Mom can find out that the child has a short bridle in the hospital. Such a pathology should be immediately eliminated. Otherwise, there may be problems with sucking the breast or nipples. The bridle is easy to correct. The procedure is well tolerated by all children, almost painless. Children's surgeons constantly carry out such operations. It’s not worth it to be afraid. Complications with a neglected case of such an anomaly will be much more serious.
Why do you need to cut the bridle?
Any parent wonders if it is really worth trimming the bridle under the tongue? In children, due to its improper size, nutritional problems may occur during the formation of pronunciation. The bridle also affects the bite and facial muscles.
It is a jumper. Needed to connect the tongue and lower jaw. Thanks to her, the first always remains in the right position.
If the bridle develops with pathology, then the functionality of the oral cavity may be impaired. Normally, it should be in the center of the tongue and be 2.5 to 3 cm long. For babies who are not yet a year old, its size is 8 mm. The most common anomalies are either the frenum attached to the tip of the tongue or too short a length. The last pathology is called ankyloglossia.
Why is a short bridle so dangerous? Because of it, the bite is broken and the jaw develops incorrectly. It is possible to understand that a baby is small because she quickly gets tired when she eats, does not suckle well, constantly cries. If the child clicks while eating, and milk spills from his mouth, then you need to cut the bridle under the tongue. Children with this pathology have problems with weight gain. It hurts them to move their tongues. This situation applies to both infants and artificers.
At an older age, to check whether the bridle is in normal condition, you should ask the child to reach out to the upper palate with his tongue. Deviation will provoke bite problems, periodontitis, difficulties with pronunciation, discomfort during chewing and swallowing. Most often, a speech therapist diagnoses such a disease, as parents turn to him because of difficulties in pronouncing letters.
Ankyloglossia needs to be treated, otherwise the child may, in addition to the above problems, have an inflammatory disease of the mouth, snoring, problems with the gastrointestinal tract, scoliosis, nasal infections.
Pathology is transmitted by a hereditary factor. If relatives have a similar problem, then most likely the baby will be born with an anomaly. Also, this defect is formed during pregnancy if the mother suffered a viral disease, especially in the first and third trimester, toxicosis, exacerbation of chronic ailments, stress. In addition, abdominal bruising, alcohol, drugs, and chemical poisoning in the first three months of fetal formation are considered provoking factors. Bad ecology can sometimes cause pathology.
At what age should the operation be done?
Correction of the frenum of the tongue is carried out at any age. It can be done by small children, schoolchildren and adults. The operation is fast enough. Doctors advise making her newborn baby right away. This is due to the fact that it will be easier for the baby to eat, there will be no problems with weight gain, in addition, at this age, surgery is tolerated most painlessly.
Older children, it is difficult enough to have an operation, since you have to use anesthesia. This is due to the fact that convincing a one-year-old baby is simply difficult to sit still. Therefore, many doctors recommend trimming either immediately after birth, or already when the child is 4-5 years old. Children at this age already tolerate anesthesia and surgery is not contraindicated for them.
But you need to understand that by this time the baby may have problems with speech, which after the procedure will require a long period for their correction and elimination.
Which doctor should I go to and where is the best surgery?
If ankyloglossia is suspected, the pediatrician will send the child to the dentist, orthodontist or surgeon. They will either confirm or refute the diagnosis. The need to trim the frenum of the tongue will be jointly decided by the orthodontist, speech therapist and surgeon.
There must be good reason for the operation. These include malocclusion, speech therapy disorders that cannot be corrected with other methods, tooth displacement, nutrition problems.
The severity of the anomaly is divided on a 5-point scale. If the deviation is very small, it can be eliminated without surgery using special exercises. The child must be over one year old.
Parents are worried about where to cut the frenum of the tongue? The operation is carried out in the hospital. If the child is older, then the procedure is carried out in dentistry. In the case of a severely advanced defect, surgery is performed in surgery in the maxillofacial department.
Operational correction
At birth, the doctor usually checks the condition of the bridle. Therefore, the operation is best done immediately. For children of 5 years, the procedure is performed in the surgical department, or in dentistry. A hospital stay is not required, therefore, at the end of the operation, you can go home.
There are some contraindications to trimming the frenum. These include diseases of the blood, oral cavity and teeth, infectious and oncological problems.
Types of operations
There are several types of operations during which trimming of the shortened hyoid ligament is performed:
- The method of grape. During the procedure, tissue is cut from the mucous membrane and sutured to the bridle.
- Glickman's way. The bridle is cut from the teeth.
- Frenulotomy. The bridle is cut, the edges of the mucosa are sutured.
There are still some other types of operations, but they are rarely used. Which version of the procedure will be used should be selected by the doctor depending on the severity of the pathology. In some situations, you can completely do without surgery.
Phrenectomy
This procedure is also known under a different name: Glickman's method. During the operation, clamps are used. They fix the bridle. Then the surgeon cuts the skin between the lip and the clamp. Stitches are applied to the edges. If we are talking about cutting in newborns, then for them such an operation is painless and quick.
After 2-3 years, vessels, nerves appear in the frenum. It becomes more dense and fleshy. Therefore, anesthesia must be used and after dissection, it is necessary to suture.
