When and how to trim the short frenulum of the tongue?

The frenulum of the tongue performs important functions, among which are ensuring correct pronunciation, maintaining the health of the mucous membranes, maintaining the facial muscles, and participating in the formation of the bite. Sometimes, in order to restore all these functions, it is necessary to perform surgical plastic surgery of the organ. This procedure is not particularly difficult and is performed mainly in childhood. However, it is not uncommon for adult patients to need correction of the shape of the tongue frenulum.

What are the reasons why cracks appear on a child’s tongue?

When a child visits a pediatrician, one of the mandatory procedures is an examination of the throat and tongue. The doctor asks to show it in full, assesses the condition of the papillae and the uniformity of coloring. Normally, it varies from pale pink to dull red. Fever, bacterial plaque or food poisoning immediately changes the structure and gives cause for concern.

In rare cases, a crack in the middle of a child's tongue is a birth defect. This is folded glossitis, which consists of the presence of numerous small folds and longitudinal damage.

They resemble cuts (sometimes small growths) but are not harmful or affect your oral health. Sometimes pits that are too deep become a place for bacterial plaque to accumulate. Therefore, from the first years such children are taught to thoroughly rinse their mouths after each snack.

Symptoms of incorrect placement of the frenulum of the tongue

With significant pathology of the frenulum, the following symptoms may be observed:

• It is impossible to stick the tongue out of the mouth due to the short length of the frenulum.
• When trying to stretch the tongue, it bends and takes an arched shape.
• When you try to reach the palate with your tongue, the tip of the organ expands, as there is a strong tension.
• When at rest, the tongue has the shape of a groove.

If you have such symptoms and discomfort, you should consult a specialist. Perhaps the doctor will conduct a more thorough diagnosis and make a diagnosis.

Stages of the procedure

Trimming a short frenulum, despite the lack of complexity of the procedure, should be performed by a qualified specialist and in a medical facility. Patients do not require hospitalization. The operation takes no more than 10 minutes. Immediately after completion of the plastic surgery, the child is sent home. It is not recommended to feed the baby in the first two hours. Young children are allowed to drink water.

Stages of plastic surgery of the frenulum of the tongue.

1. Preparation. The doctor asks parents for complaints, performs an examination and, if necessary, gives recommendations on preparation for the procedure.
2. Operation. Administration of anesthesia, antiseptic treatment of the oral cavity, trimming of the frenulum.

In newborns, the integrity of the mucous membrane is restored in 1–3 days. The child may be restless on the first day. Difficulties with feeding cannot be ruled out, but already on the second day, babies begin to correctly take the breast or bottle nipple, which caused difficulties previously. Parents are advised to give the baby water after each feeding to avoid the accumulation of formula or milk in the mouth and the subsequent development of infection. Also, the mother must maintain breast hygiene and sterilize bottles.

What complications can there be?

As mentioned above, the operation is simple and quick, and almost never leads to complications or negative consequences. However, this does not mean that you can ignore the doctor’s instructions regarding the postoperative period. You should listen carefully to what you can and cannot do after pruning. Otherwise, you can provoke the development of an inflammatory process, because plastic surgery always involves a violation of the integrity of the soft tissues. It is important to maintain hygiene and follow dietary guidelines.

Another unpleasant consequence of the operation in older patients can be a rather large scar or fold. This situation is extremely rare and requires a repeat procedure to remove the defect.

Indications for the procedure

For newborn children, cutting the frenulum of the tongue is recommended quite often. A pediatrician or dentist can identify the pathology. In most cases, disorders are detected already in the first months of a child’s life. At the same time, the doctor always takes into account the individual characteristics of the structure and position of the mucous fold.

If we are talking about a newborn baby, then plastic surgery is prescribed in the case of obvious pathology in the formation of the frenulum, or difficulties with breastfeeding. The baby may have difficulty latching on to the nipple or pacifier and difficulty sucking on the breast or bottle.

