Monday, October 31, 2011

Are You Tongue Tied? Would You Benefit From A Lingual Frenectomy?

TEST YOURSELF:   Open wide! Now while keeping your mouth wide open, see if you can touch the roof of your mouth with the tip of your tongue. If you can't, this variation of normal is referred to as "Ankyloglossia" or being "tongue-tied".

  If it is significant enough I sometimes recommended having a procedure called a lingual frenectomy done to improve the range of motion of the tongue to allow the teeth/jaws to spontaneously improve and resume more ideal normal growth. There is also a long-term benefit in promoting long term improved stability after braces.

  The tongue is one of the important muscles that influences the alignment of growing teeth. If it is restricted in its range of motion the upper jaw may develop narrower than the lower jaw causing the back teeth to bite incorrectly in what is called a "crossbite". It may also not push on the back of the bottom front teeth hard enough to balance the pressure from the lower lip, causing them to crowd and twist. 

  In significant cases, a lisp in speech may be audible which frequently improves the same day as the frenectomy is done to correct it.

Below are before and after pictures of Luke, a 7 year old boy who had a moderate case of ankyglossia (tongue-tie).

Moderate tongue-tie which was
 causing his lower teeth to lean inwards.
Because the patient's lower front teeth are tipped backward, the lingual frenectomy allowed the tongue the freedom to rest against them a little harder and push them outwards. The pressure that the tongue naturally places on the front teeth is minimal but constant,  which encourages the teeth to shift forward and improve their positions.

Actual picture of Luke 1/2 hour after 
having the procedure.

In this case, the lingual frenectomy was performed with a laser, which resulted in the patient leaving the office with little discomfort, no stitches and no bleeding. One half hour after the procedure, the patient was happily enjoying ice cream and then went to baseball practice.

36 hours post operative. Luke experienced
a slight itching sensation as the tongue healed.

The healing continued throughout the next week with no real discomfort and a minimal itching sensation for about two days. By the end of the second week, the area was completely healed and there was little noticeable evidence that the procedure had taken place. The cells of the mouth completely renew themselves every 2-3 weeks, so there is no scarring.