How and at what age do children have their frenulum cut under the tongue and why do they need plastic surgery? At what age is it better to cut a child's frenulum?

The mother can find out that the child has a short frenulum in the maternity hospital. Such a pathology must be eliminated immediately. Otherwise, problems may arise when sucking the breast or pacifier. The bridle is easy to adjust. The procedure is well tolerated by all children, almost painless. Pediatric surgeons perform similar operations all the time. There is no need to be afraid of this. Complications in advanced cases of such an anomaly will be much more serious.

Why do you need to trim the bridle?

Any parent wonders whether it is really worth trimming the frenulum under the tongue? Due to its incorrect size, children may have problems with nutrition and development of pronunciation. The frenulum also affects the bite and function of the facial muscles.

It represents a jumper. Necessary for connecting the tongue and lower jaw. Thanks to her, the first one always remains in the right position.

If the frenulum develops with pathology, the functionality of the oral cavity may be impaired. Normally, it should be in the center of the tongue and be from 2.5 to 3 cm long. In babies who are not yet a year old, its size is 8 mm. The most common abnormalities are either that the frenulum is attached to the tip of the tongue or that the length is too short. The latter pathology is called ankyloglossia.

Why is a short frenulum so dangerous? Because of it, the bite is disrupted and improper development of the jaw occurs. You can tell that your baby is small by the fact that he gets tired quickly when he eats, sucks poorly, and cries constantly. If the child clicks when eating, and milk pours out of the mouth, then the frenulum under the tongue needs to be trimmed. Children with this pathology have problems gaining weight. It hurts them to move their tongue. This situation applies to both infants and artificial babies.

At an older age, to check whether the frenulum is in normal condition, you should ask the child to reach the upper palate with his tongue. Deviation will cause problems with bite, periodontitis, difficulties with pronunciation, discomfort during chewing and swallowing. Most often, such a disease is diagnosed by a speech therapist, since parents turn to him because of difficulties in pronouncing letters.

Ankyloglossia must be treated, otherwise the child may, in addition to the above problems, develop inflammatory disease mouth, snoring, problems with the gastrointestinal tract, scoliosis, nasality.

The pathology is transmitted by hereditary factors. If relatives have a similar problem, then most likely the child will be born with an anomaly. Also, this defect is formed during pregnancy if the mother suffered a viral disease, especially in the first and third trimester, toxicosis, exacerbation of chronic illnesses, stress. In addition, abdominal bruises, alcohol, drugs, and poisoning are considered provoking factors. chemicals in the first three months of fetal formation. Poor ecology can sometimes cause pathology.

At what age should surgery be performed?

Correction of the frenulum of the tongue is carried out at any age. It can be done for small children, schoolchildren and adults. The operation goes quite quickly. Doctors advise doing it to a newborn baby right away. This is due to the fact that it will be easier for the baby to eat, there will be no problems with weight gain, and besides, at this age, surgical intervention is tolerated most painlessly.

For older children, it is quite difficult to have surgery, as you have to use anesthesia. This is due to the fact that it is difficult to convince a one-year-old baby to simply sit still quietly. Therefore, many doctors advise cutting either immediately after birth or when the child is 4-5 years old. Children at this age already tolerate anesthesia well and surgery is not contraindicated for them.

But you need to understand that by this time the baby may have problems with speech, which after the procedure will require a long period to correct and eliminate them.

Which doctor should I see and where is the best place to have surgery?

If there is a suspicion of ankyloglossia, the pediatrician will send the child to a dentist, orthodontist or surgeon. They will either confirm or refute the diagnosis. Whether the tongue frenulum needs to be trimmed will be decided jointly by the orthodontist, speech therapist and surgeon.

There must be good reasons for the operation. These include malocclusion, speech therapy disorders that cannot be corrected by other methods, tooth displacement, and eating problems.

The severity of the anomaly is divided on a 5-point scale. If the deviation is very small, it can be eliminated without surgery using special exercises. The child must be over a year old.

Parents are concerned about the question of where to trim the frenulum of the tongue? The operation is performed in the maternity hospital. If the child is older, the procedure is carried out in dentistry. In case of a severely advanced defect, the operation is performed in surgery in the maxillofacial department.

Surgical correction

When a baby is born, the doctor usually checks the condition of the frenulum. Therefore, it is better to do the operation right away. For children 5 years old, the procedure is performed in the surgical department or in dentistry. A hospital stay is not required, so you can go home after the operation is completed.

There are some contraindications to cutting the frenulum. These include diseases of the blood, oral cavity and teeth, infectious and oncological problems.

Types of operations

There are several types of operations during which the shortened hyoid ligament is trimmed:

• Vinogradova's method. During the procedure, tissue is cut from the mucous membrane and sutured to the frenulum.
• Glickman's method. The bridle is cut from the side of the teeth.
• Frenulotomy. The frenulum is trimmed and the edges of the mucosa are sutured.

There are some other types of operations, but they are rarely used. The doctor should select which version of the procedure will be used depending on the severity of the pathology. In some situations, you can do without surgery altogether.

Frenectomy

This procedure is also known under another name: the Glickman method. Clamps are used during the operation. They fix the bridle. Next, the surgeon cuts the skin between the lip and the clamp. Stitches are placed on the edges. If we are talking about cutting in newborns, then for them such an operation is painless and quick.

