Monday, February 01, 2010

Tongue Tie

Tongue-tie 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. 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.

Problems Associated with Tongue Tie
Feeding – A new baby with a too tight frenulum can have trouble sucking and may have poor weight gain. 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.

Speech - 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:
• 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
Dental - Tongue tie may contribute to dental problems as well, causing a persistent gap between the bottom two front teeth.

Does My Child Need Surgery?
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 usually warranted

Tongue-tie 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. Risks of frenulectomy are very low.
Parents should consider that this surgery often yields more benefit than is obvious by restoring ease of speech and self-esteem.

If you have any further doubts contact your ENT specialist/Paediatrician who can help you.

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