Untimely plastic surgery may subsequently lead to difficulties with chewing food, bite formation, and diction problems. In older age, recommendations for surgical treatment can be given by a speech therapist or orthodontist.

What happens if you don't operate?

But even after parents learn about the simplicity and safety of the tongue frenulum trimming operation, some still do not understand why they should do it. They believe that this is a minor defect, for the sake of which “it is not worth torturing the child.” But here are the consequences of its presence at an older age:

• improperly formed bite and crooked teeth;
• slow development and/or deformation of the lower jaw;
• “collapse” of the lower incisors into the oral cavity;
• bifurcation or other deformation of the tip of the tongue;
• indigestion and frequent bloating;
• severe snoring and related problems (apnea, etc.).

This is not to mention the fact that the child will not be able to pronounce almost all hard and hissing consonants. And with such diction, he will probably have problems at school, both psychologically and academically. Whether it’s worth taking such risks for fear of having to do a 15-minute operation is up to you to decide.

Proper care

With any modification of the body, including something like tongue splitting, the consequences can be very different. Therefore, you should think carefully before deciding on such a procedure. In addition, you need to be prepared that a split tongue will require special attention for several weeks after the operation, since its cut halves may grow together. To prevent this from happening, some people insert retainers. But this method is not suitable for everyone, as it can cause both additional pain and bleeding. The easiest way is to separate the halves every hour for 3-4 days with thoroughly washed hands. Over time, this can be done with simple muscle effort. In addition, you will also have to wake up several times a night in order to move your tongue.

Consequences of a short frenulum of the upper lip

Defects in the structure of the frenulum of the upper lip entail a number of negative consequences:

• During the neonatal period or in infancy, the child may have problems with sucking. In such cases, plastic surgery is performed as early as possible to restore breastfeeding.
• A shortened frenulum makes it difficult to pronounce certain words and impairs diction. Many speech therapists recommend frenuloplasty to correct the pronunciation of sounds in children.
• Impaired chewing due to a short frenulum can lead to problems with the digestive system.
• A short frenulum stretches the mucous membrane of the gums, which over time leads to the appearance of an interdental gap - a diastema, which is a cosmetic defect and can lead to malocclusion.
• Due to the retraction of the gums, a gum pocket appears in which plaque and tartar accumulate, which contributes to the development of caries and other inflammatory processes.
• A wide frenulum is a cosmetic defect and also contributes to excessive accumulation of plaque.
• Improper fastening of the bridle in some cases leads to increased sensitivity of the teeth.

Frenum trimming surgery is also an important part of preventing periodontal disease.

How to choose a specialist for splitting?

Typically, this type of service is provided by specialized salons that perform other cosmetic and minimally invasive operations - piercings, tattoos. Well-established large salons with a good reputation are the best choice. Before starting the procedure, check how sterile the instruments are. You have every right to do this, do not be afraid to offend the master. In self-respecting offices this should not be a problem, and a specialist will be happy to tell you and even demonstrate tools and equipment for sterilizing instruments. If you have the slightest doubt about the reliability of the master, it is better to refuse his services.

Reasons for incorrect formation

Most often, a short frenulum of the tongue in children occurs if one of the parents or relatives had the same problem, that is, due to a hereditary factor and genetic predisposition.

At the same time, boys are more inclined to adopt this defect. The non-hereditary appearance of a short frenulum depends on the negative influence of unfavorable factors on the fetus in the first trimester of its development.

Reasons for this feature may include:

• difficulties and pathologies during pregnancy (diseases or infections);
• chronic diseases of the mother or childbirth after 35 years;
• poor environmental situation in the place of residence;
• abdominal injuries;
• exposure to harmful drugs and substances (paints, varnishes, etc.);
• exposure to drugs and antibiotics.

How is splitting done?

