Unfortunately, even parents who are not privy to medical subtleties are familiar with the opinion that a short frenulum of the tongue in a child is the cause of speech therapy problems.
Why "Unfortunately"? Because it is ignorance of the material that leads to a clear decision - the bridle needs to be trimmed! Do you remember in the film “Pokrovsky Gate” the characteristic female surgeon with her famous phrase “Cut!.. without waiting for peritonitis”? So the same thing often happens to the poor bridle. However, as experience shows, there is not always only one way out. Not every case of the so-called “short frenulum” requires radical measures.
What is a short frenulum of the tongue?
The frenulum is a thin partition that connects the tongue and the lower oral cavity. Normally, the frenulum is quite elastic, stretches well and is attached to the tongue in its middle part.
An abnormal structure may be the location of the frenulum closer to the edge of the tongue or even at its tip. In addition, a significant decrease in its elasticity, that is, its ability to stretch, is possible.
So in fact, the concept of “short bridle” is not entirely correct. Therefore, there is no clear solution to this issue.
Reviews
“We had plastic surgery on our daughter’s short frenulum of her upper lip when she was 6 years old. The procedure was recommended to us by a dentist at the Smile clinic. The whole process took literally a few minutes, they calmed my daughter down, gave her an injection in her gum, so there were no tears. Everything healed within 10 days, there were no problems or complications. Thanks to all the medical staff of the clinic for their professionalism and kind attitude towards children!” Maria, 30 years old
“Before correcting the bite, the dentist recommended cutting the frenulum, due to which there was a gap between my front teeth. Everything went quickly and painlessly. Now I recommend your clinic to my friends.” Olga, 27 years old
“My son had problems with diction due to a short frenulum of the lip. I was very worried about how he would cope with the operation, but the specialists at the Smile clinic quickly found an approach to him and did everything very well. Thank you!" Marina, 33 years old
A short frenulum of the upper lip is a condition that requires proper correction. Lip frenuloplasty is performed without pain and in just one visit to the dentist. The recovery period proceeds easily and without significant restrictions. At the Smile clinic we find an individual approach to patients of any age and in treatment we are guided only by proven, modern methods.
What is the problem with the incorrect structure of the frenulum of the tongue?
In infants, an abnormal frenulum structure can cause difficulty sucking. In this case, the problem is solved in the maternity hospital by pruning. If the baby is still able to eat normally, doctors try to leave the situation alone, giving, as they say, time to grow. Indeed, in many cases, along with the growth of the jaw, the frenulum gradually stretches and takes on a normal shape.
In older children, a short hyoid frenulum creates some speech therapy difficulties:
- Difficulties arise with the pronunciation of hissing sounds.
- Correct reproduction of sonorants is not possible.
To pronounce the so-called upper lingual sounds, you need to raise the tip of your tongue upward. An insufficiently elastic bridle prevents this from being done.
However, it is very important to understand that it is not “responsible” for all speech problems. So if a child has a delay in speech development, syllables and sounds are “confused” in speech, a limited vocabulary or other problems, a short frenulum has nothing to do with it. The speech therapist will suggest effective methods of correction.
Home correctional exercises
Where to start staging sound at home? First you need to prepare your lips and tongue using articulatory gymnastics, which you read about above. Once you have prepared the base, start staging. There are several effective ways to stage it.
From the sound "d"
Ask your son or daughter to say “d-d-d” loudly. The tip of the tongue rests heavily on the alveoli (tubercles on the roof of the mouth). You need to speak protractedly and without stopping. The tongue is pressed tightly against the tubercles. At some point, the tongue will begin to vibrate, and the baby will say “ddd-rrr.” A start!
Then you can complicate the task: add syllables in which the vibrant sounds hard: “dra”, “dru”, “dro”.
When the baby masters the skill, it’s time to introduce vibrant into speech. Move on to pronunciation of words: “dragon”, “fight”, “friendship”, etc.
Then replace the syllable “dr” with “tr”. Let the baby say the words “coward”, “throne”, etc.
