Frenulum plastic

Ankyloglossia is a congenital anomaly, a congenital sublingual ligament, which prevents the full range of motion of the tongue in the oral cavity. In most cases, the defect is detected in the first days of life, and is recognized quite simply: normally a thin strand connecting the tongue and the lower mouth reaches the middle of the tongue, while the abnormal bridle is attached to its very tip. The prevalence of hookworm in Ukraine is about 1: 1000, and it is 3 times more common in boys than in girls. The short bridle of the tongue in a child disrupts the function of sucking, interferes with the formation of correct pronunciation, promotes the shift of the dentition, the formation of malocclusion, gingivitis, periodontitis, etc. In such cases, frenuloplasty or plastic bridle of the tongue is indicated - surgical manipulation, which consists in opening the bridle of the tongue to normalize its functions.

How to determine the pathology of the bridle of the tongue?

Violation of the proper development of the bridles occurs in utero and the first signs of this problem are detected immediately after birth. You can suspect pathology during the examination:

• the tip of the tongue is immobile, at tension splits like a heart;
• when you try to stick out your tongue, the back of the body rises, and the edges are slightly wrapped, this may be accompanied by a clicking sound;
• there are difficulties with swallowing food.

Trimming the bridle of the child's tongue is shown to prevent the development of the following consequences:

• the improper grip of the breast or nipple on the bottle, which causes underweight;
• speech disorders in which it is difficult to pronounce palatal, hissing, and whistling sounds;
• the appearance of diastema of the teeth of the mandible;
• periodontal problems as a consequence of increased load on the gums;
• incorrect formation of the dentition;
• difficulty breathing.

If you have these symptoms, you should see a dental surgeon as soon as possible. It is not necessary to start pathology, differently there is a risk of development of chronic inflammatory processes of mucous membranes, progressing disturbances of a bite, language deviations, and frustration of a gastrointestinal tract because of the impossibility of high-grade chewing of food.

Preparation for surgery

Plasticity of the bridle of the tongue in children is a fairly simple manipulation that requires serious training. However, the oral cavity must be healthy, without inflammatory diseases and carious processes, so they should be treated in advance. Immediately before surgery, it is recommended to feed the baby, as, within a few hours after the procedure, eating may be difficult.

How is tongue bridle plastic surgery performed?

Trimming the bridle of the tongue in newborns and infants is minimally invasive, and usually without anesthesia, because at the age of 9 months, the child has no nerve endings in the bridle. The short bridle is cut with scissors, after which the child is placed on the mother's breast for better healing. The advantages of frenulotomy in childhood are the absence of bleeding and rapid healing of the mucosa. In old age, larger manipulations are required, requiring anesthesia and suturing.

There are two main methods of plastic surgery:

1. Classic trimming - is performed using standard surgical instruments: dental scissors, periodontal knife, or scalpel. Finally, the tissues and mucous membranes are fixed with sutures, rehabilitation takes several days (during this time there may be a need to adjust the speech of a speech therapist and correct orthodontic deformities at the dentist).
2. Laser resection - involves the use of a laser scalpel, which not only cuts the tissue but also coagulates blood vessels, preventing heavy bleeding. The advantages of laser plastic surgery are the absence of the need for suturing, the speed of the process, the reduction of swelling of the tongue tissue, and the minimal probability of complications. Half an hour after the procedure using a laser, the child can carelessly do the usual things. The wound in this case heals in 1-2 days.

Rehabilitation

The rehabilitation period usually takes 2-3 days. In the first days after bridle plastic surgery, it is recommended to treat the child's oral cavity with antiseptic solutions. In case of pain after cessation of the anesthetic, you should take painkillers prescribed by a specialist.

Restrictions should also be introduced in the diet: for the period of rehabilitation, it is recommended to exclude carbonated drinks, spicy, hot, sour food, so as not to irritate the postoperative area.

At Dobrobut Dental Clinic in Kyiv, a plastic bridle of the tongue is performed both with the use of surgical instruments and with the help of a laser. Our specialists have all the techniques of surgical correction, perform everything professionally and without pain. The choice of technique is made by the doctor, based on the individual characteristics of each clinical case. The price of the procedure may vary, depending on the chosen method of trimming the bridle. You can check the price on our website or by calling the call center.

Bibliography

1. Anna H. Messner, MD, Jonathan Walsh, MD, Richard M. Rosenfeld. Clinical Consensus Statement: Ankyloglossia in Children, 2020.
2. Wake Orthodontics and Pediatric Dentistry. WAKE PEDIATRIC TONGUE-TIE CENTER
3. Mayo Clinic.Tongue-tie (ankyloglossia) - Symptoms and causes.ms and causes.