What is a tongue tie?
The “tongue tie” is the common name for the lingual ligament. It is the thin strip of white tissue that connects the tongue to the floor of the mouth when the child opens his or her mouth and tilts the tongue. A normal tongue tie allows the tongue to move freely and the tip of the tongue to stick out of the mouth naturally (or lick up to the upper gums).
Normally, a newborn baby’s tongue tie extends to or near the tip of the tongue. During development, the ligature gradually recedes toward the root of the tongue, and the tip of the tongue gradually moves away from the ligature after 2 years of age. Only a few babies have a short tongue tie. Therefore, short tongue ties in infants and children should be observed until after 2 years of age and should not be immediately judged as abnormal. Moreover, surgery may not always be necessary for mild and most moderate cases of short tongue ties.
A short tongue tie cannot be blamed for a child’s unclear speech. Even if it is a tongue tie problem, mild and most of the moderately short tongue ties do not necessarily require surgery, and with scientific speech training, they can also speak clearly and articulate.
Here, let’s understand the problem of “short tongue ligament” by comparison.
The normal tongue moves freely and the tip of the tongue sticks out of the mouth naturally, but the V-shaped tongue is too short.
1, “short tongue tie” degree table
Mild (small W) tongue can reach the position between the lower lip and chin, but the tip of the tongue is slightly pulled by the tongue ligament slightly in the shape of W
Moderate (medium W) tongue can be extended to the lips and the tip of the tongue has a more pronounced W shape
Severe (large W) tongue can not stick out the lips, the tip of the tongue is pulled by the tongue ligament W-shaped, eating and speaking have obvious obstacles
2.Teach you to identify the “big W”?
(1) Observe the baby’s breastfeeding situation?
When sucking breast milk, newborns should use their tongues to wrap up their nipples, thus forming negative pressure in their mouths and sucking milk smoothly; newborns with too short tongue ties cannot complete this action and cannot drink milk.
(2) Observe the sound of baby crying?
A baby with a short tongue tie cries with a sound similar to “woe” and “grace”; a normal baby cries with a sound like “ahh” and “wah wah “Sound cut or not cut? Only the severe need “a knife”
3, cutting the tongue tie surgery, although simple, but for children, also need anesthesia, not all children with a short tongue tie, need to “cut a knife”, according to the specific circumstances to decide.
(1) Not for small W?
The “small W” is only a slight strain on the tongue tie. As the child grows and develops, the adverse effect on pronunciation will disappear slowly, so basically no surgery is needed.
(2) Must we cut the large W?
Children with “big W” need to be operated as soon as possible, otherwise the effect on speech will be more and more obvious as they grow older.
(3) Does it depend on the condition of medium W?
In children with “middle W”, the slurred speech is often not simply the fault of a short tongue tie. The language center of the brain of children in the learning period has not yet matured, coupled with the lack of muscle strength of the articulatory organs, coordination and pronunciation “business unskilled” and other factors, speech is understandably a little poor, most of them will go through the process from unclear speech to accurate expression, when to cut.
The best time to operate on a child with “Big W” is during the neonatal period. The tongue tie of a child within a week of birth is as thin as a piece of paper, so there is little bleeding and minimal impact on the child when it is cut, and the midwife can cut the mucosa of the tie laterally with small scissors in the delivery room. If the neonatal period is missed, parents can also bring their child to the hospital for surgery before he or she is half a year old.
The tongue tie will need to be cut after the age of half a year and anesthesia will be required for children between the ages of 1 and 2 years, as they are already self-aware and have a much stronger bite, so there is a risk of accidental injury if the procedure is forced. If the tongue tie is thin, then direct cutting can be attempted. If the tongue tie is thicker and is expected to bleed more during surgery, or if the child struggles violently, then intravenous anesthesia is more appropriate before proceeding. For children over 2 years old, lingual ligamentoplasty under intravenous anesthesia is recommended.
4.Is unclear spitting a problem of “tongue tie”?
Many parents always attribute their children’s inability to pronounce and spit out words to the short tongue tie and let it take the blame for years.
Dysarthria is commonly known as slurred speech, and there are three types of dysarthria.
(1) Organic dysarthria: It is caused by congenital or acquired structural abnormalities, due to the poor development of teeth, tongue, oral structure, sinuses and other organs related to articulation, such as congenital cleft lip and palate, missing or malformed teeth and short tongue tether, etc.
(2) Motor dysarthria: It is caused by acquired diseases, such as incoordination of vocal organs due to neurological diseases, inability to hear sounds and imitate them correctly due to hearing impairment, and brain developmental disorders, which can cause inaccurate and incomplete pronunciation.
(3) Functional dysarthria: When infants are learning to speak, the language center and vocal organs of the brain are not yet mature, plus children are easily influenced by the surrounding language environment, such as the alternate use of Mandarin and dialect by their relatives, so it is difficult for them to accept it, so it is understandable that their speech is a little poor.
If your child’s speech is slurred, or if he or she is still unable to speak at the age of 2, it is important to go to the hospital for an early examination to rule out hearing, language environment, mental intelligence, brain development, autism, genetic metabolism and other factors to avoid delaying your child.