After 2-3 years, vessels and nerves appear in the frenulum area. It becomes denser and meatier. Therefore, anesthesia must be used and stitches must be placed after the incision.

Frenulotomy

This method is considered the simplest. It allows you to easily increase the length of the tongue frenulum. The surgeon must trim the bridge itself at a distance that is 1/3 of the entire length. Next you need to cut the mucous membrane. The sides of the mucous membrane begin to move closer together. Sutures are placed every 4 mm.

Frenuloplasty

This method is called the Vinogradova method. During the operation, the location of the frenulum is changed. The procedure is carried out in three approaches.

• First, a triangle-shaped flap is cut out. The wound is closed with sutures.
• Next, an incision is made from the septum to the papilla, which is located between the front teeth.
• A triangle is sewn to the wound.

After this, the operation is considered completed.

What is the pruning procedure like?

If the child is over 2 years old, then he will have to explain why the frenulum under the tongue is cut. This way you can avoid severe stress in your baby. The operation will be performed under general anesthesia. Manipulation time is no more than 5-10 minutes. At this age, there are no nerve endings or blood vessels in the frenulum, so there is no need to worry too much.

If the child is older, then lidocaine or an anesthetic gel is applied to the site of the future incision. Afterwards, the doctor makes an incision using a scalpel or scissors. Seams are not always applied.

Laser treatment

Many people are interested in whether it hurts to trim the frenulum of the tongue with a laser? This procedure is considered completely safe and is classified as microsurgery. Complications after such an operation are excluded. There are no stitches. Rehabilitation period lasts two days.

The laser operation is performed in no more than five minutes. Doctors often use this method to trim the frenulum of young children, as it is painless, precise and does not allow infections.

Rehabilitation

The rehabilitation period depends entirely on the age at which the tongue frenulum is cut. If the child is less than 9 months old, then after a few hours he can be put to the breast. For older children, rehabilitation lasts about a day. If the operation is performed with a laser, the period is halved.

Immediately after the operation, it becomes easier for newborns to eat; milk helps the wound heal quickly. Breasts immediately begin to gain weight. If the frenulum was cut on a newborn, then he will not have problems with speech. Older children will have to go through correctional therapy with a speech therapist. Your doctor will tell you what exercises to do.

After the operation, it is forbidden to eat for two hours. For the first three to four days, you should not give your baby anything salty, spicy, sour or hard. It is necessary to avoid eating and drinking too hot. At first, it is better to eat pureed food. Talking too much is prohibited. After eating, you need to rinse your mouth with special antiseptic preparations. These can be infusions of chamomile or calendula, or a solution of Furacilin. If the child is at least five years old, if there is pain, he can be given painkillers. You need to apply sea buckthorn oil or Solcoseryl to the seam. The doctor will definitely tell you what exercises to do to support speech, and they should be followed. If necessary, you should regularly visit a speech therapist.

Complications after surgery

If a child needs to trim the frenulum of the tongue, then parents should not worry. With proper postoperative treatment, no complications will arise. The surgical intervention is well tolerated by the child, therefore, in addition to the fact that for a while the child will lose the ability to speak for a long time and eat regular food.

If the wound is poorly treated, pain and inflammation may occur. If the child develops a scar, it is necessary to perform a second operation.

Is it possible to stretch the frenulum?

If the child does not pronounce hissing words, it is not necessary to immediately trim the bridle. You can try stretching it. For this purpose, exercises are carried out and performed.

You should stretch out your tongue and then move it to the sides. You need to reach the tip of it to the lower lip, then to the upper lip. You can click your tongue. To do this, you need to hold it near the sky and lower it down. The tongue should be moved between the cheeks, while the mouth should be closed. Also stretch out your tongue with a tube and smack.

If the child is small, you can often let him lick the spoon. Another way helps: you can drip jam onto your lip, and then ask the child to lick it.

Let's sum it up

It is best to trim the frenulum of the tongue when the child is not yet one year old. What is this connected with? There are no blood vessels or nerves in the area that needs to be cut. Therefore, the baby will not be hurt. Doctors will not have to use anesthesia or painkillers.

If the parents had no desire or reason for cutting the frenulum in early age, it is better to wait until 5-6 years. This is due to the fact that children at this age tolerate anesthesia well. The operation is carried out quickly for both infants and adult children. The only difference is the rehabilitation period. In the first case, it takes only a few hours. In the second - several days.

The type of operation the surgeon will perform depends on the indications and reasons. If baby light stage of pathology, it is enough to just make a small incision. Inpatient observation is not required, so you can go home immediately after the procedure. The article above described what is prohibited in the first days after surgery. You need to carefully select your diet; food should not be hard or irritate the mucous membranes (spicy, smoked, etc.).

Is it necessary to trim the frenulum of the tongue? This question worries many parents. Doctors advise doing this either immediately after childbirth, or depending on the situation. Many children with a mild form of the pathology do not experience any discomfort when eating, talking, and so on. In this case, experts recommend waiting until 5-6 years to check whether the child can pronounce words and sounds correctly. If there are any defects, for example, the baby cannot say “r,” then he is sent for surgery. In other cases, you don’t have to worry and just do exercises to stretch the frenulum. They will make it easier daily life child and will help prevent pathological changes.

You need to understand that the anomaly does not get worse over the years. The frenulum does not shorten, so this will not lead to serious complications if they were not identified before the year. Pronunciation can always be corrected, and surgery is allowed even in adulthood.