Division into two halves is a surgical operation, it is performed under local anesthesia using a scalpel. Technically, this is a simple operation, although the preparation for the operation and the method of making the incision depend on the experience and chosen technique of the specialist. The standard bifurcation steps are:

• Before surgery, the patient is recommended to brush his teeth and remove white plaque with a brush, then rinse his mouth with an antiseptic solution;
• the doctor injects an anesthetic directly into the tongue;
• With a special surgical instrument, the master clamps the tongue in the middle and leaves the clamp for 30-45 minutes to stop the blood supply at the incision site;
• Using a sterile scalpel, the doctor cuts the tongue into two parts;
• A piece of gauze with an antiseptic is placed between the halves of the fabric.

This algorithm may vary depending on the skill and experience of the performer. Applying a clamp helps keep blood loss to a minimum. Other specialists, in addition to the incision, sutured the two halves to stop bleeding and reduce the risk of tissue infection.

In rare cases, splitting can be performed with a laser, but for this you need to find a specialized medical institution that provides this type of service. In practice, it is very difficult to find, so in most cases, bifurcation is performed surgically.

Methods for correcting ankyloglossia

The procedure can be performed on patients of different age groups. However, the technology for carrying it out may differ in each individual case. Next, we will consider options for eliminating ankyloglossia, depending on the age of the patient.

Plastic surgery of the frenulum in infancy

Today, a similar operation is performed on newborns in the maternity hospital or a little later in the dental clinic. This is a simple procedure that takes very little time and is called frenulotomy1. In a small child, the frenulum is still a very thin membrane with a minimal number of nerve endings. Using special scissors, the doctor makes a small transverse incision. Sometimes the wound is treated with a local anesthetic, but in other cases even this is not required.

“When my son was 4 months old, the doctor did not find any deviations from the norm. And then, when he was already a year old, at the next appointment it turned out that the frenulum needed to be trimmed. To be honest, this scared me a little, although the doctor explained that the operation was very simple and painless. Then I had never heard of lasers, and no one told me about them. The doctor cut with an ordinary scalpel, just a couple of seconds and that’s all...”

Olga33, Novorossiysk, from correspondence on the woman.ru forum

Under 5 years of age

At one year and up to 5 years, the operation is practically no different - similar plastic surgery is performed, but in this case the mandatory use of anesthesia is required. For children of this age group, the procedure may be painful, and to avoid discomfort, local anesthetics are used.

Children under 5 years of age require mandatory anesthesia during the procedure.

Teenage children

If the problem is not corrected immediately or before the age of 5 years, then later you will have to use another surgical method - frenuloplasty. This is a more serious procedure, which necessarily requires preliminary administration of anesthesia and subsequent suturing - special absorbable threads are used.

There are 3 different options for carrying out such an operation, and the choice of a specific technique directly depends on the degree of complexity of the problem:

• removal - the doctor makes triangle-shaped incisions at the top and bottom, while simultaneously clamping the frenulum with a special tool. Removal is performed and the wound is sutured,
• moving - the doctor makes two cuts, which will allow the jumper to be given the correct position. Then he slightly sutures the distance between the edges of the wound and fixes the selected fragment there,
• cutting - a specialist cuts the fold and then tightens its edges with sutures.

The choice of frenulum correction technique will have to be left to the discretion of the specialist. In general, the operation is quite simple and quick, and the use of anesthesia makes it completely painless.

The photo shows the labial frenulum before and after surgery

Progress of the operation

It is immediately necessary to warn that tongue splitting or tongue cutting is a process that requires exclusively professional performance in a specialized salon, where an experienced master will carry it out with the utmost care and without any side effects. The fact is that two fairly large arteries pass through this part of the human body, damage to which can lead to unpredictable consequences. This is why you should never split your tongue yourself.

The operation itself is carried out as follows: the desired part of the body is cut from the tip to approximately the middle. But first, the customer and the master agree on the depth of the tongue incision, after which the entire oral cavity is disinfected and a straight line is drawn. Since this operation is usually performed under local anesthesia, the professional first gives an anesthetic injection and only then cuts with a scalpel at the intended location. Sometimes during the operation it is necessary to trim the frenulum under the tongue. At this stage, this procedure usually ends. But recently, the incision site has become increasingly sutured. This way the wound heals faster and looks more aesthetically pleasing after healing. Tongue splitting looks really very original. Thus, after the incision heals, the person is left with a forked tongue, like a snake.

