The bridle is a small sublingual piece of tissue, which is located in the mouth. It is of different lengths and elasticity, and may also differ in the place of attachment. These parameters directly affect the articulation of speech, the correct pronunciation of most sounds, and the ability to eat food in a normal way. It is the frenulum of the tongue that is often the culprit for problems with teeth and all sorts of speech defects.
How to check the hyoid bridle?
The sublingual frenulum may be of different lengths and attached in various places. The norm is the situation in which its location and size do not limit the movement of the tongue. In an adult, the jumper usually varies from 2.5 to 3 cm, for babies under one year old, it should be about 8 mm.
It is possible to visually check even a newborn baby visually how a hyoid tongue looks like and if there are any abnormalities. To do this, it is enough to delay the lower lip so that the crumb opened his mouth. This will allow you to assess where the partition is attached to the bottom row of future teeth, and how it holds the tongue. For comparison, it is enough to find photos and videos with a normal bridle without congenital anomalies.
When is trimming needed?
The presence of abnormal septum does not always require surgery. Indications for surgical correction of the bridle are situations when:
- there are difficulties with feeding the baby,
- an overbite is formed,
- offset teeth.
In case of abnormalities in the development of speech associated with pathology, the problem in most cases is solved not by surgery. Stretching is performed with the help of gymnastic exercises and massage.
Causes of a short bridle under the tongue
- Heredity. Having parents of such an anomaly increases the chances of its formation in a child.
- Environmental ecology.
- Injuries in the abdomen during pregnancy.
- The age of the pregnant. Babies born to women who give birth after 35 years, increases the likelihood of tyazha pathology.
- The presence of chronic diseases in a pregnant woman.
- Infection of the fetus during gestation.
- Transferred by a woman during pregnancy viral or infectious disease.
Symptoms of a shortened bridle with a photo
A dentist or an experienced pediatrician can accurately diagnose the jumper pathology. However, the parents themselves can also suspect the presence of the problem if there are certain symptoms, as well as when visually inspected using a photo of normally formed cords from the Internet. Infants with short bridles are characterized by:
- strong smacking and tongue-feeding when feeding,
- nipple biting while sucking
- using lips to grip the chest
- the requirement to apply frequently to the chest,
- letting the nipple out of your mouth
- poor weight gain
Older children may experience the following symptoms:
- respiratory arrest in sleep,
- V-shaped tip of the tongue,
- frequent bridle tears,
- increased saliva secretion during conversation.
The age of the child in which it is desirable to do cropping
The actual question is at what age it is better to do a dissection of the bridle under the tongue. If the problem is found still in the maternity hospital, and the revealed pathology causes difficulties in feeding the baby, then it is eliminated there. The procedure is painless, and after its implementation, the crumbs are applied to the chest to stop bleeding.
Starting from 6 months, such an operation becomes dangerous, since the babies are not able to stay stationary for a long time, and any sudden movement of the head during the manipulations can lead to serious damage.
Cropping should be postponed to 4-5 years. At this age, it is already clear whether the pathology affects speech, and whether it is possible to make a correction with the help of stretching, massage and special exercises. Of course, it is possible to cut the partition already to an adult, but this requires anesthesia, stitching, and the recovery process will be longer.
How is the operation performed?
Correction of the frenulum can be carried out even in a maternity hospital in a newborn, if this defect was detected immediately after birth. At this age, it is cut so that the baby can fully eat.
In those cases where shortening of the bridle is diagnosed in children older, and various speech therapy exercises and massage cannot correct the defect, surgical intervention is required. There are three main types of trimming the hyoid bridle:
Phrenectomy - dissection of the skin fold
The second name for frenectomy is the Glickman method. The essence of the method is reduced to the use of clamps, with which fix the bridle. After that, make cuts between the lip and the clip. On the wound edges are stitched. In newborns, dissection of the skin fold is carried out fairly easily and without pain, without the use of anesthesia, since they do not yet have blood vessels and nerve endings in this area.
After 2-3 years of age in children, the structure of the lingual fold changes. Vessels appear in the connective tissue, and the septum itself becomes more dense and fleshy. As a result, the operation will require anesthesia and subsequent stitching of the wound.
Frenulotomy is the easiest way to trim, which aims to increase the length of the shortened jumper under the tongue. During such an operation, an incision should be made on it with the help of special scissors closer to the lower row of the front teeth. The distance at which the bridle of the tongue is trimmed is 1/3 of its total length. The mucous membrane is dissected, and then the cords themselves. Next, the sides of the mucous bring together and stitched every 3-4 mm.
This method of plastics, which is also called the Vinogradova method, is based on a change in the place of attachment of the bridle in the oral cavity. This plastic of the bridle of the tongue is carried out in several stages:
- cutting and flaking of the flap in the form of a triangle is made, and the edges of the wound are connected by suturing,
- a cut is made in the direction from the septum to the papilla between the front teeth,
- triangle sewn to the surface of the wound.
Apply and other similar methods of plastic short bridle, including the lip lintel. For example, Limberg or Popovich plastic.
In addition to the use of scissors or a scalpel in order to trim the shortened sublingual septum (which is often quite painful), in modern dentistry, doctors use a laser. Laser circumcision is a more benign method of performing an operation, which should be addressed if the patient is a small child.
Laser bridle removal has several advantages:
- simultaneous evaporation of tissue sites,
- lack of blood during surgery,
- wound closure
- coagulation of vessels or, in other words, their roasting,
- Sterilization of the edges of the incisions
- no seams
- fast healing
- minimal risk of complications
- ease of procedure.
Contraindications to surgery
Usually the operation for trimming the sublingual frenulum has no contraindications. However, there are certain circumstances related to health problems in which doctors do not recommend carrying out the procedure or may advise you to postpone it for some time. These include:
- infectious diseases,
- low blood clotting,
- oncology in the oral cavity (we recommend to read: the first stage of oncology of the oral cavity: symptoms, prognosis),
- pulpitis, stomatitis or other diseases in the mouth.
Is it possible to stretch the hyoid bridle?
- pull the tongue forward and drive them around,
- alternately reach the tip of the tongue to the lower and upper lips or teeth,
- snapping his tongue, holding him up at the sky and dropping him down,
- with your mouth closed to drive the tip of your tongue between your cheeks,
- pulling lips with a closed mouth and smacking.
In addition, children should often be given a spoon to lick. Another way: drip jam on the lip and ask the baby to lick it. Also, let the baby smile with closed lips more often.
What is fraught with a short bridle?
Pathology associated with a shortened bridle is a fairly common problem. This is a congenital defect, as a result of which there is a violation of the development and functioning of the element connecting the tongue and the lower jaw, which, in turn, affects the mobility of the speech organ itself. A short bridle of the tongue in a child leads to the following consequences:
- Problems with grabbing and sucking the breast in babies. This causes malnutrition in infants. He throws his chest early, not yet fully eaten, which explains the poor weight gain, frequent crying and nervousness.
- The appearance of speech defects. The limitations of the language complicate the pronunciation of certain sounds and words, which hinders speech development in children. Sounds like “p”, “l” and a sibilant child with a shortened bridle will not be able to pronounce, being an adult. Difficulties in communication and the full expression of their thoughts can cause psychological problems for a child, develop self-doubt and other complexes.
- Formation of the wrong bite. This is due to the fact that the language is constantly located unnatural.
- Digestive problems. They appear gradually due to the inability to chew food thoroughly.
- Increased risk of injury and tear.