The final stage is to turn off the sound “d”. Choose other words and phrases, for example: “thunder - grenade”, “ford - beard” and others.
Method of setting from the sound “zh”
If the baby pronounces “w” correctly, you can build on it. Ask your daughter or son to forcefully say “w” and at the same time move the tongue as far into the oral cavity as possible. You should get a single-stroke “r”. You need to repeat this exercise until it is fixed, and then, by analogy with the first technique, we bring it to automatism and introduce it into speech: we start from the syllable “zhr”, then “dr”, “tr” and further.
Method of setting from the sound “s”
If the baby pronounces “s” correctly, you can build on it. It is usually pronounced while exhaling, but when placing the “r” it must be pronounced while inhaling.
Ask your baby to say “sssssss,” then inhale a little through his mouth and press his tongue against the bumps on the roof of his mouth. It should look like a short "r".
The further scheme is the same as with other techniques.
Introduction of vibrant into speech
In simple cases, you can not only teach your baby to pronounce “r” on your own, but also introduce it into speech. To do this, first bring the isolated sound pronunciation to perfection. And then introduce it into speech using the following exercises:
- first the baby pronounces it in syllables;
- then pronounces it in words, with different syllables: “r” should be at the beginning, and in the middle, and at the end;
- connect stories, proverbs, phrases - this is the final stage.
Do all the exercises in the form of a game - this is how little children learn any material well. You will need imagination to captivate your son or daughter. Classes should be a joy for the little one, otherwise he will be tense and even the most effective exercise will not help achieve the desired result.
Why don't classes help?
For what reasons may difficulties arise in staging sound at home?
Firstly, the baby is not 4 years old. Before this age, it is pointless to even try to put “r”, since it simply does not exist and cannot exist - this is the pattern of speech development in children. It appears the very last. Parents, don't rush things!
Secondly, incorrect articulatory posture. Should be normal
the lips are stretched, the tongue is raised up, its tip is trembling, there is a strong directed air stream, the vocal cords are vibrating. Perhaps the baby is simply adopting an incorrect articulatory posture. If there is insufficient movement, the “r” will not give in to it.
Thirdly, improper breathing. To be able to pronounce “r”, you need a strong directed air stream that makes the tip of the tongue vibrate. If the baby does not distinguish between mouth and nasal breathing, you need to first work on this point.
Fourthly, unformed phonemic hearing. The baby may simply not yet perceive “r” by ear and, accordingly, cannot distinguish it either.
Fifthly, organic reasons. We are talking about the structural features of the facial apparatus - a short frenulum, a large or small tongue, for example. This also includes neurological disorders.
If you exercise with your baby at home, but the exercises do not produce results, consult a doctor. He will identify the cause and offer effective treatment methods for your child.
conclusions
If you notice that your preschooler has problems pronouncing “r,” contact a speech therapist. The specialist will conduct speech therapy tests, evaluate your child’s articulatory apparatus and identify the cause of the disorder in sound pronunciation. This will allow us to develop a correction program that will be effective specifically for your child.
You need to exercise regularly. As a rule, classes take place 2–3 times a week. But parents should also be involved in the process. You need to continue doing the exercises at home - then the result will not take long to arrive.
If a consultation with a neurologist or surgical intervention (for example, cutting the frenulum) is necessary, this will allow you not to waste time and quickly solve the problem.
Typically, parents of children aged 5 to 6 years turn to a speech therapist. But if you notice a problem earlier, don’t wait - go to a specialist. But you shouldn’t go earlier than 4.5 years either.
How to check if a child has a short frenulum
The presence of difficulties with the frenulum can be easily determined independently:
- Open your mouth slightly and place the tip of your tongue in the area behind your upper teeth. In this position, the place of attachment of the frenulum is clearly visible. If it is not “where it needs to be,” it is difficult to lift the tongue up.
- Pull your tongue forward. A short frenulum does not allow this to be done; in addition, the tip of the tongue visually looks forked
- Open your mouth and try to touch your upper lip with your tongue and lick it. Difficulties with the bridle make this movement difficult to perform.