Every person has a tongue frenulum. It's small thin strip, which serves to hold the tongue in its proper place, near the lower row of teeth.

However, this is not its only function. Control of the tongue, its mobility, breathing, swallowing, and food intake in general is carried out precisely with the help of the frenulum.

It looks like a thin fold located on the mucous membrane under the tongue. It starts almost from the gums of the central lower teeth and reaches the lower plane of the tongue to its middle.

However, sometimes a slight pathology can be observed - this fold is not located as it should be, or is too short. Then a simple operation is used to trim it.

Reasons for incorrect formation

The scientific name for this phenomenon is ankyloglossia, that is, “curved tongue”. This is a fairly common problem. The main reason for its appearance is considered to be a hereditary factor. Moreover in boys it is more pronounced and occurs much more often than in girls.

It is not at all necessary that the baby’s parents had a short frenulum. It is enough that one of the closest relatives faces this problem. That is, in addition to heredity, they also distinguish genetic predisposition.

The second reason for the appearance of ankyloglossia is possible pathologies of pregnancy. It is difficult to single out any one of the many factors here. However, it has been noted that children of mothers who used drugs during pregnancy are more likely to have this pathology.

It is also often observed in those newborns who have other birth defects that cause deformities of the head and face.

Clinical picture

This pathology, especially if it is pronounced, has the following picture:

• the tip of the tongue cannot be moved beyond the boundaries of the oral cavity, since it is quite rigidly fixed near its bottom;
• if a child tries to stretch out his tongue, it simply bends in an arc;
• if you don’t stretch it, but just try to raise your tongue to the upper palate, then its tip, due to the strong tension of the frenulum, bifurcates and takes on a heart-shaped shape;
• When folded, a characteristic clicking sound and groove shape appears.

Why is correction needed?

Correction of ankyloglossia or trimming of the hyoid frenulum is necessary for a variety of reasons. Moreover, these reasons change with the age of the child. Based on this, we will consider the need for surgery.

Why do this to newborns?

Breastfeeding is very important for babies. With mother's milk they receive everything they need not only for growth, but also for normal development in general. That is why It is necessary for the baby's tongue to work normally, since this organ plays a vital role in the feeding process.

Using the correct tongue movements, the nipple is properly grasped and retracted, and a specially shaped groove is formed to hold it and collect milk before swallowing.

And if ankyloglossia is detected, then a number of problems may arise during feeding.

• Inability to attach baby to breast correctly, also he will not be able to hold it for any long time.
• Difficulties also arise with the process of milk absorption. To do this, the baby begins to strongly squeeze the nipples with his gums and bite them, which causes cracks and severe pain.
• When sucking milk, the baby swallows a large volume of air. This leads to frequent belching and colic.
• Insufficient milk supply leads not only to an increase in the time of feeding, but also affects the growth of the child– he gains weight less quickly and may be stunted in growth.

Consequences of ankyloglossia

If the operation was not performed in the maternity hospital, as well as in infancy, then problems breastfeeding are quickly forgotten. However, if the bridle was too tight and short, then it will not stretch on its own over time.

And this can lead to further violations. Among them, first of all speech therapy problems, since the tongue plays a big role in the pronunciation of sounds.

It is also possible that other disorders may occur, including orthopedic, dental and general medical:

• Delayed growth and development of the lower jaw.
• Formation of malocclusion. Possible options are open or . In the first case, the upper and lower dental rows may intersect at several points, resembling a checkerboard pattern. And in the second, the teeth in the front part do not close at all, leaving an open space in the shape of an oval.
• Turning the lower central teeth inward.
• Changing the shape of the tip of the tongue, for example, bifurcating.
• Injury by the incisors of the lower row of the frenulum itself.
• Early, especially in the bottom row.
• Problems with the pronunciation of those sounds for which you need to lift your tongue up - r, l, zh, sch, sh, ch, d, t.
• Poor chewing of food, as well as air entering the esophagus. This leads to frequent bloating, severe gas formation, pain and colic in the abdomen.
• The appearance of snoring during sleep is still childhood, as well as apnea.

Technologies for eliminating ankyloglossia at different ages

Frenum cutting can be performed regardless of the patient's age. However, this operation has several types and degrees of complexity.

Babies

A similar operation in infancy can be performed in a maternity hospital or in dental clinic. It takes a lot a short time and is called frenotomy.

In newborns, the frenulum is a very thin formation that contains a small number of nerve endings and blood vessels.

That's why Using special scissors, a small incision is made in the transverse direction. A local anesthetic may be used to lubricate the incision site.

However, in many cases even this is not required. You can calm the baby and stop the bleeding by simply holding him to the breast.

Children under 5 years old

For children of this age, the procedure is not much different, but it is mandatory use of local anesthetic, as it is quite painful. After complete healing, orthodontic treatment may most likely be required - bite correction.

School-age children and teenagers

If the frenulum has not been corrected earlier, then starting from the age of five, when children already understand and adequately perceive what is happening, frenuloplasty. This is a more complex operation that requires local anesthesia and stitches. For this purpose, a material that has the property of resorbing is usually used.

Depending on the complexity of the problem, frenuloplasty can be performed in three ways: different ways.

How to trim the frenulum of a child under the tongue can be seen in the following video:

Using a laser

New technologies are widely used in modern medicine. In particular, lasers can be used instead of surgical scalpels and scissors. It is also used to trim the frenulum under the tongue.