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A sign of a short bridle in a newborn baby is difficulty in sucking the breast, while the baby bites the nipple and very quickly refuses the breast. Most often, a short bridle is found in boys than in girls. Very often this phenomenon is typical for children whose parents had a similar problem.
Slightly shortened bridle in a newborn baby is not a disease, it is only a defect of the oral cavity, which doctors often discover even in the hospital. In this case, the procedure of cutting is carried out immediately, although there are cases that doctors send mother with a newborn child to the dentist.
The procedure for dissection of the frenulum is practically painless, because the newborn baby has a very small number of blood vessels in the membrane and there are no nerve endings. Therefore, in a newborn baby, the bridle is cut without anesthesia using special scissors.
In order to stop the blood, after the procedure, the baby is immediately applied to the chest or give a bottle. The operation of trimming the bridle is quite simple, the wounds after it are healed the next day. After the procedure, newborn babies start to suckle much better, and their appetite improves.
This procedure is shown only when breastfeeding is difficult. If there is a defect, 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 when the tongue moves. The baby can not stick his tongue out of the mouth due to the fact that the bridle pulls its tip down. The baby's tongue is shaped like a groove, and this is accompanied by a certain sound.
As a result of the difficulty of movements of the tongue, during a conversation, the grown-up child has difficulty pronouncing the letter p, as well as hissing sounds. Sometimes there is a violation of diction - the child is illegible or indistinctly talking.
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. What subsequently contributes to the development of gingivitis and periodontitis of teeth.
When a child at the age of 5 incorrectly pronounces the letter r and hissing sounds, and also with great difficulty lifts the tongue up, it is necessary to check his bridle. In the stretched state for a 5-year-old child, the characteristic length of the bridle is at least 0.8 centimeters. When lifting the tongue up, it should not split apart and take the form of a heart.
The front edge of the bridle is normally attached a few millimeters above the base of the papilla, but not quite close to the tip of the tongue. For a more accurate recognition of the short frenulum, you can ask your child to lick the saucer with the tongue or poke it with the tongue.
When a child performs these actions without difficulty, the cause of speech defects is not in the length of the bridle. Children older than 4 years of the operation to dissect the short frenulum will not help correct speech defects, so you will need to contact a specialist in speech therapy.
The need for cutting the bridle under the tongue in children
Cutting the bridle under the tongue in children is a common procedure in surgical dentistry. The operation is recommended at any age and is carried out to eliminate congenital abnormalities. The sooner the plastic is held, the faster and better the correct speech, jaw and bite of the child will begin to form.
What are the bridles and why are they needed?
The bridle is normal in the mouth can lengthen and shrink. It is an elastic fold of the mucous membrane, which stretches from the middle of the tongue to the very base of the gums, approximately in the region of the lower anterior incisors. Its main purpose is to ensure the mobility of the language and the normal pronunciation of sounds.
The fold may have some deviations, in particular related to its elasticity, length and area of attachment. They are found in early childhood during examination of the child by a doctor.
What is the danger of a short bridle?
This pathology has the scientific name ankyloglossia, which means "curved tongue". Most often this phenomenon is observed in boys. An abnormally short bridle prevents the child from normal language control, swallowing and even breathing. Usually, a pediatric neonatologist helps to detect pathology, but there may be oversights on the part of some doctors.
A short bridle prevents the child from normal language control, swallowing and even breathing.
A pronounced symptom of pathology - the baby barely sucks the breast during nursing, as a result of which it is poorly saturated, behaves restlessly, is naughty, often requires attachment to the breast, does not gain weight.
It is important! In children older than three years, the short frenulum of the upper lip can lead to abnormal development of the interdental spaces, which are located between the upper incisors, as a result of which they move forward sharply. Anomaly of the lower lip most often leads to the wrong formation of a bite.
A short frenulum in a newborn is a congenital abnormality. The reasons may be different:
- Genetic predisposition - it is not necessary that the parents of the baby have the same problems. Often the anomaly is inherited from the next of kin.
- Pathology can be during pregnancy, in the first and third trimester. The determining factors are various: the use of narcotic substances in the period of gestation, somatic or infectious diseases, adverse natural conditions, abdominal injuries and much more.
- In some cases, an abnormally developed upper lip bridle is diagnosed in children who already have other congenital anomalies that cause various kinds of deformities.
If there is such a problem, the following are observed complications:
- the baby hardly sticks out his tongue or is unable to do it,
- the baby cannot stretch out the tongue, since in this case it takes the form of an arc,
- the child cannot lift the tongue to the sky, since at the same time its tip forks.
There may be other symptoms that the bridle of the child is too short. An accurate diagnosis can be made by a doctor after a thorough examination.
At what age is plastic recommended?
When the suspicion of parents is confirmed, it is recommended to carry out an operation - plastic lining of the tongue in children. Surgical intervention has a number of features depending on the age of the child:
- Up to 1 year. If the baby has difficulty sucking the breast while nursing, you should contact your pediatrician for an examination. The operation itself is already 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 local anesthesia. Most often costs minimal bleeding.
- From 4 years old. If the child has not been done plastic before this age and has speech defects, and massage and various exercises do not help to stretch the tongue, it is recommended to hold the plastic. Such a 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, cutting the upper lip of the frenulum already causes discomfort and pain. Therefore, surgery is performed using local anesthesia. After this, the child is stitched.
The photo shows a short bridle of the tongue.
On a note! Наиболее подходящий для проведения пластики возраст подбирается врачом в зависимости от индивидуальных особенностей ребенка. The least hassle and discomfort causes cropping at the age of 1 year. In some cases, the doctor may advise the operation immediately after the birth of the baby.
The sooner the parents take care of the elimination of this anomaly, the faster the child can begin to live fully.
What is plastic for?
A short frenulum of the tongue in a newborn causes a lot of difficulties. Therefore, experts recommend a correction at an early age to minimize the consequences. Most often, difficulties arise already during breastfeeding:
- It is impossible to attach the baby in the right way to the chest.
- The child hardly absorbs the milk.
- In the process of feeding, the baby swallows too much air, which further leads to belching and abdominal pain.
- Insufficient consumption of breast milk leads to the fact that the baby is not growing fast enough.
If you do not perform the operation at an early age, the abnormally developed frenulum of the upper lip in the child leads to the consequences:
- growth retardation and abnormal development of the jaw,
- the child has a wrong bite,
- lower central teeth may turn inward
- cervical caries appears at an early age
- the bottom row of the bridle can be injured by incisors,
- there are problems in the pronunciation of many sounds
- the child has snoring.
What way to choose for correction of a short bridle?
Surgical dentistry offers two methods of correction:
- Using a scalpel. In this case, the operation takes at least 20 minutes. The doctor makes a small incision, and then stitches. After that, the child may have a slight swelling or pain. The scar which appeared as a result of correction heals approximately within 10 days. In the future it will be difficult to see.
In order for the intervention to proceed without complications, it is recommended to rinse the baby’s mouth with a special solution, which is prescribed by a doctor, in the postoperative period. It is advisable to eat soft food.
- Using laser. The operation takes less than 15 minutes. Correction by this method does not cause pain, passes practically without bleeding. The doctor makes an incision using a special laser that immediately solves the wound. This avoids discomfort during surgery and eliminates stitching.
The dental gel used here has an anesthetic effect. For several hours after the graft, 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 recommendations of a specialist. Sometimes the temperature rises in children after correction, which is an individual reaction rather than the norm.