Please note: sometimes a child cannot cope with these exercises not because there is something wrong with the frenulum. The cause may be weak muscles of the articulatory apparatus. Take a clean handkerchief and try to help your tongue. If resistance is felt when moving, then the problem is still in the hyoid frenulum.
Gymnastics for lips
The complex includes 3 exercises:
- "Let's smile!" The baby smiles, showing all his teeth. The duration of the approach is 5 seconds.
- "Tube". There are 2 variations of this exercise. The student stretches out his lips, imitating a tube, silently “reproduces” the sound “u” or closes his teeth and slightly stretches his lips forward so that a square is formed.
- "The doors are opening." The baby slowly opens his mouth so that there is a distance of 10 mm between the teeth of both jaws.
Then he smiles, showing his teeth.
Who to contact for help
Depending on the complexity of the situation, an orthodontist or speech therapist will help you cope with the problem. In any case, it makes sense to first get a consultation to decide what method of correction the child needs.
The dentist will carefully trim the frenulum, relieving the child of discomfort with one movement of his hand. However, recently doctors still recommend leaving surgical intervention as a last resort. An experienced speech therapist will offer a set of exercises and massage to stretch the frenulum.
Experts say that there are not many situations when the hyoid frenulum is absolutely unable to stretch. In almost all cases, a conservative approach achieves results.
Parents can evaluate the pros and cons of different approaches on their own.
Surgical method:
- A quick, radical solution to the problem.
- The operation is performed using anesthesia.
- The healing process takes some time and is uncomfortable.
- Dietary restrictions due to surgery.
- It is advisable to maintain vocal rest for several days.
- Psychological trauma in the child is possible.
- After the operation, classes with a speech therapist are necessary to correct sound pronunciation.
Frenum stretching method:
- Conservative, does not cause psychological difficulties in the child.
- Effective in most cases.
- Does not require changes to your usual routine.
- It takes some time (several months).
- Requires discipline and regular practice.
In any case, to resolve the issue, you need to consult a speech therapist.
Dental therapist's opinion
Frenuloplasty is a simple operation that will help the child avoid many unpleasant consequences for health and speech. Many parents do not take this condition seriously and delay visiting a doctor. However, you need to understand that a short frenulum when changing the bite can disrupt the normal growth and relationship of the teeth. Today we use gentle techniques and high-quality anesthesia, so the entire process for young patients is painless and in a comfortable atmosphere.
How long will it take to heal?
After plastic surgery of the frenulum of the lower lip, the rehabilitation period takes up to two weeks, and the wound on the upper lip heals in just a few days. In the first case, anti-inflammatory treatment is often prescribed to ease the postoperative period and eliminate the risks of complications.
To avoid injury and the risk of infection, thorough but gentle oral hygiene twice a day is necessary. You should avoid hard and hot foods in your diet, and rinse your mouth after eating. Parents are advised to pay closer attention to the cleanliness of their child’s hands.
Return to list of articles
Are there any contraindications?
When deciding whether to undergo lip frenuloplasty, the doctor will definitely assess the risks and check for contraindications. There are few of them, since the operation is considered minimally invasive:
- recurrent pathologies of the oral mucosa;
- tendency to develop keloid scars;
- bleeding disorders;
- inflammatory diseases of the jaws;
- decompensated forms of chronic systemic diseases;
- general disorders - mental disorders, cerebral pathologies, oncological processes, exacerbations of chronic diseases.
At what age should this be done?
If we talk about a non-surgical method for stretching the hyoid ligament, it is effective up to the age of 5 years with constant and regular training.
The operation as a whole has no restrictions and no special recommendations about at what age it should be done. Each stage of development of a child’s body requires one of several ways to correct this ligament. Thus, newborns undergo a dissection of the frenulum, and already at the age of 2–3 years, when the tissue of the ligament becomes denser, the need for sutures arises. Sometimes it may be necessary to remove some of the ligament tissue. Laser surgery has no age restrictions.
To avoid the formation of malocclusion and displacement of the dentition, it is advisable to correct the frenulum before the molars appear.