Reviews and results

The most famous Russian pediatrician Komarovsky, whose opinion is listened to by millions of mothers throughout the CIS, categorically states that correction must be done and the sooner the better. The baby will not feel anything and may never even know that minor plastic surgery was performed. For older children, even if it hurts, it will be after the anesthesia wears off. But these unpleasant sensations in childhood are forgotten very quickly.

Mothers who share their experiences on forums also unanimously speak about the simplicity and safety of such an operation. Children recover quickly, begin to speak a lot and clearly, and gain confidence in communicating with peers. So in general, the reviews are only positive.

For those who still doubt whether correction is needed and what type of operation to choose - laser or scalpel, we recommend watching numerous photos and videos. They fully illustrate the process and we can conclude that the baby really does not experience much discomfort. If he cries, it is more likely from fear than from pain.

Author: Anna Alexandrova

Pros of the operation

• Uniqueness . A person decides to take such a step in order to be different from other people. All for the sake of the so-called emotional uplift.
• To attract attention. Anyone who sees such a modification on someone will definitely not remain indifferent. Riveted glances are guaranteed. For young people, this is, in a sense, a manifestation of protest against society, the destruction of stereotypes.
• Popularity. A person with a split will definitely become famous in his circle, since the operation, although fashionable, is quite rare.
• Self-determination . This operation is also performed by people in order to maintain their status as a certain subculture. Most often, punks, emo, and followers of body mod apply for this modification.
• Aesthetics . For some people, a split is a decoration of the body for the soul.
• New sensations. The operation is sometimes performed in pursuit of something unusual that will dilute the gray everyday life. It even becomes possible to control each half of the taste organ.
• Possibility of reverse action . The tongue can always be sewn back together.

Contraindications for surgery

Like any surgical intervention, frenuloplasty has contraindications:

• Bleeding disorder
• Congenital pathologies of the oral mucosa
• Multiple caries (operation is carried out after treatment)
• Osteomyelitis
• Malignant neoplasms
• Mental disorders
• Autoimmune diseases
• Immunodeficiency
• Tendency to form keloid scars
• Severe diabetes mellitus
• Any infectious and somatic diseases during exacerbation

To decide or not

If a person doubts whether or not to make an incision, then... Uncertainty will only hinder your ability to survive the subsequent days of recovery. But it is absolutely clear that if a person finally decides to split his tongue, then no shortcomings and possible consequences of the operation will stop him. In this case, you need to look for one, preferably with a medical background, to avoid unnecessary damage. You can't put your life in danger for the sake of a fashion trend. You need to read reviews on the Internet or from friends to be sure of the result. After surgery, the main thing is to monitor your health and disinfection of the oral cavity. Then you can enjoy the result.

Symptoms

In order to determine the size of the child's frenulum, it is necessary to open his mouth, retract his lips and lift his tongue up.

Typically, the attachment point of the hyoid frenulum is located at an equal distance from the tip of the tongue and its root. Tongue with short frenulum:

• bends in an arc (especially when trying to stick it forward);
• has a curved tip that bifurcates and takes on a heart-shaped shape;
• Makes clicking and clunking sounds when folded.

The frenulum may have a thick appearance or be a continuous fold attached to the sublingual space.

In addition, the frenulum may have an incorrect location and limit the free movement of the tip of the tongue upward or protruding it from the mouth.

Is special training required?

The procedure does not require special preparation. Immediately before surgery, it is necessary to perform thorough oral hygiene. You also need to feed the child - hunger negatively affects blood clotting. In addition, it will be difficult to eat for several hours after the operation.

Since plastic surgery of the upper lip frenulum is performed mainly on young children, first of all, psychological preparation is necessary. Parents should reassure the child, assure him that the procedure is painless, this will help significantly speed up and simplify the doctor’s work.