In the case of scar after plastics, which is usually observed in older children, the doctor may prescribe a second operation.
Good afternoon, dear readers! A short frenulum of the tongue can be a serious problem for babies and their parents. Because of this defect, breastfeeding suffers, and subsequently the speech of babies. Cutting the bridle 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 consider whether it is necessary to carry out cropping, at what age, what kind of doctor does this and what methods of cropping exist.
Is it necessary to trim the bridle of the tongue to the child?
In half of the cases, ankyloglossia (short frenulum) is a hereditary defect. But this does not mean that absolutely all children need cropping. Many people live well with a short bridle and at the same time correctly speak and do not feel any discomfort.
If your child’s ankyloglossia was not indicated by the doctors at the maternity hospital, you can find out for yourself how to determine the short bridle.
Normally, in a newborn, the length of the muscular lintel (it is the muscular partition that is the bridle) should be 8 mm. By five years she grows to 17 mm. There are three degrees of impairment:
- light - the length of the septum is more than 15 mm, but at the same time the child has difficulty with pronouncing individual sounds,
- medium - jumper length from 10 to 15 mm, all symptoms are present,
- severe - the length of the bridle is up to 10 mm, the baby has difficulty with pronunciation, feeding, there are all signs of a violation.
Cut the bridle of the tongue to the child with a laser
The latest achievement of dentistry is laser trimming jumpers. It has many advantages:
- no risk of infection, since the laser has disinfectant properties,
- minimal risk of bleeding, as the laser beam is sealed vessels
- stitching is not required,
- minimal undesirable effects
- accuracy of the cut,
- fast healing
- no pain
- acceptable price.
The laser bridle trimming operation received excellent feedback from parents, as the children had easily tolerated it, and the side effects were minimal.
The procedure is very simple. Before the start, 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 part of the septum and dissolves it. On the wound is applied a bandage impregnated with healing solutions. The whole procedure takes up to 5 minutes. Rehabilitation lasts no more than 2 days.
How much is such an operation, it is easy to know if you look at the website of any dental clinic. The average cost is 4 thousand rubles.
We have examined the possible ways of cutting the frenulum of the tongue and the need for the procedure. How much it is appropriate for your child, you decide.
If you have thoughts about this issue, you can share them in the comments or advise your friends to read the article.
How and at what age do children undercut their bridles under their tongues and why do they need plastic?
A short bridle is a frequent diagnosis in babies that a mother can hear while still in the hospital. In the same place, this pathology should be immediately eliminated, because the newborn baby will have difficulty in sucking the maternal breast or when feeding from a bottle. The bridle can be successfully corrected, the procedure is quick, practically painless and well tolerated, so you should 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 bridle is found in many newborns, but if prompt intervention is carried out, the child will not remember this problem in the future.
Why does a child have a bridle cut, and is it really necessary?
A tongue bridle is a webbed web that connects the tongue and the lower jaw (see also: what if the infant sticks out the tongue?). Due to its presence, the tongue is kept in a normal position. It is responsible for many important functions in the human body:
- food, in infancy - breast sucking,
- correct pronunciation,
- normal bite,
- the work of the facial muscles.
When the bridle has a developmental pathology, 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, for babies up to a year - 8 mm. Usually bridle anomalies consist in shortening the length or attaching it to the tip of the tongue. This deviation is called ankyloglossia, or short bridle. Typical for this anomaly location of the frenulum in the mouth is shown in the photo.
What is dangerous for baby ankyloglossia? It causes abnormalities in the development of the jaw and a violation of the bite. To understand that a baby has a short bridle, you can immediately after birth. The baby badly sucks the breast, quickly gets tired, cries and is often applied to the maternal breast. During feeding, the characteristic sounds are heard, and milk is poured from the mouth. Such babies grow slowly and gain weight, because their tongue is inactive, and sucking gives you discomfort, it hurts to move the tongue. The same is observed in artificial children.
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 bridle is normal. The specialist may suspect a deviation, when the child has a violation of bite, periodontitis, speech therapy pathologies, discomfort when chewing and swallowing food. Usually, this problem is diagnosed by a speech therapist, who is asked for help if the sounds and words are pronounced incorrectly.
Ankyloglossia is to be treated, otherwise it leads to serious violations:
- chewing food
- snoring (apnea),
- inflammatory diseases of the oral cavity,
- frequent colds due to mouth breathing,
- disorders of the gastrointestinal tract,
Often ankyloglossia occurs for hereditary reasons. If the relatives had such a pathology, the probability of having a child with the same violation is quite high. In addition to genetic predisposition, a short frenulum is formed in the case of maternal pregnancy pathologies and other factors:
- viral diseases (first and third trimesters are especially dangerous),
- exacerbation of chronic diseases
- traumatic situations
- taking alcohol, drugs, chemical poisoning in the first 3 months of pregnancy,
- poor environmental situation in the region of residence,
- abdominal contusion or other injuries.
At what age do such an operation?
There are no age restrictions on plastics, it is done both to the smallest patients, and children of school age, and adults. Mom is practically not separated from the child, because the plastic of the bridle itself passes quickly.
In older children, it is more difficult to carry out the correction, since it is performed under general anesthesia, and it is much more difficult to convince a one-year-old child to sit quietly for a few minutes than to operate on the 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 disturbances may appear, which subsequently will require lengthy corrective work and constant exercise. Other experts recommend cutting the membrane between the tongue and jaw during the growth of the upper teeth.
Where do plastic bridles and what doctor to contact?
If an ankyloglossia is suspected, the child will be referred for consultation to the dentist, orthodontist or maxillofacial surgeon, who will confirm or deny the preliminary diagnosis. The decision on the need for surgery will be jointly made by the orthopedist, the surgeon and the speech therapist.
Grade 3 pathology: mild, moderate and severe
There must be good reasons for this:
- serious nutritional problems in a newborn baby,
- irremovable speech disorders in the usual ways,
- violation of proper eating,
- the displacement of teeth, inclination of incisors inside.
Experts share the degree of pathology on a 5-point scale. Small deviations are successfully eliminated without surgery over the age of 1 year through specific exercises.
The operation is performed in the maternity hospital or in dental clinics for older children. If the case is complex, operate in the maxillofacial compartments.
Quick correction of the short frenulum
A newborn baby can be operated on in a maternity hospital, because at birth a neonatologist will check for the presence of this pathology. In older children, the procedure is carried out quickly, it does not require a hospital stay, after it you can immediately go home.
Contraindications to trimming the bridle can be:
- oncological diseases (including the oral cavity),
- blood diseases
- acute infectious diseases
- diseases of the oral cavity and teeth (caries, pulpitis, osteomyelitis).
Bridle trimming is performed if the child is completely healthy, and if there is caries or another disease, surgery is not possible.
The main types of operations during ankyloglossia
The decision on what type of surgery will be appropriate, the specialist makes. Usually this:
- frenulotomy - cutting the frenulum and suturing the edges of the mucous membrane,
- frenuloectomy, or Glikman's method, when the bridle is cut by the teeth,
- frenuloplasty, or Vinogradova's method, in which a layer of tissue is cut from the mucous membrane and stitched to the bridle.
There are other ways - it all depends on the specific case. The specialist will advise how best to act in this situation, perhaps cutting the bridle is not required.
How is the bridle trimming procedure?
A child older than 2 years old needs to be explained why it is necessary to trim the jumper between the tongue and the jaw. It is necessary to calm him down so as not to cause severe stress.
