|
1.
|
What Is A Tongue-tie?
|
|
Incomplete development of the tissue under the tongue (called a frenulum) results in a condition called tongue-tie. This is a relatively common condition that frequently comes to the attention of doctors. This condition may be a cause of poor speech in children.
|
|
back to top
|
|
|
|
2.
|
How Is Tongue-tie Diagnosed?
|
The evaluation of a child with tongue-tie is quite simple. Physical findings that may indicate a need for surgical correction include a heart shaped tip of the tongue (due to the tight frenulum holding the tongue down to the bottom of the mouth). Movement of the tongue is often limited so that the child is unable to touch the tongue tip to the upper teeth, unable to stick the tongue tip past the lower teeth, or difficulty moving the tongue from side to side.
The diagnosis is usually made shortly after birth. Some babies do not feed well because the tongue does not allow the baby's mouth to hold onto the nipple. These babies may have a lot of trouble gaining weight. Breastfed infants with significant tongue-tie often need urgent surgical therapy to improve tongue movements so that breast-feeding may continue. However, if your child is nursing well or drinks from a bottle well with good weight gaining, no urgent surgical treatment is needed.
|
|
back to top
|
|
|
|
3.
|
Should It Be Surgically Corrected?
|
|
There is very little argument about the need for surgery to release tongue-tie when there is a problem with feeding and growth. However, the most common reason children undergo frenulectomy to release tongue-tie is to prevent or improve speech problems. Some doctors and speech therapists feel tongue-tie rarely affects speech. Other doctors feel that more extensive evaluations of children with tongue-tie reveal a higher incidence of improper pronunciation of words. A lot of these improper pronunciations is considered acceptable and is felt to be baby talk. It is only when the baby talk fails to resolve that a speech problem is considered. These children will then undergo speech therapy to improve speech that may have been normal if the child had had the ability to correctly move the tongue.
|
|
back to top
|
|
|
|
4.
|
At What Age Should A Tongue-tie Be Corrected?
|
The timing for surgical intervention is purely elective when done for speech reasons. Most parents elect not to interfere at all citing other relatives who have tongue-tie with no obvious problems. Other parents wish to prevent problems with speech or with developing abnormal tongue positioning to compensate for the limited tongue movements. Repair is then done usually between the ages of 6 and 12 months.
During this time, babies are beginning to babble and learn how to control their tongues. Releasing the tongue at this stage is most common. Still other parents wait until speech has developed and shows signs of misarticulation, this usually occurs between the ages of 18 months and 3 years.
Most people feel that if your child is having enough difficulties to warrant speech therapy, the frenulum should be clipped to allow your child to maximize the benefit of speech therapy classes. Many children do not make satisfactory progress in speech therapy because they simply cannot position their tongues correctly.
|
|
back to top
|
|
|