Tongue-Tie in Children: When to Seek Treatment

Frenulum of the tongue

The child is over one year old and has started to make sounds.
Recently, it has been noticed that the tongue cannot fully extend.
A visit to a general clinic revealed that the issue is due to the frenulum under the tongue being too tight.
The doctor suggested a frenotomy to prevent future impacts on speech clarity.
Could you please advise which specialty to consult for this procedure and which type of doctor to see?

Ah Huadan, 20~29 year old female. Ask Date: 2002/09/12

Dr. Shi Zhongxian reply Pediatrics

Dear Mr.
Ahua,
I apologize for the delay in my response due to various matters.
I hope for your understanding! Regarding the issue of a short frenulum, our hospital's dental department (which is part of the oral medicine specialty) will handle it.
You may come in to schedule an appointment with the dental department.

Reply Date: 2002/09/12

More Info

Tongue-tie, or ankyloglossia, is a condition where the band of tissue (frenulum) that connects the tongue to the floor of the mouth is shorter or tighter than normal, which can restrict the movement of the tongue. This condition can affect a child's ability to speak clearly, eat, and even breastfeed in infants. In your case, since your child is already one year old and has started to make sounds, it's understandable to be concerned about how tongue-tie might affect their speech development.

When considering treatment for tongue-tie, it is essential to consult with the right specialist. The most appropriate medical professionals to evaluate and treat tongue-tie are typically pediatricians, pediatric otolaryngologists (ear, nose, and throat specialists), or pediatric dentists who have experience with this condition. These specialists can assess the severity of the tongue-tie and determine whether a frenotomy (the surgical procedure to cut the frenulum) is necessary.

The decision to proceed with a frenotomy often depends on several factors, including the degree of restriction caused by the frenulum, the child's age, and any associated difficulties with feeding or speech. If the tongue-tie is significantly impacting your child's ability to articulate sounds or if it poses challenges during feeding, it may be advisable to consider the procedure sooner rather than later.
In terms of the procedure itself, a frenotomy is typically a quick and straightforward outpatient procedure. It can often be performed in the office of a pediatric dentist or ENT specialist, and it usually requires only local anesthesia. The recovery time is generally short, and many children experience immediate improvement in tongue mobility.

It is also important to follow up after the procedure, as some children may need exercises or therapy to help them adjust to the increased range of motion in their tongue. Speech therapy can be beneficial if there are concerns about speech development following the procedure.

In summary, if you are considering treatment for your child's tongue-tie, I recommend scheduling an appointment with a pediatric dentist or an ENT specialist who has experience with this condition. They will be able to provide a thorough evaluation and discuss the best course of action for your child. Additionally, if you have any concerns about your child's speech development or feeding, do not hesitate to bring these up during your consultation. Early intervention can often lead to better outcomes, so it's great that you are seeking information and guidance on this matter.

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