The laser has the ability not only to cut, but to evaporate certain areas of tissue. Thus, there is no need to apply sutures, since in remote areas of the frenulum, simultaneous with removal, the wound is closed.

It is very good to use a laser in cases where surgery is required for a child of kindergarten age. The baby will watch cartoons while he is given an anesthetic.

And then they will ask you to wear special safety glasses. This way the child will feel involved in an interesting game.

This method has many advantages:

• bloodless tissue cutting;
• sterilization of the edges of the incision occurs simultaneously with its application;
• the laser causes coagulation of cut vessels - “baking”;
• no stitches during surgery of any complexity;
• faster healing process;
• significant reduction in the risk of complications;
• making the process easier for the patient.

Possible complications

Almost always such an operation takes place without any complications. This is due to its lightness, as well as the simplicity of the structure of the bridle itself. The only one possible variant when complications arise - postoperative period.

At this time, if the rehabilitation regime and doctor’s instructions are not followed, small rather painful inflammatory processes in damaged areas. Therefore, it is necessary to strictly follow all instructions regarding hygiene, diet, and so on.

Another possible complication is very rare in older children (teenagers) a visible and hard scar may form. This necessitates repeated plastic surgery to remove it.

Reviews

Quite a lot of people undergo cutting of the hyoid frenulum at a very young age. Usually this procedure is not too painful and takes minimal time.

If you find an error, please highlight a piece of text and click Ctrl+Enter.

• Daria

  November 16, 2015 at 07:17 pm

  Our son had his tongue frenulum cut at a very young age (up to a year old, when he and I were in the hospital for ARVI. The attending physician who observed us drew my attention to this frenulum and explained what consequences the baby could have in the future if not done cutting on time. And indeed, the operation went quickly, one might say, successfully, the child did not even have time to get scared when everything was done. kindergarten or with any of the mothers about this very frenulum, I advised cutting as quickly as possible. And of course, don’t be afraid of anything. Moreover, now there is a laser, with it the operation will be much easier and painless.

• Nikita

  November 20, 2015 at 9:34 am

  I had this operation as a child. Honestly, it didn’t hurt at all, and besides that, there was no powerful painkiller, just novocaine. My frenulum was trimmed in order to even out the bite, since the plate did not help with a wide frenulum. After cutting, everything evened out over time, and I am grateful to the doctor for this, for his responsibility and talent.

• Alina Snezhinina

  April 13, 2016 at 6:17 am

  I didn’t even know that there are several ways to trim a bridle. And even more so, in our local clinic no one suggested solving the problem with a laser. My daughter (she is five years old) underwent a simple operation, according to the surgeon, using a bloody method (using a scalpel). The child was very worried, but everything went well. At first it was uncomfortable to eat. Over time, the wound in the oral cavity healed. The frenulum became longer and my daughter was finally able to pronounce the sound “R”. And other sounds began to come easier.

• Irina

  January 11, 2017 at 01:22 pm

  The first time we went to see a surgeon, when our daughter was 4 months old, the doctor did not find any problems with the frenulum, but by the time she was a year old, at the next appointment it turned out that the frenulum needed to be trimmed. Of course, I didn’t want to, I felt sorry for the child, it hurt, but I had to. Of course, they didn’t tell us anything about the laser; there is nothing like that in a regular children’s clinic; they cut it with an ordinary scalpel, quite quickly, the child cried a little.

• Vitaly

  March 7, 2017 at 4:58 am

  And in mature age can the bridle be trimmed?

• Elizabeth

  June 8, 2017 at 10:20

  My younger sister Around the age of one and a half years, I just couldn’t talk. I don’t know if it was related to the frenulum under the tongue, but we went and trimmed it, after which it really became easier for the child to pronounce sounds. The procedure itself was not particularly painful (because anesthesia was not even offered) and was performed with such small scissors. I also remember when I was 12 years old, my frenulum under my lip was cut, but that’s another story, because... it was much more serious.

Humans have a frenulum in their mouth. Despite the fact that it is a thin fold located from the beginning to the middle of the tongue on its inner side, it has many functions. It is not only responsible for holding the tongue in the desired position, but also provides control over it. Thanks to the frenulum, a person is able to eat, swallow and even breathe.

Sometimes there are problems with it. A frenulum that is too short or incorrectly positioned can cause many unpleasant consequences. The way out of the situation is often to trim it. This is a simple and common procedure.

Short frenulum of the tongue: types and difficulties that arise

At normal development The frenulum is localized almost from the gums of the central dental units of the lower row to the middle of the tongue in the lower plane. It happens that deviations from the norm arise, and then they talk about its shortening. Two situations are considered under this diagnosis:

1. The length of the bridle itself is less than required.
2. Wrong location. That is, the absolute length of the frenulum remains normal, but due to the fact that it is not located where it should be, symptoms similar to the first option arise.

The problem can cause discomfort and cause various complications. Due to a short frenulum, infants are not able to latch onto the breast correctly. Having put in a lot of effort, the baby quickly gets tired and does not receive required quantity breast milk.

In older children, a shortened frenulum can cause problems with tooth formation. If short is upper frenulum, the formation of large gaps between the incisors and their sharp advancement forward is possible. If the lower frenulum is shortened, an incorrect bite is formed.

