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Should
it be surgically corrected? At
what age should a TONGUE-TIE be corrected?
Incomplete
development of the tissue under the tongue (called a frenulum) results in
a condition called tongue-tie. This is a relatively common condition that
frequently comes to the attention of doctors. This condition may be a
cause of poor speech in children. The
evaluation of a child with tongue-tie is quite simple. Physical findings
that may indicate a need for surgical correction include a heart shaped
tip of the tongue (due to the tight frenulum holding the tongue down to
the bottom of the mouth). Movement of the tongue is often limited so that
the child is unable to touch the tongue tip to the upper teeth, unable to
stick the tongue tip past the lower teeth, or difficulty moving the tongue
from side to side. The
diagnosis is usually made shortly after birth. Some babies do not feed
well because the tongue does not allow the baby's mouth to hold onto the
nipple. These babies may have a lot of trouble gaining weight. Breastfed
infants with significant tongue-tie often need urgent surgical therapy to
improve tongue movements so that breast-feeding may continue. However, if
your child is nursing well or drinks from a bottle well with good weight
gaining, no urgent surgical treatment is needed. Should
it be surgically corrected? There
is very little argument about the need for surgery to release tongue-tie
when there is a problem with feeding and growth. However, the most common
reason children undergo frenulectomy to release tongue-tie is to prevent
or improve speech problems. Some doctors and speech therapists feel
tongue-tie rarely affects speech. Other doctors feel that more extensive
evaluations of children with tongue-tie reveal a higher incidence of
improper pronunciation of words. A lot of these improper pronunciations is
considered acceptable and is felt to be baby talk. It is only when the
baby talk fails to resolve that a speech problem is considered. These
children will then undergo speech therapy to improve speech that may have
been normal if the child had had the ability to correctly move the tongue. At
what age should a tongue-tie be corrected? The
timing for surgical intervention is purely elective when done for speech
reasons. Most parents elect not to interfere at all citing other relatives
who have tongue-tie with no obvious problems. Other parents wish to
prevent problems with speech or with developing abnormal tongue
positioning to compensate for the limited tongue movements. Repair is then
done usually between the ages of 6 and 12 months. During
this time, babies are beginning to babble and learn how to control their
tongues. Releasing the tongue at this stage is most common. Still other
parents wait until speech has developed and shows signs of misarticulation,
this usually occurs between the ages of 18 months and 3 years. Most people feel that if your child is having enough difficulties to warrant speech therapy, the frenulum should be clipped to allow your child to maximize the benefit of speech therapy classes. Many children do not make satisfactory progress in speech therapy because they simply cannot position their tongues correctly. The information provided on
this web site is not intended to take the place of consultation with your
physician. You should always consult a physician whenever you require
diagnosis or treatment. |
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Copyright © 2008 Atlanta Children's ENT. | |