An older child is sprayed with lidocaine or put on a gel to the place of the future incision. The doctor then performs cutting with a surgical scalpel or scissors. Stitching is not always required.
Laser correction is considered the safest method of operation and refers to microsurgery. It almost does not cause complications. Stitches after surgery are not superimposed by a laser, this is not necessary, and the postoperative period lasts 2 days.
The duration of the laser surgery is only 3-5 minutes. This method is suitable for babies, because it does not cause bleeding, complications in the form of the addition of secondary infections, it is accurate and virtually painless.
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 the operation, the laser rehabilitation is even faster.
Immediately after the operation, the babies begin to eat normally, without experiencing discomfort, and the mother's milk will help the wound in the mouth to heal faster. Infants quickly gain weight and grow well. Speech disorders in children up to one year 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 look at the video.
In the presence of pathology, it is recommended to perform simple exercises regularly.
After the plastic bridle should:
- do not eat for 2 hours,
- 3-4 days not to eat irritating foods - salty, spicy, sour and too hard,
- give up hot food and drink
- some time it is better to eat food in the wiped look,
- Do not overload the language of conversation,
- after eating, it is necessary to rinse the mouth with antiseptic agents (chamomile decoction, calendula tincture, Furacilin solution),
- do special exercises developed by a doctor
- to lay on the site of surgical intervention sea buckthorn oil, Solcoseryl,
- visit a speech therapist as prescribed by the attending physician,
- if there is pain, the child is given a pain reliever (Nurofen, Ibuprofen).
Are there any complications after surgery?
Usually, no consequences other than short-term restoration of normal function of the oral cavity and tongue occur. Everything passes quickly, almost painlessly and is well tolerated by the child.
With poor postoperative treatment of wounds, poor hygiene, inflammatory processes can occur and pain can occur. School-age children sometimes form scars - in this case, re-dissection is required.
The essence of the problem
Photo: It looks like a normal bridle 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 bridle. Normally, it should be of such length that a person could easily move his tongue, slightly stick it out of the lips, touch the front surface of the teeth, make sounds.
The shortened frenulum of the tongue severely limits its mobility, speech capabilities and ability to normal nutrition.especially in children. The same problems arise when it is incorrectly attached when it is in close proximity to the tip of the tongue.
Photo: This is what the wrong bridle looks like.
During the breastfeeding period, the baby is unable to suck the breasts properly, as the tongue is restricted in movement. Because of this, children are very anxious, crying, lacking weight.
The bridle in newborns normally has a length of about 8 mm and more, and in five-year-old children it increases to 17. But mothers are far from always able to take measurements, especially if the baby is very active. И понять, правильно ли все расположено в ротовой полости, под силу только специалистам.
Определить, есть ли у ребенка короткая уздечка, можно по некоторым внешним признакам:
- In infants because of the low ability to suck milk, there is a loud smacking, clattering.
- The baby is incorrectly applied to the breast, does not cover the areola with the mouth, therefore it often bites the nipple, which then becomes inflamed.
- The baby is nervous, bent, pimples and legs when feeding, often throws and is applied to the chest again. Not gaining weight or even losing it.
- The tip of the tongue due to the shortening of the septum can be forked. Looks like the forked child with a short bridle, look at the photo on the right.
- In older children, speech defects are noticeable, the voice is nasal and quiet.
- Excretion of saliva increases.
- Apnea attacks are possible.
- Due to inadequate food processing, there are digestive problems.
Causes of Defect
Newborn's short frenulum of tongue - congenital anomaly, laid in the first months of fetal development, when the formation of all organs. There are several reasons for its appearance:
- The presence of genetic predisposition: if the parents had such a feature, it can be inherited.
- The older the expectant mother, the more likely the shortened bridle to appear in her child due to the increased risk of anomalies.
- The defect can develop if a woman has an infection during pregnancy or suffers from chronic diseases.
- A strong early toxicosis can lead to a lack of nutrients, due to which the organs of the fetus are formed incorrectly.
- The impact of any teratogenic factors: radiation, toxic substances, heavy drugs for the body, alcohol, tobacco and drugs.
- Accidents with getting pregnant.
Ways to solve the problem
At the moment there are several ways to correct:
- Cutting the bridle in children with a scalpel.
- Trimming the bridle under the tongue with a laser.
- Stretching through exercise.
- Removal of the defect through massage.
Surgical interventions can be performed in different ways, the main methods are:
- Frenuloplasty is the removal of a flap from the tissue of a defective web that is stitched to the resulting wound to increase the mobility of the tongue. Local anesthesia is needed, but the damaged mucosa heals very quickly. Used for children of preschool age.
- Frenulotomy: the length of the frenulum is conditionally divided into three parts, an incision is made between the lower and middle lobes, the edges of the mucous membrane are sutured. This method is suitable for infants.
- Frenulectomy - the same manipulations, but the bridle is clamped with instruments. The method is suitable for five year old children.
In more modern clinics, pruning is performed using a laser. The dissection is carried out after treatment with anesthetic: gel, spray. For patients, such trimming is less traumatic, damage to blood vessels is minimal - the laser simultaneously incises the mucous membrane and causes a spike in the affected capillaries.
Regeneration of tissues after laser pruning takes place within a few days, you can return to your usual lifestyle an hour after the procedure. But how much to stay in the clinic, the doctor decides. Complications are less common than after elimination of the defect with a scalpel.
The optimal age for surgery
Is it worth it to manipulate the bridle under the tongue and at what age it is better to cut it - such decisions depend on when the anomaly is discovered, what are the individual characteristics. If the neonatologist determines that the infant has a defective hyoid bridle, it is best to do the trimming right away.
The baby is not yet so mobile to interfere with the procedure, and the membrane itself is small, thin and does not contain blood vessels. Due to these factors, local anesthesia will be enough for manipulations, and you can calm the baby by applying it to your chest after surgery.
Cutting the frenulum of the tongue in children after the age of 6 months is associated with some difficulties. The baby becomes mobile, and parents can not discipline him persuasion. Due to careless movements, surgery may not work properly, which is why surgery is delayed until the age of five.
During this period, the children talk, the doctor can determine if there are speech defects, whether the child is hampered by the bridle under the tongue, whether it is necessary to trim or to stretch it with gymnastics.
If the infant didn’t perform a dissection of the frenulum of the tongue, and after many years he had speech defects, problems with breathing and digestion developed, then it is necessary to perform its circumcision in adulthood. But the older the person, the tighter the membrane becomes, it becomes covered with capillaries and nerve endings - which is why it is much more painful to cut through than in the case of infants. Anesthesia is required to perform the incision.
Why should a child cut a bridle under the tongue?
The reason for the correction of the bridle is a violation of the functions of the tongue. If it is short or close to the tip of the tongue, this makes it difficult for the child to eat and speak. What is the bridle for? The tongue bridle performs a number of important functions:
- normal breastfeeding in babies and chewing on food in older children,
- correct language setting when pronouncing sounds
- development of bite,
- fixing the uvula in the mouth.
Against this background, nutritional problems can occur even in newborn babies. The baby either refuses to eat, or the feeding process lasts a very long time. As a result, the child does not receive the required amount of food, there is no weight gain.
Older children, between two and five years old, have a hyoid bridle that can cause problems with speech and articulation. The child utters the words illegible, swallowing the endings or the initial sounds. Sometimes when the baby falls, the ligament may tear, causing bleeding and swelling. For timely diagnosis it is necessary to contact a pediatrician and a speech therapist. If the bridle of the tongue in a child is the cause of a speech defect, specialists will first of all offer a massage or gymnastics. If this does not help, the defect is corrected using the bridle trimming procedure.
