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Treating Abnormal Frenum Attachments in Infants Treating Abnormal Frenum Attachments in Infants

Author(s):

Fred Margolis, DDS

Date Added:

1/2/2008


Summary:

Ankyloglossia is a developmental anomaly of the tongue characterized by a short, thick, lingual frenum resulting in limitation of tongue movement. The severity of the short frenum is variable and ranges from a light degree without clinical importance to a complete ankyloglossia with the tongue fixed to the floor of the mouth. Ankyloglossia can lead to breast-feeding problems, atypical swallowing habit, speech problems, as well as preventing mouth cleaning of the buccal vestibule. The tongue-tie can also favor orthodontic and orthopedic anomalies. Ankyloglossia can“be diagnosed when the length of the free-tongue (length of the tongue from the insertion of the lingual frenum into the base of the tongue to the tip of the tongue is 16 mm. or less.” Wallace and Clark concluded that the “benefits of breast feeding are well know and lactation consultants are becoming more aware of tongue-tie as a treatable cause of breast feeding difficulty.” Dollberg, et al, stated; “Ankyloglossia occurs in nearly 5% of neonates…” They further state that there was a significant decrease in nipple pain after frenotomy in breast-fed infants with ankyloglossia. They concluded that “frenotomy is an effective therapy for these difficulties.” Ballard et al, described the Hazelbaker assessment tool for lingual frenum function. They state; “in children older than four months, anesthesia is usually required because of the infant’s strength and awareness. In early infancy, however, the procedure may be accomplished without anesthesia and with minimal discomfort to the infant.” Gontijo, et al, described a case of a labial frenum in an infant necessitating the frenectomy procedure. The purpose of this article is to present two cases where infants exhibited frenums that were abnormal which resulted in difficult nursing. Surgical treatment with an Erbium laser was utilized to incise the frenum to release the tongue.

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