Another complication that pathology provokes is speech impairment. Children cannot pronounce certain sounds. It can be difficult to eliminate these defects.

Solution to the problem of short frenulum

This article talks about typical ways to solve your issues, but each case is unique! If you want to find out from me how to solve your particular problem, ask your question. It's fast and free!

Now there are two ways to correct the frenulum:

1. Conservative method. It consists of stretching the frenulum with exercises. This gymnastic complex is taught by a speech therapist. Exercises will have a positive effect if you do them correctly and regularly for several months. Due to anatomical features, this approach is applicable exclusively to the frenulum under the tongue.
2. Plastic surgery of the frenulum of the tongue. This surgical method boils down to cutting the frenulum. The correction is carried out regardless of age, both in adults and in newborns, infants and preschool and younger children school age. If the short frenulum does not affect the formation of the bite, the pronunciation of sounds and does not cause other problems, you can do without surgery and plastic surgery.

Conservative treatment: exercises for stretching the frenulum (video)

Conservative treatment includes a set of exercises and a special massage prescribed by the doctor. Before performing gymnastics, it is recommended to perform a preliminary massage to help stretch the soft tissues.

To this end, you should:

• gently move the tongue by the tip up, to the sides and forward;
• stroke the bridle from bottom to top with your finger.

After the procedure, you should proceed to perform simple, but effective exercises which are carried out 2 times a day every day:

1. Maximum relaxation of the tongue. Place it on your lower lip. You need to hold it in this position for 10 seconds, then repeat the approaches twice more.
2. Stick your tongue forward out of your mouth as far as possible. A 10-second fixation in this state is required. Perform 3 approaches.
3. Using your tongue to trace your lips in a circle.
4. Clicking your tongue for 10 - 13 seconds.
5. You need to slowly move the tip of your tongue across the palate, while opening your mouth wide. The direction of movement is from the teeth to the throat.
6. Fixation of the tongue on the palate behind the teeth. In this case, you need to try to open your mouth as wide as possible.

Massage is not always enjoyable; sometimes it can be painful for the child. However, the effect of massage is always significant. To carry it out, your hands must be clean. You can find many videos showing both exercises and massage, but it is better to entrust children to a professional and go for a consultation so that he can show what and how to do correctly.

Surgical treatment: frenuloplasty

The operation to trim the frenulum is one of the most common and easiest. She has no age restrictions. It is performed on a newborn in the maternity hospital. Cutting the frenulum before 9 months of age does not hurt at all, since in children of this age it does not yet have blood vessels and nerve endings. For the same reason, there is no blood at all during pruning. The rehabilitation period takes a couple of hours.

Most favorable time For frenuloplasty of the frenulum of the tongue in children, the age is considered to be 5–8 years, when all of their baby teeth have not yet been replaced. The dissection is performed in a hospital setting under local anesthesia using electric scissors or an electrocoagulator.

However, technology does not stand still, and traditional tools such as scalpels and scissors are being replaced by lasers. Laser oral surgery has many advantages:

1. No stitches required. The laser not only makes an incision, but also vaporizes areas of tissue, which leads to the closure of the wound.
2. There is no blood during surgery.
3. Carrying out simultaneous trimming and sterilization of the edges of the incision.
4. Baking affected vessels after tissue cutting.
5. The wound heals faster after laser surgery.
6. Minimal risk of complications.
7. A more comfortable process of plastic surgery for a preschool child.

More about the operation

There may be three options to solve the problem:

1. Frenulotomy. This type of trimming is done to increase the length of the frenulum.
2. Frenectomy. The frenulum is trimmed when it is almost completely excised.
3. Frenuloplasty. During this surgery, the attachment site of the frenulum in the mouth is changed.

Carrying out such a simple operation allows you to solve many problems associated not only with discomfort. If you do not take appropriate measures in a timely manner, this can lead to improper formation of the dentition and the development of problems with speech function.

Preparing the child

No special measures are required to prepare the child for surgical intervention with such a correction. Effective method prepare the organ - perform gymnastics, which includes the same set of exercises as for conservative stretching.

Sometimes the doctor prescribes laboratory and instrumental tests before surgery:

It is also always worth taking into account the emotional component and how the little patient will behave. For the procedure to go smoothly, the little one must be well-fed and well-rested. Then he will more easily endure a stressful situation, which is plastic surgery.

Carrying out the operation

The operation is performed in the office of a dental surgeon. First, the patient is given an anesthetic injection, after which the doctor, having pulled the desired fold, makes a small incision with a scalpel. Then it’s time to apply small stitches to the edges of the wound. There is no need to remove them, as after a while they dissolve on their own. If they resort to more modern technology and use a laser, then there is no such step as suturing. This promotes rapid healing of exposed tissues.

Postoperative care and possible complications

The procedure itself takes no more than 10 minutes. The wound after plastic surgery of the frenulum of the tongue heals within 24 hours, but for a few more days you should adhere to certain recommendations:

1. Nutrition. You should not eat too hot or hard foods for a couple of days.
2. Personal hygiene. It is important to implement more quality care behind the oral cavity.

After seven days the course is carried out speech therapy rehabilitation. It comes down to training and strengthening the muscle tissue responsible for linguistic mobility. Incorrectly pronounced sounds are set and reinforced.