In adolescents, the facial skeleton is actively formed, the bones of the jaws grow. A short bridle prevents the development of the lower jaw, over time, it turns out to be shorter than the upper one, respectively, the occlusion is disturbed. In this case, the upper teeth strongly protrude. In addition to a cosmetic defect, this position of the teeth leads to a violation of chewing food - the incisors do not touch, it is difficult to chew. In addition, increased load accelerates the process of destruction of the chewing teeth.
Underdevelopment of the lower jaw causes problems with the dentition - all dental units do not have enough space. Part of the teeth will grow with an unnatural inclination, others may turn around, perhaps the formation of the second row of teeth. In addition, incorrect bite affects the posture and gait - the actual change in the position of the head increases the pressure on the spinal column, which results in a curvature of the spine. To avoid all of these negative manifestations will help timely plastic frenulum.
In adults, bite and speech have long been formed, but existing defects can not be fixed by simple cropping. However, the cutting is carried out in adulthood, the plastic of the bridle of the tongue helps to cope with periodontitis and facilitates the installation of dentures.
The causes of the defect in children
Short frenulum (ankyloglossia) is a congenital defect. For a variety of reasons, a small bridle is formed in the fetus. The ligament is laid in the first trimester of pregnancy when the main organs are formed. Factors that influence the appearance of pathology:
- heredity (if there is such a defect in the family, there is a high probability that the baby will also have it),
- maternal age (the older the woman, the higher the risk),
- maternal condition during pregnancy (infectious diseases and chronic diseases can provoke the development of a defect),
- strong early toxicosis (mother and baby do not receive the necessary nutrition, which leads to disruption of the child’s development process),
- the situation in which there is a pregnant - violations cause toxic substances, alcohol, tobacco smoke, radiation, some medications,
- frequent or prolonged stress,
- injuries sustained during the gestation period.
What are the types of hyoid bridles?
Sublingual ligament may have various defects. How short bridles look like can be seen in the photo. There are 5 types of shortened folds:
- a thin transparent film that interferes with the free movement of the tongue,
- a thin dense ligament adjacent to the very tip of the uvula, causes the muscle to split apart when moving up, taking the form of "heart",
- a thick fold tightly fixing the tip of the tongue (when stretching, the muscle rolls up and the middle bulges upward),
- a ligament spliced with muscles is often diagnosed against the background of other defects (cleft palate and lips),
- plexus membrane with muscles.
Characteristic signs of a defect
Identify the defect sublingual bridles can be on certain grounds. In a newborn child, the presence of pathology is indicated by:
- nipple biting and smacking during feeding,
- abnormal weight gain,
- long feeding, during which the baby is naughty,
- crying often when the baby calms down after receiving food.
To check the condition of the bridle in a child at an older age, you need to ask him to perform a series of actions. To make a diagnosis at home, it is necessary that the kid:
- showed the tongue - with a short bundle, he will be able to stick out the tongue for a short distance, the tip will be tilted down,
- raised the tongue to the sky - the tongue either will not reach the sky, or only the edges will rise, and the middle will not change the position,
- I licked my lips - if there is a defect, this will not succeed, the tongue will not even reach the upper teeth.
It is possible to determine whether the bridle is normal along its length. In infants, it should be more than 8 mm, and in a five-year-old child - from 17 mm.
The optimal age for cropping
If the pathology is detected in the maternity hospital, the operation is best done immediately. Why do you need it? The correction will give the baby the opportunity to eat and grow properly, and his limited mobility will help the doctor to make an incision without problems. It is convenient to carry out the dissection of the membrane at this age also because there are no blood vessels in it.
After 6 months, the grown-up child will interfere with the surgeon, to persuade him to fail, therefore, in most cases, the shortening is delayed to 4-5 years. During this period, it becomes clear whether the child can correctly pronounce the sounds, how the bite is formed. The doctor determines whether you want to cut the bundle or you can stretch it with the help of massage and special exercises.
Circumcision is carried out later, if the measures taken earlier did not help stretch the fold. In this case, the doctor will examine the baby and offer surgery.
Problem solving methods
You can change the size and shape of the bridle in various ways. The choice of option depends on the nature of the defect, the age of the child, individual testimony. Ankyloglossia is eliminated by the classical surgical method, dissection with a laser (pictured below) or by a conservative method aimed at stretching the ligament.
Surgical correction is called frenulotomy. A bundle is cut with scissors or a scalpel. Surgery in infants up to six months is not accompanied by pain. There are no blood vessels and nerve endings in the membrane, it is dissected easily, and attachment to the chest allows you to immediately calm the baby.
When a child grows up, the fold is penetrated by blood vessels and innervated. For children over 4 years old, the dissection is performed under local anesthesia so that it does not hurt.
Short dense ligament cut through completely. A so-called Z-shaped excision with tissue removal is used. Such an operation is called frenectomy. Surgical intervention is performed in a hospital under general anesthesia. The method is used to treat children who have not done the plastic at an early age, and adults.
The most difficult type of surgery is frenuloplasty. The essence of frenuloplasty is that a triangular area is cut out of the membrane, then an incision is made, into which the excisional flap is inserted. Frenuloplasty allows you to increase the length of the bridle to normal values.
Exercises for stretching the bridle
An alternative to surgery are exercises to stretch the frenulum of the tongue. Whether the result or an operation is necessary, only a doctor can determine. If there is a chance to stretch the bundle with the help of massage and gymnastics, a specialist will appoint special exercises that will have to be performed regularly.
To lengthen the bridle, there are many simple techniques (even for the smallest). Newborns are given to lick a small spoon, preferably a silver one. If you drop it on the upper sponge with milk, the baby will try to lick it, which will also help develop a bundle.
Classes with older children include similar techniques, pulling the tongue out, clicking the tongue. Exercises should be carried out in a game form so that the kid does them with pleasure. Adults are prescribed to perform sets of exercises aimed at stretching the bridle. One of them is shown in the video.
After the operation, which was performed under general anesthesia, the child should be helped to cope with the effects of anesthesia, to ensure his peace. He may be crying and excited or, conversely, slightly slowed down.
In the future, the main attention should be paid to oral hygiene - make sure that there are no food particles on the teeth and a plaque is formed. In the first days it is advisable not to give the baby too hot and cold food.
Possible consequences of the operation
In general, the result of surgery to increase the length of the frenulum is positive. However, medical errors can lead to complications. With too few stitches, infection from the mouth is possible. Unevenly tightened seams contribute to fold movement.
However, most often problems arise through the fault of the patients themselves. Poor hygiene of the oral cavity and failure to comply with the received appointments can trigger the development of a purulent process. At the same time, the child's temperature rises, his head starts to ache, other characteristic symptoms appear. In order for the plastic to eliminate the existing problems and not to add new ones, it is necessary to carefully consider the condition of the child after the operation.
Surgery before the operation and contraindications
Any surgical action in the mouth is a risk to the body. In order to prevent complications after surgery, it is necessary to pass the preliminary examinations, which are prescribed by the doctor. The most significant are blood and urine tests, blood coagulation and fluorography.
Contraindications for frenuloplasty are infections of the throat, oral cavity, inflammatory processes in any part of the body., as pathogenic microorganisms can get into the incision of the mucous membrane. That is why they conduct a mandatory examination before the intervention. You can not operate on patients with cancer, low blood clotting.
