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Posted in Articles on November 13th, 2010 by Lilly – Be the first to comment
There are about four out of every 1,000 babies born are affected with a condition called ankyloglossia or tongue-tie. Ankyloglossia or tongue-tie in layman’s term is a minor birth defect in which the flap of mucous membrane under the tongue is too short and limits the normal mobility of the tongue. No clear definition has been identified, however, as there is no universally applied criteria for the diagnosis of ankyloglossia. During the early fetal development, the tongue is attached to the floor of the mouth. Due to the cell death and atrophy, the only renaming attachment is the frenulum. Tongue-tie results when the frenulum is too short and this may limit the movement of the tongue. When there is an attempt to stick the tongue out, there may be a V-shaped notch at the tip.
During the physical exam, ankyloglossia or tongue-tie will easily demonstrate the short or anteriorly placed lingual frenulum. The shortness of frenulum and its clinical presentation has little correlation. Many children may not face any problem but some may face host of problems, such as feeding difficulty, speech disorder, and various mechanical and social issues related to the inability of the tongue to protrude sufficiently.
Diagnosis may be suggested by history and confirmed by physical examination. The frenulum may be thick and fibrous or thin and membranous, and is abnormally short, inserting at or near the tip. On protrusion the tongue may have a notch in the center or it may be heart shaped on protrusion.
In some cases, it does seem that breastfeeding can be successful even if the baby has a tongue-tie. In other cases, the tongue-tie may cause breastfeeding problems. In an attempt to draw the breast into the mouth and milk the breast with the tongue, the baby becomes frustrated and may bite at the breast or may not be able to fully compress the milk sinuses to remove milk. Baby’s tongue normally cushions the breast from the bony lower jaw while breastfeeding, and when it cannot, breastfeeding is painful. When a baby attaches to the breast, his tongue extends and grooves to cup the breast, removing milk with a rolling motion while lifting up to compress the breast. Mechanical problem related to tongue may include difficulty in licking the lips, and sweeping the teeth free of food debris, local discomfort or cuts beneath the tongue.
Tongue-tie represents partial ankyloglossia and fusion represents complete ankyloglossia. Case reports indicate that sequelae of ankyloglossia may include speech defects, difficulty breastfeeding, or dental problems. However, controlled trials on ankyloglossia have not been appropriately studied, and therefore indications for therapy remain controversial. The tip of the tongue normally grows until 4 years of age, and initial restrictions of movement may improve as the child gets older. Therefore, frenulectomy should not be performed before 4 years of age.
TheraBreath Premium Tongue Cleaner effectively removes food debris even to the most difficult to reach areas of the tongue. It is easy to use since it has a flexible handle that assists you in removing all foreign bodies within your tongue. This is one of the most recommended tongue cleaner most especially to those who are affected with ankyloglossia.
The management for ankyloglossia or tongue-tie would encompass physician education, parental education and reassurance, the monitoring for appropriate weight gain if exclusively breastfeeding and completion of fusion that will require surgery.
