The condition noticed by the dentist is partial ankyloglossia,
sometimes called "tongue-tie." The word ankyloglossia comes from the
Greek for "crooked tongue." The condition is also called
"ankyloglossitis" or "short frenulum." This is a common condition: one
study found that ten percent of newborns are affected to some degree.
The condition can be corrected with a very safe and simple surgery
called a frenulectomy or frenotomy, which involves snipping the
lingual frenulum (the membrane which attaches the tongue to the floor
of the mouth).
Surgery of this sort used to be done routinely, but these days the
need is evaluated on a case by case basis. There is no urgency about
rushing a child into surgery; many experts take a "wait and see"
approach, believing that there is no need for the surgery unless the
condition interferes with normal speech or eating patterns, or causes
a risk of dental malocclusion (crooked teeth). Your son's dentist is
in an excellent position to make a recommendation, since he
undoubtedly has had experience with other patients in similar
circumstances. Before proceeding with the surgery, you may want to
discuss with the dentist the precise reasons why he believes it to be
necessary.
I have gathered some information from the Web that will give you an
overview of the situation and of your options. For reasons of
copyright, I am posting brief excerpts from each website, but you may
want to read these articles in their entirety (just click the link
under each excerpt).
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"Tongue tie is a condition in which the midline sheath of tissue
attached to the base of the tongue (lingual frenum) is attached too
far forward on the tongue, causing restriction of tongue motion.
If the lingual frenum extends to the tip of the tongue, a V-shaped
notch may be seen in the tip of the tongue. Tongue tie may cause
feeding problems, problems with teeth, and also has the potential to
affect speech."
MedLinePlus Medical Encyclopedia: Tongue tie
http://www.nlm.nih.gov/medlineplus/ency/article/001640.htm
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"Tongue-tie is a fairly common condition that runs in families. It
occurs when a thin web of skin under the tongue connects the tip of
the tongue to the floor of the mouth. The tip of the tongue may appear
heart-shaped rather than round, especially when the tongue is lifted.
If this piece of skin, called the lingual frenulum, is very tight, it
prevents the tongue from being able to move normally... Some people
have mild cases of tongue-tie and are not much bothered by the
condition. Others develop speech problems and their dental health may
be affected...
Sometimes a tight lingual frenulum will stretch over time, allowing
the tongue to move more normally as the baby grows. Occasionally
tongue-tied toddlers fall down and bite through the lingual frenulum,
accidentally clipping their own tongue-tie! In the old days, midwives
and doctors recognized that tongue-tie could cause breastfeeding
problems. They performed a simple procedure called a frenotomy to free
the tongue. Today, pediatric Ear, Nose, and Throat (ENT) specialists,
children?s dentists (pedodontists) and many pediatricians can evaluate
tongue-tie and perform this simple outpatient procedure."
Medela: Tongue-tie
http://www.medela.com/NewFiles/Tonguetied.html
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"Tongue-tie... refers to a condition where the tongue remains more
anchored to the bottom of the mouth than it should be, restricting
movement. Babies and children with this condition have a short lingual
frenulum (the piece of skin that joins the tongue to the floor of the
mouth) and it may or may not cause problems with breastfeeding and
speech... The medical name for the condition is ankyloglossia...
Research at the University of Cincinnati, USA, published in 2002,
found that around 16 per cent of babies who were experiencing problems
with breastfeeding had a tongue tie. Another study conducted at
Southampton General Hospital found about 10 per cent of babies born in
the area were affected. 'This was much higher than all the medical
text books say,' says Carolyn Westcott, lactation consultant at the
hospital."
BabyCentre: Tongue-tie
http://www.babycentre.co.uk/refcap/552046.html
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"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...
In toddlers, an experienced speech pathologist should evaluate your
child to determine whether tongue tie may be hindering language
development. If the speech pathologist finds that your child?s speech
is impaired, then frenulectomy is usually recommended. If there is no
speech impediment, you may wish to consider surgery for cosmetic
reasons...
For children who do require frenulectomy, we use a brief general
anesthesia, and cautery to divide the frenulum. A few dissolvable
stitches may be placed to re-approximate the mucous membrane of the
tongue. The whole procedure takes approximately 15 minutes."
Columbia Presbyterian Medical Center: Frenulectomy
http://www.entcolumbia.org/frenul.htm
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"Years ago it was routine to clip the frenulum at the time of
delivery. Midwives had a long sharp nail to cut the frenulum and
obstetricians would inspect the mouth and cut the frenulum
immedialtely after the delivery. It was felt that tongue-tie was
associated with speech abnormalities especially lisping and inability
to pronounce certain sounds.
Tongue-tie actually represents partial ankyloglossia and fusion
represents complete ankyloglossia. There is no evidence in the
literature that partial tongue-tie causes speech defects, difficulty
breastfeeding, or dental problems. The tip of the tongue normally
grows until 4 years of age, and initial restrictions of movement may
improve as the child gets older. Therefore, frenulectomy should not be
performed before 4 years of age."
University of Chicago: Tongue-Tie (Ankyloglossia)
http://pedclerk.bsd.uchicago.edu/tongueTie.html
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Additional useful links:
WebMD Medical Encyclopedia: Frenotomy for tongue-tie
http://content.health.msn.com/hw/health_guide_atoz/ux1152.asp
Ask Our Expert: Tongue-Tied Toddler
http://www.drspock.com/faq/0,1511,907,00.html
Ask Dr. Needlman: Tongue Tie
http://www.drspock.com/faq/0,1511,1596,00.html
Dr Alan Greene: Ankyloglossitis (Tongue-Tie)
http://www.drgreene.com/21_93.html
Ask Dr Sears: Tongue Tied Baby
http://www.askdrsears.com/faq/az12.asp
Ask Dr Warren: Tongue Tie
http://www.askdrwarren.com/qa971110.htm#q1
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Google search strategy:
Google Web Search: "tongue tie" OR ankyloglossia OR ankyloglossitis
://www.google.com/search?hl=en&q=%22tongue+tie%22+OR+ankyloglossia+OR+ankyloglossitis
Google Web Search: frenulectomy OR frenotomy
://www.google.com/search?hl=en&q=frenulectomy+OR+frenotomy
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I hope this is helpful. Please keep in mind that Google Answers is not
a source of authoritative medical advice. The material I've posted
above is for informational purposes, and should not be viewed as a
diagnosis nor as a substitute for the services of a qualified
professional.
If anything is unclear or incomplete, or if a link doesn't work for
you, please request clarification; I'll gladly offer further
assistance before you rate my answer.
Best regards,
pinkfreud |
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