The tongue tie, also called the tongue tendon in some areas, is a thin strip of tissue between the tongue and the floor of the mouth when we open our mouths and cock our tongues. It is similar to the membrane between the toes of a duck’s paw. In a normal newborn, the tongue tie extends to or near the tip of the tongue. As the tongue develops, the tie gradually recedes toward the base of the tongue. However, in the case of abnormal development, the tongue tie does not recede or does not recede sufficiently, and then the tongue tie becomes too short. In children with short tongue tie, tongue extension is limited, and the part of the tongue that extends out of the mouth is not as long as that of a normal child; moreover, the tip of the tongue appears to be a depression due to pulling, and the tip of the tongue is in the shape of “W”, so that the tip of the tongue can not be upturned or licked to reach the upper part of the mouth, and at the same time the tongue can not be rolled up, and the tongue can not be rolled up, and in order to overcome the pulling of the tongue tie, the child incorrectly puts his tongue between the upper and lower teeth or compensates for it by pronouncing. In order to overcome the traction of the tongue tie, the child incorrectly extends the tongue between the upper and lower teeth or compensatingly raises the back of the tongue, thus forming an abnormal articulation, and is unable to correctly pronounce the palato-lingual and consonants, which is the main reason for the inability to pronounce the palato-lingual and consonants caused by the short tongue tie; it manifests itself as the difficulty in distinguishing the pronunciation of the letters “4” and “10”. This is the main cause of the inability to pronounce the palatals and consonants due to the short tongue tie; this is shown by the inability to distinguish between the sounds “4” and “10”, and the inability to pronounce the word “male” as “east” and “knife” as “high”, “pants” as “rabbit”. However, not all children with a short tongue tie will suffer from dysarthria, which means that even if they have a short tongue tie, they do not always need to undergo surgery. Without further ado, let’s talk about the issues that the families of the children are more concerned about: 1. The timing of the surgery. Nowadays, regarding the choice of the operation time, academics and hospitals are not very consistent, ranging from newborn to five or six years old. And each has its own rationale. Even different doctors in the same hospital give different answers. This causes confusion for families. Who to listen to in the end that. First of all, purely from the perspective of the tongue tie, we recommend surgery between the ages of six months and one year. This way the anatomical problem can be solved before speaking. However, from the child’s physical point of view, it must be done under general anesthesia at this age, and the family will bear the surgical risk. Moreover, the small size of the surgical area makes it more difficult to perform the surgery, and there is also the possibility that it may not be done adequately and will need to be done again at a later date. In this regard, the older the child the better to do. Especially after the age of five it can basically be done on an outpatient basis under local anesthesia. But these two problems occur in the same child. The point is, is there an exact time? No, the timing of the surgery still depends on the severity of each child, if the child is weak in breastfeeding, the tongue can not wrap the pacifier, affecting the eating. Or if the child has recurring ulcers at the tongue tie when teething. In both cases, timely surgery is recommended. If the tongue tie is still attached to the tip of the tongue at eight months to one year of age, with no sign of retraction, surgery is recommended before one year of age. Surgery is recommended before the age of one year. If the tongue tie, although a little short, is not attached to the tip of the tongue and the tongue can partially protrude out of the mouth, then it can be observed. Then it can be observed. By the age of three, if there is no improvement and the tip of the tongue is still forked or has a “w” shape when the tongue is extended and there is no clear articulation, surgery is recommended. Surgery is recommended. After surgery, speech training will be added. If the problem is detected after the age of three, it is advisable to do it as soon as possible. If the short tongue tie does not affect the articulation, surgery can be avoided. The exact timing of the surgery is not possible for a family with no medical experience to confirm the diagnosis through a few articles alone. Ultimately, it will have to be checked at the hospital by an experienced doctor. Meanwhile, it is recommended that every newborn can go to the dental hospital before the age of one year to check. 2, general anesthesia or local anesthesia? This may be the most concerned about the problem of the family, this surgery before the age of four are generally recommended to do general anesthesia, local anesthesia under the child basically does not cooperate. Can not be done in place, facing the possibility of secondary surgery. And the child’s psychological and parental tolerance is also a challenge. Now the general anesthesia are very safe, will not have any harm to the child’s brain. What’s more, there is no possibility of becoming stupid after doing it. 3, surgical trauma. This surgery, whether general anesthesia or local anesthesia, is a small operation. Generally ten minutes can be done. Use scissors to cut longitudinally, horizontal alignment suture on it. 4, after the operation, the pronunciation is normal? This depends on the age of the operation, the operation before the age of one year generally does not affect the child to learn pronunciation. Generally, there is no need for voice training. Children after two or three years of age, the general improvement after the operation is not great. They need further speech training. Correct the bad pronunciation habits. 5, what are the precautions after surgery? General anesthesia after surgery can generally be six hours to eat, local anesthesia after surgery can be two hours to eat and drink. 24 hours can not give the child to brush the teeth and rinse the mouth, limit the child’s tongue activity. 24 hours can eat warm and cool fluid or semi-fluid food, avoid spicy stimulation as well as too hot, avoid strenuous exercise. It is normal to have slight blood in the mouth for 1 to 2 days, but if there is a lot of bleeding, please consult a doctor. In order to prevent infection, you can take oral antibiotics such as Hickory for 2-3 days. Sutures can usually come off confidently without removing them. If you have the condition, you can choose absorbable suture directly. Seven days later, you can basically resume normal diet. 6.Is all dysarthria caused by tongue tie? Some parents attribute their children’s dysphonia to the short tongue tie. Dysphonia and spitting incorrectly are of course related to the short tongue tie, but it is not the only reason for dysphonia. The tongue tie is too short, usually only affects the child’s pronunciation of individual words inaccurately, the whole pronunciation does not play a major role. It is basically a rolled tongue. For example: say “pants” as “rabbit”, etc., resulting in inability to pronounce there are two main reasons: one is a congenital physical defects, such as cleft lip and palate, missing teeth or deformities, and short tongue tie, etc.; the second is the result of acquired diseases, such as children due to the child’s neurological disorders resulting in vocal motor coordination. Secondly, it is caused by acquired diseases, such as children’s childhood neurological diseases resulting in the movement of the vocal organs is not coordinated, due to hearing damage caused by the inability to hear the sound and can not be correctly imitated, brain development disorders, etc. can be caused by mispronunciation. In addition, before the age of 3, children’s vocabulary gradually increased, they are very eager to use language to express their own thinking, so there are often mispronunciation phenomenon, especially some more complex sounds. This is because they have just learned to speak soon, and the language center of the brain and the vocal organs are still immature, or in the process of learning to speak by the influence of the language environment and caused. For example, in some provinces, “F” and “H” are not clear. Therefore, there are multiple reasons for unclear pronunciation, which may not always be caused by a short tongue tie. However, it is recommended to go to the stomatology department for examination first, to rule out stomatological problems, and then go to other departments for further examination.