Correction with the help of gymnastics for the language
It is only a doctor who can determine whether it is necessary to have an operation on a short bridle of the tongue in a child or it is better to remove the defect with the help of exercises. Therefore, even if the parents are not set up for surgical intervention, they still need to go to the pediatrician, the dentist for consultation and surgery or correct individual selection of exercises.
The possibility of carrying out gymnastic exercises appears when the baby can already repeat some given actions. But there are simple exercises even for newborns: they are given to lick a spoon of silver, milk is dropped on the upper lip, which is why they try to lick it, a little later they smear jam.
When the baby is able to understand the requests of the mother to repeat these or other actions, you can do more complex gymnastics:
- Close the mouth and feel the side walls of the tongue, the sky and the lower part of the mouth.
- Open your mouth and reach as far as possible to the outer surface of the lips.
- Click the language.
- Put the tongue on the lower lip and hold in this position for 10 seconds.
- Stick your tongue as far as possible and hold it for 10 seconds. It is possible and the baby in the form of a game to ask to show what is his long tongue.
In some children, when an unsuccessful fall occurs, a rupture of the tongue frenulum occurs. Such injury can be caused by close contact of the septum with the lower teeth. If the child has cut the bridle, he may start bleeding and swelling in the mouth, the baby becomes painful to chew, talk.
Нельзя полагаться на самолечение, сразу стоит обратиться к врачу. Иногда приходится зашивать образовавшуюся рану из-за опасности обильного кровотечения.
Нельзя недооценивать важность такой части тела, как уздечка. There are many ways to lengthen a small partition to free the tongue for free speech and eating. Before taking certain measures, it is necessary to consult with a specialist and make preoperative tests, if it is necessary to trim the bridle.
If an anomaly causes an organ malfunction, then frenuloplasty is necessary, and it is better to perform it at that age, which the doctor advises. Ignoring such a problem means exposing the child to the risk of frequent diseases of the respiratory and digestive organs, the problem in the pronunciation of sounds.
Causes of Inappropriate Formation
The scientific name of this phenomenon is ankyloglossia, i.e. “curved tongue”. This is a fairly common problem. The main reason for the appearance is considered a hereditary factor. And in boys this is more pronounced and occurs more often than in girls.
It is not necessary that the short bridle was the parents of the baby. It is enough that someone from the next of kin faces this problem. That is, in addition to heredity also emit genetic predisposition.
The second reason for the emergence of ankyloglossia is possible pathology of pregnancy. It is difficult to identify any one of the many factors. However, it has been observed that children of mothers who used narcotic substances during pregnancy are more likely to have this pathology.
Also often seen in those newborns who have other birth defects that cause head and face deformities.
Approximate terms of teething of milk teeth are voiced by dentists, but there are also deviations.
And in this painful period, gum gel will help children.
Why do I need a correction?
Correction of ankyloglossia or cutting of the hyoid bridle is necessary for a variety of reasons. And these reasons vary with the age of the child. Based on this, and we will consider the need for surgery.
Why do newborns
For babies, breastfeeding is very important. With mother's milk, they get everything they need, not only for growth, but also for normal development in general. That is why baby should be working properlyas this organ plays a crucial role in the feeding process.
With the help of the correct movements of the tongue, the nipple is properly wrapped and drawn in, and a special gutter is formed to hold it and collect milk before swallowing.
And if ankyloglossia is found, a number of problems may arise during feeding.
- It is impossible to properly attach the baby to the breast.neither can he hold her for long.
- Difficulties also arise with the process of sucking milk.. To do this, the baby begins to squeeze the nipples strongly and bite them, which causes cracks and great pain.
- When the suction of milk, the child swallows a large amount of air. This leads to frequent belching, colic.
- Insufficient amount of milk produced not only leads to the increase in time of the feeding process, but also affects the growth of the child - it is less rapidly gaining weight and may be stunted.
Consequences of ankyloglossia
If the operation has not been done in the maternity hospital, as well as in infancy, then breastfeeding problems are quickly forgotten. However, if the bridle was too tight and short, then it will not stretch on its own over time.
And this may lead to further violations. Among them first of all speech therapy problemsas the language plays a big role in the pronunciation of sounds.
It is also possible the emergence of other disorders, including orthopedic, dental and general medical:
- Delayed growth and development of the lower jaw.
- Formation of the wrong bite. Possible options - open or cross bite in children. In the first case, the upper and lower dentitions may intersect at several points, resembling a chess order. And in the second - the teeth in the front part do not close at all, leaving an open space in the shape of an oval.
- Unfolding of the lower central teeth inside.
- Changing the shape of the tip of the tongue, for example, splitting.
- Injury incisors of the lower row of the bridle.
- Early cervical caries, especially in the bottom row.
- Problems with the pronunciation of those sounds for which you need to raise the language up - p, l, f, n, sh, h, d, t.
- Poor chewing of food, as well as air entering the esophagus. This leads to frequent bloating, severe gas formation, pain and colic in the stomach.
- Snoring in a dream still in childhood, as well as apnea.
How is silvering milk teeth and what are the prices for this service?
In this publication, the symptoms of herpetic stomatitis in children are voiced.
Technologies for eliminating ankyloglossia at different ages
Bridle trimming can be done regardless of the age of the patient. However, this operation has several types and degrees of complexity.
Such an operation in infancy can be done in the hospital or in the dental clinic. It takes a very short time and is called frenotomy.
In newborns, the bridle is a very thin formation that contains a small number of nerve endings and blood vessels.
therefore with the help of special scissors a small cut is made in the transverse direction. A local anesthetic may be used to lubricate the incision site.
However, in many cases even this is not required. To calm the baby and stop the blood, you can simply put it to the chest.
School children and teenagers
If the bridle is not fixed earlier, then from the age of five, when the children already understand and adequately perceive what is happening, frenuloplasty. This is a more complicated operation that requires local anesthesia and suturing. To do this, usually use a material that has the property to dissolve.
Depending on the complexity of the problem, frenuloplasty can be performed in three different ways.
- Deletion. Cuts are made in the form of a triangle below and above, while the main part of the bridle should be clamped with special tools.
A wound is formed, the edges of which are sewn with self-absorbable surgical sutures.
How is the cutting of the bridle of the child under the tongue can be viewed in the following video:
In modern medicine, new technologies are widely used. In particular, a laser may be used instead of surgical scalpels and scissors. It is also used to trim the frenulum under the tongue.
The laser has the ability not only to cut, but to evaporate some sections of tissue. Thus, it is not necessary to put stitches, because at the remote sites of the bridle, simultaneously with the removal, the wound is closed.
It is very good to use a laser in cases where surgery is required for a child of kindergarten age. The baby will watch cartoons, while he will hold the imposition of anesthetic.
And then offered to wear special safety glasses. So the child will feel involved in an interesting game.
This method has many advantages:
- bloodless cutting of tissue
- the edges of the incision are sterilized simultaneously with its application,
- laser causes coagulation of cut vessels - “roasting”,
- no seams during surgery of any complexity,
- faster healing process
- significant reduction in the risk of complications
- facilitating the process for the patient himself.
Almost always, such an operation takes place without any complications. This is due to its ease, as well as the simplicity of the structure of the bridle itself. The only possible option when complications appear is the postoperative period.
At this time, if the rehabilitation regime and the doctor’s prescriptions are not followed small painful inflammatory processes in damaged areas. Therefore, it is required to accurately follow all instructions relating to hygiene, diet and so on.
