Short tongue ligament is a series of problems caused by the abnormal attachment of the tongue ligament, which restricts the mobility of the tongue. First of all, this disease is not a particularly serious disease, but as the standard of living improves, parents’ requirements for their children’s future quality of life also improve day by day, and do not want their children to have any gap and different from other children, so the attention is gradually higher, which is also a manifestation of the improvement of the overall standard of living. Here I combine some of my own experience to talk about a little insight into this disease and surgery, representing only my personal opinion for your reference.
Common reasons for visiting the doctor with short tongue tether
1.Weakness in breastfeeding, tongue can not wrap the pacifier.
2.Recurrent ulcers at the tongue tie during teething.
3.The tongue cannot be stretched out to the lips, or the tip of the tongue is bifurcated or “w” shaped when the tongue is stretched out.
4.Speech is not clear.
5.The tip of the tongue is not in good shape.
6.Parents always feel that their children are different from others and feel sad.
7.The gap between the lower front teeth is sometimes related to the tongue ligature.
8.Some orthodontists recommend lingual ligature surgery for children with “Diastema”.
9.It is difficult to keep the mouth and lips hygienic when eating and cannot lick the crumbs.
10.Individual children need to learn vocal music, some musical sounds need to be more flexible tongue than ordinary articulation.
11.Learning special musical instruments such as the transverse flute and other musical instruments require the tongue to play with the case.
12.Children who learn American voice and recitation and other specialties that require higher oral articulation.
Diagnosis
1.We need to see whether the tongue ligament is attached to the tongue too close to the tip of the tongue and the dental bed.
2.It is necessary to see whether the tongue tip shape is bifurcated after tongue extension or the tongue extension activity is heavily restricted, and the tongue tip is not easily lifted or the range of activity is too small.
Surgical methods.
1, simple local anesthesia: scissors, electric knife or laser to cut the attachment of abnormal tongue ligament, generally without sutures. This method is suitable for children with thin tongue ligament, not much bleeding after cutting and the wound is not easy to adhere to the child.
Advantages: simple.
Disadvantages: some children may have a slightly poor surgical result, may not be able to fully achieve the normal level, may need a second operation.
2.Complex local anesthesia: Generally, children over 6 years old who can cooperate can be operated on, and sutures are needed to reduce the chance of wound adhesions after the lingual ligament is incised.
Advantages: local anesthesia, good surgical results.
Disadvantages: the child needs to cooperate, and if there is already partial dysarthria, speech training may be required.
3.General anesthesia surgery: mostly for children who cannot cooperate with the surgery and need sutures to close the wound.
Advantages: The result can be more satisfactory in one operation.
Disadvantage: Hospitalization is required and the cost of surgery is relatively high.
Indications for surgery
1, the newborn child can only judge whether the lingual tether is short by judging the position of the lingual tether attachment, generally around 6 months as the child grows teeth lingual tether position may be some changes, but for the direct attachment to the tip of the tongue children changes may be less obvious, and with the eruption of the lower front teeth, repeated ulcers may appear under the tongue, some children will form granulation, so for the lingual tether does attach close to the tip of the tongue It is recommended to do the surgery earlier, as the child is not yet crying too much during the local anesthesia surgery within 6 months, and it is better to perform the surgery when the child is older. However, not all children can undergo local anesthesia surgery at this time, some children have thick tongue ties, which are difficult to suture after local anesthesia surgery and may require general anesthesia surgery.
2, as the child increases (1~5 years old), the tongue ligament will become thicker in the middle of some children who have a slightly muscular component, which will cause more bleeding after local anesthesia, and the child’s fear of the hospital will make the child cry more so that the procedure is not easy to force, a small number of children with thin ligaments can be operated under local anesthesia for the tongue ligament under force, but it will cause some trauma to the child’s heart. However, this can be traumatic. Some children with thicker ligaments may also have more bleeding and postoperative adhesions, etc. It is recommended that general anesthesia be performed.
3.After 6 years of age, most of the children can cooperate with this surgery and can choose to undergo outpatient local anesthesia.
4.Short tongue tie may not necessarily affect the pronunciation, some children have short tongue tie but no pronunciation problem, this may have a great relationship with the different compensating ability of different children, but in general, children with short tongue tie may have a higher chance of unclear pronunciation than normal children. From the perspective of pronunciation, the surgery should be performed before the child is one to two years old, but because the child’s voice is in the process of development, it is not easy to judge whether the short tongue ligament necessarily affects the surgery.
5, from the perspective of improving appearance, there is no absolute indication for the correction of short tongue tie, if you are afraid that your child will feel different from others and affect self-esteem or communicate with other children, you can always consider surgery.
6, for other reasons need surgery according to the need and the child’s own situation to apply the appropriate surgical methods.
Why is it necessary to do preoperative examination? : The reason is that
Many parents do not understand why they need to check the venous blood for such a small operation, because the child is very small and there is no medical history for the doctor’s reference, such as the history of bleeding, etc. There are clinical cases where a small wound leads to excessive blood loss in the child, and I believe that these are the endings that parents would rather make two more trips than to see. We all hope to minimize the possible risks and accidents of surgery.
This is not a very serious disease or defect, and I hope that parents do not have to worry about it.