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GaramChai features Medical articles by Dr.Kumaresh Krishnamoorthy
is the non-medical term for a relatively common physical condition
that limits the use of the tongue, ankyloglossia. Before we
are born, a strong cord of tissue that guides development
of mouth structures is positioned in the center of the mouth.
It is called a frenulum. As we grow, it recedes and thins.
This frenulum is visible and easily felt if you look in the
mirror under your tongue. In some children, the frenulum is
especially tight or fails to recede and may cause tongue mobility
problems. In tongue-tie, the free movement of the tongue is
restricted due to abnormal attachment of the base of the tongue
(lingual frenulum) towards the tip of the tongue.
Associated with Tongue Tie
- A new baby with a too tight frenulum can have trouble sucking
and may have poor weight gain. Such feeding problems should
be discussed with your child's pediatrician who may refer
you to an ear, nose, and throat specialist.
Nursing mothers who experience significant pain while nursing
or whose baby has trouble latching on should have their child
evaluated for tongue tie. Although it is often overlooked,
tongue tie can be an underlying cause of feeding problems
that not only affect a child's weight gain, but lead many
mothers to abandon breast feeding altogether.
- In some children, tongue tie may also cause speech defects,
especially articulation of the sounds - l, r, t, d, n, th,
sh, and z. Preventing speech defects or improving a child's
articulation may be another reason to consider surgical intervention.
Although, there is no obvious way to tell in infancy which
children will have speech difficulties later, the following
associated characteristics are common:
- Tongue tie may contribute to dental problems as well,
causing a persistent gap between the bottom two front teeth.
V-shaped notch at the tip of the tongue
Inability to stick out the tongue past the upper gums
Inability to touch the roof of the mouth
Difficulty moving the tongue from side to side
My Child Need Surgery for Tongue Tie?
Tongue tie often resolves on its own after two or three years
of age. As a child grows and develops, the frenulum often
continues to recede (normally it recedes before birth), lessening
the abnormality. Unless feeding is a problem, it is recommended
to wait at least a year before considering surgery. If tongue
tie interferes with a baby's feeding, early intervention is
surgery (frenulectomy) is a simple procedure and there are
normally no complications. For very young infants (less than
3months old), it may be done in the office of the ENT specialist.
General anesthesia may be recommended when frenulectomy is
performed on older children. While frenulectomy is relatively
simple, it can yield big results. A few dissolvable stitches
may be placed to re-approximate the cut surface of the tongue.
The whole procedure takes approximately 15 minutes. Risks
of frenulectomy are very low.
should consider that this surgery often yields more benefit
than is obvious by restoring ease of speech and self-esteem.
Krishnamoorthy, M.S (ENT)
Head and Neck Surgery Fellowship (Buffalo, USA)
Neurotology & Skull Base Surgery Fellowship (Cincinnati,
Senior Consultant in ENT - Head and Neck Surgeon and Skull Base
Apollo Hospitals, 154/11, Bannerghatta Road, BANGALORE 560 076,
Phone: 91-(0) - 99002 36819