Mother: The baby is almost three years old and will start kindergarten soon, but he still can’t speak clearly, is it a “climbing tongue”? Do I have to have an operation to cut it out? The problem of unclear speech is not necessarily a tongue-climbing problem. Even if it is, some of these babies do not necessarily need surgery. After scientific voice training, you can also do the words clearly, expression without hindrance. Oral surgeon: what we call “tongue-climbing” is actually professionally known as “tongue ligament is too short”. The tongue ligament is the thin strip of tissue that connects the tongue to the floor of the mouth when the tongue is pried up after opening the mouth. 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 tether extends to or near the tip of the tongue. During development, the ligature gradually retracts 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 patients with mild and most moderate lingual tethering shortage. Let’s learn more about “short tongue tie” by comparison! What is considered a short tongue tie? Although simple, tongue tie cutting surgery requires general anesthesia for children. Not all children with a short tongue tie need to be “cut”, but the decision will be made on a case-by-case basis. Studies have shown that if a child undergoes this surgery before the age of two, it is in fact 95% redundant. Even without surgery, it will gradually reach its normal state later, so many innocent children are likely to have received a knife for no reason at all. The best time to operate on a child with the “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. At present, it is not considered necessary to perform immediate tongue tie correction surgery until the age of 4 years, except in cases of recurrent ulcers that can hinder health, and we just need to ‘wait and see’. After the age of 4, when the child has a high degree of autonomy and cooperation, the surgery is completed by cutting the ligature horizontally under general anesthesia and closing it vertically with several stitches. Many parents always attribute their children’s inability to pronounce and spit out words to the short tongue tether and let it take the blame for years. In fact, there are many reasons for mispronunciation, and a short tongue tie is only one of them. There are two main reasons for mispronunciation: one is congenital physiological defects, such as poor development of teeth, tongue, oral structure, sinuses and other organs related to pronunciation, such as congenital cleft lip and palate, missing or malformed teeth and short tongue tie; the other is due to acquired diseases, such as uncoordinated movement of vocal organs due to neurological diseases, inability to hear sounds due to impaired hearing and brain development, etc. The inability to imitate correctly due to hearing impairment and brain development disorders can cause inaccurate and incomplete pronunciation. When infants are learning to speak, the language center and vocal organs of the brain are not yet mature, and children are easily influenced by the surrounding language environment, such as the alternate use of Mandarin and dialect by their relatives, which makes it difficult for them to accept it. Most children will gradually complete the self-adjustment of their language system after the age of 4, and they can communicate and talk with adults seriously and well. In addition, when the baby has the so-called “big tongue” symptoms, you can improve the pronunciation problem through some voice training. Therefore, parents should not worry too much about their children’s unclear speech, if it is really a tongue tie problem, to cut or not to cut, just feel free to leave it to the doctor’s judgment!