The operation takes place without complications due to its ease and simplicity of the structure of the frenulum.
Unpleasant consequences may appear already in the postoperative period. The development of inflammatory processes in damaged areas is possible. Their cause is non-compliance with the rehabilitation rules established by the doctor. Sometimes a hard scar forms at the site of the incision. As a result, a repeat operation is required to eliminate it. However, this occurs mainly in adolescents and is very rare.

Is it possible not to cut the baby’s frenulum if there is evidence?

Some doctors believe that there is no need to trim the short frenulum, since it will stretch on its own with age. However, most experts do not share this point of view. Naturally, surgical removal is not always required. Plastic surgery is necessary only if the pathology negatively affects the newborn’s ability to suckle at the breast or the quality of pronunciation of sounds.

It can be prescribed by a speech therapist, orthopedist or dental surgeon if there are the following phenomena:

• malocclusion;
• displacement of dental units;
• blurred pronunciation that cannot be corrected by conservative methods;
• difficulties with breastfeeding.

Sometimes frenulum cutting is contraindicated. It cannot be trimmed if the baby has:

• oncological diseases;
• infections in the body;
• pathologies of the circulatory system;
• diseases of the oral cavity.

Why and when to trim the frenulum is up to the parents to decide. It is advisable to show the baby to several specialists before taking any action.

If a child has a short frenulum of the tongue, then experts may recommend surgery to eliminate this pathology. We have collected material about at what age this operation is performed, how to trim the frenulum of the tongue in different ways (laser, scalpel). Also from the article you will learn the answers to current issues about caring for a child after surgery.

At what age is tongue frenulum trimmed for children?

Table No. 1. Features of the operation to trim the frenulum of the tongue in children under 1 year old and older children

At what age is it better to have surgery to trim the frenulum of the tongue in children?

The optimal age at which a child needs to have the frenulum trimmed is selected individually. In most cases, the operation is performed before 1 year or immediately after the birth of the child directly in the maternity hospital. The earlier the frenulum trimming operation is performed, the easier it will be.

Dentist D.P. Yumashev about optimal age for performing surgery to trim the hypoglossal ligament in children over 1 year of age:

Indications for surgical intervention on the frenulum of the tongue are determined only by a speech therapist; he must give a written opinion. This is usually done at the age of 4-5 years. At an earlier age (for example, at 2 years), the child is unlikely to be able to study with a speech therapist, and without these classes there is no point in performing plastic surgery of the frenulum of the tongue.

Preparing for surgery to trim the frenulum of a child’s tongue: tests, examinations

Before performing the frenulum trimming procedure, no special preparatory measures are required. In some cases, the patient is asked to:

• pass general analysis blood;
• take a blood test for hemosyndrome (blood clotting);
• undergo fluorography.

But most often there is no need for this, since cutting the frenulum is considered a low-traumatic event.

The only advice that doctors give is to feed the child before the operation, since this procedure is stressful for the baby, and hunger causes additional discomfort.

What is the best way to trim the frenulum of the tongue - with a laser or a scalpel?

There are two ways to trim the frenulum: using a scalpel or a laser.

Table No. 2. Features of the operation to trim the frenulum of the tongue with a scalpel and using a laser

Each of these methods is effective and has its supporters and opponents, but the choice always remains with the parents. The price of the methods differs, but this difference is insignificant. You should always remember that saving on your child’s health is not worth it, so choosing a method based solely on cost is unreasonable.

After trimming a child’s tongue frenulum: proper care and possible problems

In rare cases, the following complications may occur after trimming the frenulum of the tongue:

• Unpleasant consequences of the operation may be small painful sensations that occur after the end of anesthesia.
• Sometimes in a child the temperature may rise . The reason may be the individual reaction of the body to the operation.
• After cutting the hyoid frenulum in adult children a scar may appear. IN In this case, it is necessary to perform the plastic surgery again.

Other complications may arise if the doctor's recommendations for postoperative care are not followed. The rehabilitation period after surgery lasts from 2 to 7 days. After this, you can return to the normal rhythm of life.

• carefully monitor oral hygiene;
• give up solid food;
• talk less, as the stitches may come apart.

After complete healing of the scar, speech therapists recommend that adult children do exercises for the muscles of the tongue and stretching the frenulum.

Dentist I.V. Solovyova gives the following recommendations for caring for an adult child after cutting the hyoid ligament:

1. In the first 2 hours after surgery, you are not allowed to eat.
2. In the next 3-4 days, it is recommended to exclude foods that irritate the gastric mucosa (sour, spicy, salty, hard) from the diet and maintain speech rest.
3. For 7 days, treat the oral cavity with antiseptic solutions after meals. Keratoplasty (Solcoseryl, sea ​​buckthorn oil and so on.).
4. In the future, special physical training is prescribed to restore tongue mobility.

Parents often have many questions about caring for their child after tongue tie trimming. The answers to the most popular ones are presented below.

How should a child feel after surgery? What's normal and what's not?

After cutting at a later age, when the operation was performed under local anesthesia, the child may experience slight pain and a rise in temperature. In this case, the doctor will prescribe painkillers to relieve unpleasant symptoms. In the first days, the baby will experience minor inconvenience due to stitches and refuse to eat. The reason for this behavior may be ordinary stress.

The child does not eat. What to feed and drink?