Another complication is very rare in older children (adolescents) visible and hard scar may be formed. This causes the need for re-plastics already to remove it.
Quite a lot of people are exposed to clipping the hyoid bridle at the very young age. Usually this procedure is not too painful and takes a minimum of time.
If your children are also faced with this problem, you can share your experiences and advice with other parents by leaving a comment on this article.
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The main reasons for trimming the bridle
Causes of cropping are related directly with symptoms that appear when a child has this defect:
- wrong bite is formed,
- older problems with diction and pronunciation of sounds in general appear,
- difficulties in breastfeeding (the child improperly captures the nipple, often rests, bends and whims during food, or cannot take a breast at all).
At the time of the presence of these signs There is a 85-95% chance that doctors will recommend that you trim the jumper.
Other signs that are quite easy for adults to notice without help can point to this pathology:
- older kids have difficulty chewing on solid food,
- frequent oral diseases, caries,
- nasal and low voice,
- profuse salivation,
- weak mobility of the tongue (ask the child to reach the sky with the tongue, to hold them around, when these actions create complications, it is necessary to consult a doctor),
- frequent problems with the gastrointestinal tract.
Types of pathology bridle
Several varieties identified sublingual short bridles:
- translucent thin, fixed with the front edge practically near the tip of the tongue,
- thin and transparent, holding down the movement of the tongue,
- bridle, spliced with the muscles of the tongue,
- tight and short screed, which is connected to the tongue muscles (quite common pathology in children who suffer from labial and palatal crevices),
- opaque and thick, fixed near the edge of the tongue.
Symptoms of anomaly
You can easily determine the short bridle of the tongue from the first days of the baby’s life. The first and main symptom of pathology is difficulty during breastfeeding.
In order to suck milk From the breast of the mother, the newborn must make very great efforts, involving other organs than the tongue. The tongue irritates the mother nipple, as a result, breast milk begins to stand out.
With a short bridle, this process is very complicated and the small mobility of the tongue, most children try to compensate with their lips and gums, it is quite difficult both for the baby and for the mother directly.
The child quickly gets very tired, the mother feels discomfort during feeding, the very process of breastfeeding is disturbed, meals become restless, long and frequent with breaks for rest.
When attached to the breast of the mother, the baby throws back the head, bends, capriciously, and can completely abandon the breast. As a result, the child is nervous, lagging behind in weight.
In older children and adults, due to the shortened frenulum, a bite defect occurs, the sound pronunciation of hissing and other letters is complicated, diseases of the oral cavity develop, the installation of dental prostheses and implants becomes problematic.
What will happen if you do not cut?
In a child, a short frenulum of the tongue can have significant consequences:
- hypersensitivity of the teeth and gums, it often causes problems with teeth in adulthood,
- difficulties with the pronunciation of some letters,
- due to improper bite, an unaesthetic appearance of the front row teeth is noted,
- mouth breathing, this is the cause of frequent respiratory diseases.
But most of the above effects can be cured by conservative means. For example, in order to learn how to pronounce sounds, you need to perform exercises on stretching the bridle. In 80% of cases diction is possible adjust the speech therapy methods. Incorrect bite in adolescence is well corrected by braces.
Whether to trim the jumper, you need to decide when there are difficulties with breastfeeding, or doctors do not see other solutions. In this case, an operation may be required.
Where does the child cut the bridle of the tongue?
If a question arises before adults, which doctor can decide whether cropping is necessary, then the first thoughts are transferred to the head in dentistry. Absolutely correct: the surgeon itself performs the operation.
But before making a decision Need to consult with doctors of other profiles:
- orthodontist (when the wrong bite begins to form),
- speech therapist (when difficulties with pronunciation are noted)
- a breastfeeding adviser or pediatrician (when there are problems with feeding).
When your problem does not suggest other effective solutions, then you need to take a referral to a surgeon in a children's dental clinic.
At what age does a bridle of the tongue be cut in a child?
Surgical intervention to trim the muscular septum in an infant is performed in the maternity hospital, when the problem was noticed in a timely manner, and the parents give consent. It is believed that this is the best time to correct the problem.
Newborns in the bridle do not have blood vessels, because the operation itself takes literally seconds, and the consequences are minimal. To heal faster, baby immediately need to attach to the chest.
The next age when the doctor considers it necessary to perform the operation is 5-6 years. At this time, the child is forming a speech, and the defects are determined, as well as the possibility of their correction by conservative methods.
An orthodontist can predict how a bite will form in a child. When there are real problems, he will indicate this to parents.
In 5-6 years, the operation is longer and is done under anesthesia, since the lintel is already overgrown with vessels. But the operation of hospitalization will not require: after her baby goes home.
At the moment, there are two main methods for treating short frenulum in children: operative cropping and conservative therapy.
During the denial of surgical intervention for trimming the frenulum, at home you can make exercises for stretching.
- close your mouth and stretch your lips into a tube
- put a little bit of jam on the baby’s top sponge and then ask to lick it,
- abut alternately with the tip of the tongue on the cheeks with the mouth closed,
- squeeze lips and ask them to stretch in a smile,
- reach the lower and upper lips with the edge of the tongue,
- lips stretch and try to "smack" them,
- newborns need to be given more often to lick a silver spoon,
- pull the tongue forward and move it to the right and left.
Classes need to be done every day at least 4 times for 7-10 minutes.
A speech therapist for stretching a bridle may recommend performing a speech therapy massage. The process is rather unpleasant, but quite effective. Produced absolutely clean hands, in some cases, the doctor can afford to wrap fingers with a sterile bandage or handkerchief:
- Under the tongue, place the index and middle fingers in such a way that the bridle is between them. Then use your thumb to press on in front of the tongue and gently pull it out.
- It is necessary to clamp the bridle between the index finger and thumb and move them along the tie from bottom to top.
- Put the cut-off edge of the pipette on the tip of the tongue, press the ring to the sky with the tongue and close the mouth. These manipulations should be performed 3 times daily, 9-12 times.
- Pull the tip of the tongue down and up, then gently pull the jumper upwards with your index finger.
Surgical trimming of the tongue frenulum
There are several ways to trim a bridle:
- Frenuloplasty. The meaning of this method is that the flap in the form of a triangle is excised from the lintel. After an incision is made, and the flap is sewn to the desired area, in order to lengthen the bridle.
- Frenulectomy. A clamp is applied to fasten the partition, then an incision is made between the clamp and the lip, which is then stitched.
- Frenulotomy. This method is resorted to when the child’s age is not more than 9 months. It lies in the fact that a scissors is made closer to the teeth cut. Is performed at the beginning of the mucous dissection, and after strands of muscles. Then seams are applied.
The first two options are suitable for kids from 5 years. The operation for them should begin with the introduction of anesthesia. Frenuloplasty is infrequently used. The main indications for this operation are significant orthodontic defects.
Wound healing takes place throughout the day. Во время реабилитации запрещается употреблять очень холодную или горячую еду. Great attention must be paid to oral hygiene.
Another important question is how much this operation costs. Counting cost can start from 600 rubles and reaches 7 thousand, taking into account the chosen method, the level of the doctor and clinic, the age of the child.
Laser trimming of baby's bridle
The modern achievement of surgery is laser trimming jumpers. This method has many advantages:
- minimum risk of bleeding, because the laser beam is sealed vessels
- there is no risk of infection, as the laser has disinfectant properties,
- minimum of side effects
- no stitching required
- fast healing
- the accuracy of the cut,
- acceptable cost
- no pain.
