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The frenum of the tongue is a special fold on the oral mucosa that connects the middle of the tongue to the lower part of the gums in the region of the anterior lower incisors. There is an anomaly – a shortened frenulum or ankyloglossia. The anomaly implies the location of the frenulum as close as possible to the tip of the tongue and limits its motor functions.
Interesting facts: ankyloglossia occurs in almost 5 percent of people, most often observed in men in a ratio of 3 to 1, in 1/4 of newborns, due to a short frenulum, there are difficulties with breastfeeding.
Signs of an anomaly
Among the signs of the presence of a short frenulum of the tongue, it is worth noting: during the period of raising the tongue, it takes on a heart-shaped shape; the tongue cannot be pulled out so that the tip takes on a sharp shape; when protruding the tongue, its tip looks down; it is hard to chew and swallow, and babies have a disturbed sucking reflex; altered diction and difficulties in the process of speaking; bite changes; periodontal disease.
It is quite difficult to independently identify the pathology, since in the presence of a slight shortening of the frenulum, all the symptoms are washed away. For this reason, it is necessary to seek the advice of a dentist. Newborns are examined by pediatricians, you can also show the children to surgeons.
Indications for plastic frenulum of the tongue
In infancy, pathology entails a number of serious disorders: complicated swallowing, impaired sucking function, the child does not gain weight well, as a result, deviations in development and growth are observed. A pediatric neonatologist can determine the presence of ankyloglossia immediately after the baby is born. The lingual frenulum in newborns is avascular and non-muscular, therefore, it can be easily cut with scissors without the need for suturing. After the incision of the bridle, it is important to attach the crumb to the chest – so the wound will heal as quickly as possible.
After a simple dissection of the frenulum has been carried out, over time, a scar may form in that place, which must later be subjected to plastic surgery.
It is important to understand that vessels appear in the frenulum with age. If there are complications regarding speaking, chewing, or swallowing, children of school age and older are shown plastic frenulum of the tongue.
At preschool age, the anomaly is detected by a speech therapist. The child does not pronounce palatal whistling and hissing sounds. It is the speech therapist during the period of classes that determines that it is difficult for the child to stick out his tongue and perform simple speech therapy exercises.
After frenuloplasty, speech will not recover on its own, therefore, speech pathologists need to take courses of remedial classes with a speech therapist.
Among the orthodontic indicators for plastic surgery, it is worth noting:
- poorly developed lower jaw;
- incorrect inclination of the lower and upper incisors;
- difficulty in fixing orthodontic structures.
Before proceeding with any orthodontic manipulations, it is mandatory (if necessary) to perform plastic surgery of the frenulum of the tongue.
The procedure can be recommended not only for children, but also for adults, at the stage of orthopedic therapy. Improper functioning of sublingual tissues can provoke the removal of mandibular prostheses during chewing or talking. It is important to carry out plastic surgery before installing dental implants, since ankyloglossia can provoke the development of peri-implantitis – violations around the implant of tissue nutrition, the implant coils are exposed, as a result, the prosthesis may simply fall out.
Plastic surgery of the frenulum of the tongue may be needed: for preventive purposes, with pathological tooth mobility, with recession, the presence of pathological pockets in the anterior part of the lower jaw, in the presence of periodontal diseases.
Contraindications to the procedure
Among the contraindications, it is worth noting: non-sanitized foci of the oral cavity, diseases of inflammatory genesis in the oral cavity and on the mucous membranes, diseases of an infectious type in an acute state; diseases of the hematological type, oncological diseases.
Plastic frenulum of the tongue (laser or scalpel)
There are two types of operations for ankyloglossia: frenuloplasty (plasty of the frenulum of the tongue) and frenulotomy (dissection of the lingual frenulum).
Plastic surgery can be carried out by the classical surgical method using a scalpel, or a special laser can be used. The procedure is performed on an outpatient basis using local anesthesia.
The classic method with a scalpel involves a thorough and accurate excision of old scars and mucous cord, and, if necessary, the place of attachment of the frenulum is transferred from the edge of the tongue to the middle. After surgical procedures, independent sutures are applied, which will dissolve over time. During the operation, the doctor closely monitors the condition of the submandibular and sublingual salivary ducts in order not to accidentally catch them. If you disrupt the salivary glands, you can disrupt the outflow of saliva.
Laser intervention has a number of advantages: no need for stitches; fast healing; filigree; ergonomics; no bleeding; bacteriostatic and bacteriological effects. Local anesthesia is used during the operation. The procedure requires dexterity, attentiveness, precision of movements and experience of the doctor. The duration of laser intervention, excluding the preparatory period, can be from 3 to 5 minutes. A bandage with drugs that accelerate healing is carefully applied to the resulting wound. After the procedure, the patient will stop noticing the wound already on the 3rd day.
Laser therapy is more comfortable and safer.
Recommendations after surgery
After the operation it is recommended: in the first few hours to refuse food; up to 4 weeks in the diet should not be hard, salty, spicy and sour foods; try to talk less a week to use soluble antiseptics for rinsing the mouth after eating; apply keratoplasty to the wound within a week; after healing, it is recommended to engage in speech special physical education.