Frenulotomy
This method is considered the simplest. It makes it easy to increase the length of the frenum of the tongue. The surgeon must cut the jumper itself at a distance that is 1/3 of the entire length. Next, you need to dissect the mucous membrane. The sides of the mucosa begin to bring together. Sutures are applied every 4 mm.
Frenuloplasty
This method is called as the Vinogradova method. During the operation, the location of the bridle is changed. The procedure is carried out in three approaches.
- First, a flap is cut in the form of a triangle. The wound is healed with sutures.
- Next, an incision is made from the septum to the papilla, which is located between the front teeth.
- A triangle is sewn to the wound.
After that, the operation is considered completed.
How does the pruning procedure go?
If the child is already more than 2 years old, then he will have to explain why the bridle is cut under the tongue. So you can avoid severe stress in the baby. The operation will be carried out under general anesthesia. The manipulation time is not more than 5-10 minutes. At this age, the bridle has no nerve endings and blood vessels, so it is not worth it to worry much.
If the child is older, then lidocaine or an anesthetic gel is applied to the site of the future incision. After - the doctor makes an incision with a scalpel or scissors. Stitches are not always applied.
Laser treatment
Many are interested in whether it is painful to cut the frenum of the tongue with a laser. This procedure is considered completely safe and refers to microsurgery. Complications after such an operation are excluded. Stitches are not overlapping. The rehabilitation period lasts two days.
A laser operation is performed for no more than five minutes. Doctors often use this method to cut the frenum of small children, as it is painless, accurate and does not allow infections.
Rehabilitation
The period of rehabilitation depends entirely on the age at which the frenum of the tongue is cut. If the baby is less than 9 months old, then after a few hours it can be applied to the chest. In older children, rehabilitation lasts about a day. If the operation is performed by a laser, then the period is reduced by half.
Immediately after the operation, it becomes easier for the newborn to eat, milk helps the wound to heal quickly. Breasts immediately begin to gain weight. If the bridle was cut in the newborn, then he will not have problems with speech. Children older will have to undergo corrective therapy with a speech therapist. The doctor will tell you what exercises to do.
After the operation, it is forbidden to eat for two hours. The first three to four days should not be given crumbs of salt, spicy, sour and hard. It is necessary to refuse too hot food and drink. At first, it is better to eat mashed food. Too much talk is forbidden. After eating, you need to rinse your mouth with special antiseptic drugs. It can be infusions of chamomile or calendula, a solution of "Furacilin". If the child is already at least five years old, if there is pain, he can be given pain medication. It is necessary to put sea buckthorn oil or Solcoseryl on the seam. The doctor will tell you what exercises to support speech should be done, they should be followed. If necessary, you need to regularly visit a speech therapist.
Complications after surgery
If the child needs to cut the frenum of the tongue, then parents should not worry. With proper postoperative treatment, no complications will arise. Surgical intervention is well tolerated by the child, therefore, in addition to the fact that for a while the child will lose the ability to talk and eat regular food for a long time.
If the wound is poorly treated, pain and inflammation may appear. If the child has a scar, it is necessary to do a second operation.
Is it possible to stretch the bridle?
If the child does not pronounce hissing, it is not necessary to immediately go to cut the bridle. You can try to stretch it. For this, a speech therapy massage is performed and exercises are performed.
It should stretch out the tongue, and then move along the sides. It is necessary to reach with its tip to the lower lip, then to the upper. You can click the tongue. To do this, hold him near the sky and lower him down. Between the cheeks should be driven with the tongue, while the mouth should be closed. Also pull out the tongue with a straw and smack.
If the child is small, he can often be given a spoon lick. Another way helps: you can drip jam on your lip, and then ask the child to lick it.
To summarize
Trimming the frenum of the tongue is best when the child is not yet a year old. What is the reason for this? In the area that needs to be dissected, there are no vessels and nerves. Therefore, the baby will not be hurt. Doctors will not have to use anesthesia or pain medication.
If the parents did not have the desire or reason for cutting the bridle at an early age, it is better to wait until 5-6 years. This is due to the fact that children at this age tolerate anesthesia well. The operation is carried out quickly for both infants and adult children. The only difference is in the rehabilitation period. In the first case, it takes only a few hours. In the second - a few days.
The operation the surgeon will perform depends on the indications and the reasons. If the child has a mild stage of pathology, it is enough to just make a small incision. Inpatient monitoring is not required, so immediately after the procedure you can go home. Above, the article described what is prohibited in the first days after the operation. You need to carefully choose a diet, food should not be hard or irritating to the mucous membrane (spicy, smoked and so on).
Do I need to trim the frenum of the tongue? This question worries many parents. Doctors advise to do this either immediately after childbirth or to look at the situation. Many children do not experience any discomfort with a mild pathology when eating, talking, and so on. In this case, experts recommend waiting 5-6 years to check whether the child will be able to pronounce words and sounds correctly. If there are any defects, for example, the baby cannot say "p", then he is sent for surgery. In other cases, you can not worry and do only exercises to stretch the bridle. They will facilitate the daily life of the child and help prevent pathological changes.
You need to understand that the anomaly does not get worse over the years. The bridle is not shortened, therefore, serious complications, if they were not identified before the year, it will not lead. The pronunciation can always be adjusted, and the operation is allowed to be done even in adulthood.