Laser surgery to trim the bridle received positive feedback from parents, as children can easily tolerate it, and side effects are minimal.
The course of the operation is quite simple. Initially, local anesthesia is performed.while the dosage of painkillers is much less than with traditional methods.
The doctor focuses the laser beam on the necessary part of the septum and dissolves it. On the incision impose a bandage, which is impregnated with healing compositions. The whole process takes up to 7 minutes. Rehabilitation takes less than two days.
Causes of abnormal formation
Most often, a short bridle of the tongue in children occurs if one of the parents or relatives had the same problem, that is, due to a hereditary factor and genetic predisposition.
In this case, the boys are more likely to borrow this defect. The non-hereditary appearance of a short bridle depends on the negative influence of adverse factors on the fetus in the first trimester of its development.
Among the reasons for the emergence of such features may be:
- complexity and pathology during pregnancy (disease or infection),
- chronic maternal illness or childbirth after 35 years,
- bad ecological situation in the place of residence,
- abdominal trauma,
- exposure to harmful drugs and substances (paints, varnishes, etc.),
- exposure to drugs and antibiotics.
In order to determine the size of the bridle in a child, it is necessary to open his mouth, put off his lips and lift his tongue up.
Typically, the attachment of the hyoid bridle is located at an equal distance from the tip of the tongue and its root. Short bridle tongue:
- bends arc (especially when trying to stick out forward),
- has a bent tip, forking and taking heart-shaped,
- makes clicking and clicking sounds when folded.
In addition, the bridle may have the wrong location and limit the free lifting of the tip of the tongue up or sticking it out of the mouth.
After 4 years
At the age of two years and older, children may experience difficulties in the pronunciation of sounds, bite and speech function may be impaired in babies. Children will be difficult to give hissing sounds, as well as the letters "P" and "L".
Formed the defect of the oral cavity after the age of four is established by both the dentist and the speech therapist, who sends the child to the operation.
In this situation, surgical intervention with the use of local anesthesia is surely complemented by a set of exercises for stretching the frenulum and a logopedic massage.
With the wrong arrangement of the bridle and its anomalies, children are subjected to plastic surgery after the eruption of permanent incisors, that is, at the age of about 7 years.
And here you will find a lot of useful information about thrush in the mouth of the infant.
Preparing for surgery
Bridle trimming is a fairly simple operation that does not require special preparatory measures. Most often, before surgery, the following procedures should be performed:
- prepare a complete blood count,
- check blood for clotting (the so-called hemosyndrome test),
- do a photofluorography.
The operation is carried out in infancy by a child more simply because he does not understand and does not remember what is happening around him.
At the age of one year, surgery for a baby is sufficient stress, so it is very important to prepare it for this procedure in advance.
It requires psychological support from parents, encouraging and explaining the importance of the moment. So that the child is not capricious, you can take with him his favorite toys or a tablet with cartoons.
Methods of operation
There are two methods for performing a bridle trimming operation: classic - using a scalpel or scissors, and modern, more expensive - using a laser.
Both methods are effective and have their own characteristics, while there is practically no difference as a result. Depending on the complexity of the defect, the age of the baby, his character and condition, doctors are advised to choose one or another method of cropping.
A scalpel operation is a bit painful, causes discomfort, and also requires a special postoperative rehabilitation period. Its features:
- The duration of the operation for trimming children with a scalpel for the sublingual frenulum is at least 20 - 30 minutes.
- All actions the doctor conducts using local anesthesia.
- A small incision is made in the oral cavity on the bridle with a scalpel, depending on the width, thickness and length of the bridle.
- Sutures are applied to the wound with special absorbable sutures.
- Cutting with a scalpel is accompanied by slight bleeding, possible swelling, discomfort and pain in the postoperative period.
- In a week, the scar heals and then passes.
On the first day after surgery, it is important to observe speech peace. During the rehabilitation period, you should limit the use of solid food.
For the fastest healing, it is recommended to rinse your mouth with special healing and antibacterial solutions.
And here we have a photo and a description of the problems associated with red spots in the mouth of a child.
A more modern way to eliminate the defect of the sublingual frenulum is to use a laser. This method has several features and advantages:
- Cutting the frenulum of the tongue with a laser is painless and lasts only 10 to 15 minutes.
- As anesthesia, use special dental tools (gels or sprays), they are applied to the bridle and around it.
- The dentist makes an incision with a modern laser, which instantly seals the edges of the incision, eliminating the appearance of bleeding.
- Due to the rapid sealing of the wound, it is not necessary to stitch.
- The site of the incision heals quickly, within a period of not more than two days, so long-term care of the wound is not required.
- Elimination of the defect of the frenulum with the help of a laser is more easily tolerated by patients, greatly reducing the risks of complications in operations of varying degrees of complexity.
Laser surgery for children is less painful. How it is carried out, we learn in the following video:
If you prepare your baby in advance, he will definitely feel like a brave hero when they wear protective glasses and perform a quick procedure.
Recommendations after surgery
In the postoperative period, it is important to follow the instructions and recommendations of the attending physician.. This will help avoid painful inflammation, damage to the stitches and contribute to the speedy recovery of the patient.
Key recommendations and tips:
- In the first few hours after the procedure, you cannot eat and disturb the sore spot, examine or touch the stitches.
- After two hours after the operation is completed, it is allowed to eat soft food: soups, porridges, water. It is important to limit solid and irritating mucous foods (sour, spicy, salty).
- The rehabilitation period after surgery with suturing lasts about a week, at this time you can not talk a lot so that the seams do not go away.
- Daily after meals, you should clean the teeth and mouth, rinse your mouth regularly with chamomile, sage or oak bark decoction, and use antiseptic medicinal solutions.
- In addition, the wound itself should be smeared with medicines as prescribed by a doctor (ointment solcoseryl, sea buckthorn oil, etc.).
- According to the purpose of the treating dentist and speech therapist, prophylactic gymnastics should be performed to avoid disturbing diction, as well as developing the muscles of the tongue.
What to do if the child does not eat
Due to oral discomfort, pain or stress in the postoperative period, the baby will refuse to eat.
Sucking reflex can cause discomfort and anxiety. Therefore, babies should try to feed from a syringe or spoon with soft (liquid) food.
For older children, it is best to cook food by chopping its blender to a puree-like state.
What if there is pain
If a child has pain after local anesthesia after surgery, the doctor prescribes painkillers.
The first few days of minor discomfort and pain are quite normal due to the stitches. It is important to observe peace, do not allow the child to talk and distract him with unpleasant thoughts.
What to do if there is inflammation, pus
After surgery, a baby may have a white bloom in the mouth, this is a normal reaction of the body.
This is a natural process for the formation of a new mucosa. Careful rinsing with antiseptic solutions will help to cope with the bloom. You can try to rinse your mouth with ordinary furatsilinom.
What to do if the temperature rises
When the baby has a high fever immediately after surgery, he must be given antipyretic.
Temperature is a common reaction of the body during post-operative treatment. But if she stays more than a day, and even more than a few days, she should contact her doctor. Prolonged temperature may indicate infection.
What to do if seams are gone
If, due to conversations or injuries (falls), the child has seams, you should contact your dentist for reapplication, and the sooner, the better.
In an open wound, inflammation may begin. A wound with damaged stitches can scar overgrow, be rough and cause discomfort.