There are cases when the baby feels discomfort after surgery or is simply scared and may refuse to eat. In this case, you should try to feed him using a syringe (without a needle) or some other way so that he does not have to suck or eat from a spoon. Feed should be liquid food that does not require chewing. Immediately after surgery, it is recommended to give the baby breast milk, it acts as an antiseptic. It is necessary to carefully monitor the child’s oral hygiene. After eating, adult children should brush their teeth and rinse their mouths with furatsilin or a decoction of herbs with anti-inflammatory properties, for example, chamomile, sage herb, oak bark.

The child began to smack his lips. What to do?

In the first few days, the baby may smack his lips, in which case it is necessary to pay attention to the correct sucking of the breast or pacifier. If, a few days after the operation, the smacking has not gone away, you should consult a doctor; perhaps the cutting was performed incorrectly.

How long will it take to speak?

It is not recommended to talk much in the first few days. And on the first day after the operation you cannot speak. If stitches were placed, they may take longer to heal or simply prevent the child from communicating. Complete healing of the sutures occurs from 2 to 10 days after surgery, depending on the cutting method. During this period, you should put less strain on the tongue muscles.

What to do if the temperature rises?

If the temperature rises in the first hours after surgery, it is necessary to give the baby a mild antipyretic. You shouldn’t panic because of this right away; each body can react to surgery differently. If, a few days after the operation, the fever does not go away, you need to consult a doctor; perhaps the doctor performed the cutting with non-sterile instruments, and an infection was introduced.

A white coating and pus appeared under the tongue. What is it and what should I do?

Within a few days after the operation, a white coating may appear; in no case should you think that this is pus; thus, new mucous membrane begins to form. Regular rinsing allows you to remove plaque over several days. Pus can occur if the doctor's recommendations regarding oral hygiene are not followed. In this case, you need to consult a doctor.

What to do if your tongue is numb or swollen?

Numbness and swelling of the tongue is a normal reaction of the body. The discomfort should go away within 24 hours.

The child is capricious after the operation. What to do?

If the baby begins to be capricious and cry, in this case it is necessary to occupy the child with something, distract him and measure the temperature. This is normal, the baby could be scared, especially if the cutting was done at an older age. Any operation is stressful, and for children it is even more scary and unconscious.

What to do if the seams come apart?

Sometimes there are cases when a child falls and his stitches come apart, then you should immediately consult a doctor for re-suturing, otherwise the scar may become overgrown.

Children's dentist D.P. Yumashev:

Plastic surgery of the frenulum of the tongue is usually performed under local anesthesia, the usual “freezing” and lasts no more than 20 minutes. However, young children do not always allow this particular stage of the operation to be performed. Additional pain relief (eg Nurofen) is usually required in the first 4-6 hours after the procedure. In the future, we recommend a regimen of restriction on the intake of hard food for 4-5 days and active classes with a speech therapist on the 7th day.

Dental surgeon I.V. Solovyova about contraindications for performing surgery to trim the frenulum of the tongue:

Contraindications for surgery:

1. Oncological diseases.
2. Hematological diseases.
3. Acute infectious diseases.
4. Inflammatory diseases of the oral mucosa.
5. Presence of unsanitized lesions in the oral cavity.

Dentist S. I. Zaretsky:

Trimming the frenulum is a very simple operation. I would say that it’s too loud to call it an operation. The mucous membrane is slightly trimmed - a zigzag incision is made, not deep. The mucous membrane heals very quickly, no care is needed. Possible rinses with chamomile or sage. This can be compared to a slight cut on your finger. But the mucous membrane heals much faster than a cut finger. Literally in 2-3 days. This is provided that the child is physically healthy, has normal immunity, no systemic diseases type diabetes mellitus, bronchial asthma, tuberculosis and so on.

If the doctor has identified it through an examination, then you should not put off solving the problem indefinitely. The longer you delay solving this problem, the more serious the consequences may be and the harder it will be to eliminate them. Malocclusion, slow development, light weight and other consequences of a short frenulum can cause irreparable consequences for the development of your child.

Boy circumcision or circumcision is performed at an early age. To remove the foreskin, there must be compelling reasons for this - religious beliefs (Muslims, Jews), social and medical indications.

This procedure is performed under general or local anesthesia. At proper care There are no complications during the postoperative period. Today we will tell you why circumcision is needed, when it is performed and how to care for the penis.

Indications

Circumcision (circumcisio) is a surgical procedure where the foreskin of the penis is cut off and there are several ways to remove the skin.

In Russia and the CIS countries there is no such custom as circumcision in children, so health problems are a direct indication for the operation. Circumcision in some cases is considered the only way out intimate question future man.

For example, phimosis in a boy can manifest itself in constant inflammation, difficulty urinating, painful hygienic procedures, and in severe cases surgery cannot be avoided.

The religion of some countries involves the removal of the foreskin. Many people wonder why? First of all, get closer to the Almighty and become purer.
In some countries where there is a problem with hygiene, such as the African continents, circumcision is a necessary measure.

When smegma accumulates, bacteria begin to multiply, inflammation appears, which leads to more serious consequences. Care intimate area it becomes easier and more convenient for men.

How they do it

Children up to adolescence are given general anesthesia; children 1-8 weeks of age are not given any anesthesia; adults are given epitural or local anesthesia. By retracting the foreskin and fixing it with surgical clamps, cutting occurs like a guillotine.

Circumcision for a child and an adult lasts no more than 15-25 minutes, after which there is no need to stay in the hospital. After about a week, the stitches can be removed. All these days to take care of the wound so that it happens fast healing, splicing and preventing complications.

