children are cut again and in the usual way precisely because of scarring. I don't know if it's true. I am not a dentist. But I tend to trust the experts. She is a doctor of the highest category and reviews about her are good. I hope our experience will be useful to someone in the same situation. Be healthy.