The sublingual frenulum is an anatomical structure that joins the tongue (ventral area) to the floor of the mouth.
On the other hand, ankyloglossia is an anchored tongue, that is, a tongue limited in its movement by a short, poorly inserted and inelastic frenulum.
Classically, 4 types of ankyloglossia are established:
- Type I: Very anterior, very limiting and should be intervened.
- Type II: Somewhat more posterior than type I. It is very limiting and should be intervened.
- Type III: Posterior to the tip of the tongue. Limiting, so that intervention should be evaluated, but it is recommended.
- Type IV: Submucosal and difficult to identify. It is limiting and needs exhaustive evaluation, because it may not be necessary to intervene. However, if it generates problems, it should be evaluated and followed up in case of not intervening.
When is frenulum surgery necessary?
- Types I and II should always be operated.
- Types III and IV should be operated according to assessment. It will depend on several factors, depending on the age of the patient. These factors can be: feeding problems (babies), damage to the mother during breastfeeding (cracks, mastitis…), limitation in the placement of the tongue when sleeping, rotacism (problems in pronouncing the R), problems in the pronunciation of other phonemes…
How is surgery for ankyloglossia performed?
It is a minor intervention, which consists of cutting the frenulum that anchors the tongue and ensuring the release and mobility of the tongue. Depending on the age and type of intervention, stitches may be necessary.
In infants it can be performed in the office with topical anesthesia.
After the intervention, should I do anything else?
I know, this intervention requires some aftercare. This care will depend on the age of the patient and, therefore, on the type of intervention that has been performed.
In infants, it is necessary to perform a series of exercises to prevent poor healing (which can leave the tongue more anchored than it was before).
The approach must be comprehensive, several revisions must be made for an adequate follow-up and the collaboration of other professionals such as physiotherapists, osteopaths, dentists and speech therapists may be necessary.