Why is it necessary?

What is this procedure for? Children are given medical indications when the condition requires circumcision.

• Elimination of phimosis, which interferes with the opening of the genital organ.
• Removal of the foreskin if it pinches the head of the penis.
• Inflammatory processes of the penis.
• Balanitis and balanoposthitis.
• Various formations on the genital organ (papillomas, condylomas).
• Pathological changes in the foreskin.

If there are indications, then do it at the age when the problem arose. For religious reasons, it is better to perform the operation on a newborn; their nerve receptors in the organ are not so pronounced.

In adolescents, the process of circumcision is a painful procedure, therefore it will be performed under general anesthesia and from a medical point of view it is not recommended to do this. The development of psychological trauma at this tender age is great.

The boy’s parents must decide on the operation and weigh the pros and cons. Many men, already in adulthood, undergo circumcision for aesthetic reasons; the ease of caring for the organ and the interest of the opposite sex increases significantly.

What age

Most best age for this manipulation up to 8-9 weeks from birth, when the baby does not understand the essence of what is happening. How older child, the more conscious the operation.

Stress, negativity and an imprint for the rest of his life are guaranteed for the boy. Especially if the parents made the decision, and not he himself consciously. But there are inevitable situations that can seriously affect the health of the future man.

If parents have not decided on circumcision until 3-4 years of age, then it is better to postpone it until 8-9 years. During this period, you can explain to the guy how important it is to have this procedure done to improve his health.

Circumcision can also occur after puberty, for example, if physiological phimosis occurs. Why wait so long? Because this condition may disappear as the boy grows up.

IN adolescence, according to statistics, is diagnosed in only 1% of children. The incurable form of phimosis is cicatricial, and surgery is mandatory.

For religious reasons, the age of circumcision often does not exceed 7-8 days from the birth of a boy.

How to prepare for circumcision

A specific operation is carried out in specialized clinics, where the necessary preparation is done before the procedure. The required tests are taken, a visual examination of the boy takes place, an anamnesis is collected, and the general condition of the child is taken into account.

These preparation measures are necessary to understand what anesthesia to use, whether there are contraindications, and whether it needs to be rescheduled for another period.

Preparation before surgery - hygiene procedures for the genitals; if there is hair, it must be removed. The reaction to anesthetics and painkillers must be checked.

How is it carried out?

This resection is performed by surgeons in clinics and outpatient clinics. After the manipulation, which lasts no more than 15-25 minutes, the little patient is sent home.

An anesthesiologist must be present at the operation; it is he who selects the correct dosage of anesthesia and monitors the child’s condition during circumcision. If the age is adult, then local or epidural anesthesia is performed.

Procedure steps:

1. Anesthesia.
2. Determination and delimitation of the cutting line.
3. The process of excision of the skin of the penis.
4. Stitching.

Local anesthesia - punctures the nerve fibers of the genital organ until complete loss of sensitivity. General anesthesia is administered intravenously by an anesthesiologist.

Epidural anesthesia is injected into the lumbar region by puncture, after which the effect of the medication is checked. How younger age, the less sensitivity of the nerve endings of the penis and therefore anesthesia may not be used at all.

Types of operation:

• Removal of the foreskin is minimal - the skin around the head of the penis is cut off.
• Partial resection, which exposes the penis by 1/3.
• Free look - a fold of skin is left at the base of the frenulum.
• The average is based on the constant opening of the head.
• Complete removal. The genital organ becomes visually smaller.

Modern medicine allows you to choose several possible operations - strip and laser. The second has more advantages, fewer complications and is easier to resolve recovery period. The downside is the cost, which is significantly higher than usual.

How to care

After the operation you need to create everything the necessary conditions, peace and comfort. And of course, the most important period is wound care. With proper therapy, recovery will be painless, without consequences and quickly.

What to do:

1. Quiet, little movement.
2. Treatment of the wound surface up to 6 times a day.
3. Wash your hands thoroughly before the procedure.
4. The bandage must be removed by first moistening it with hydrogen peroxide.
5. Wash the wound with potassium permanganate.
6. Recommended ointments for healing: Levomekol, Actovegin, Methyluracil.

After 7-10 days, the boy’s stitches are removed. The dressing process is completed. The doctor decides what treatment tactics will be next. Hygiene of the genital organ is an important condition for recovery. At improper care serious consequences may begin.

Complications

As a result of circumcision, the following sensations arise:

1. Pain in the area of ​​excision is considered a normal condition after surgery.
2. Swelling and increased sensitivity of the nerve endings of the penis.

With proper care, they become less intense every day. If the child has pronounced sensations, painkillers are prescribed. Swelling can be removed using chamomile or salt baths.

Reasons to see a doctor are:

• Obvious uncharacteristic swelling of the genital organ.
• Inflammatory process with purulent discharge.
• Body temperature exceeds 37 °C.
• Blue shade of the penis.

Do not prolong this condition, which can result in abscess and necrosis. Contact your surgeon immediately and do not self-medicate. Only a specialist can select antibacterial therapy for the boy.

Does it make sense to do surgery without an appointment? Doctors in Europe and America are clearly convinced that circumcision has many positive aspects.

But without obvious reasons, parents should not carry out this procedure on their child. Until he reaches adulthood and makes this decision on his own. Subscribe to our website. There is a lot of new information ahead. Be healthy!