Tongue-tie, a congenital anomaly, occurs when the lingual frenulum—a thin membrane beneath the tongue connecting it to the mouth's floor—is either too tightly attached or unusually short. Doctor Nguyen Duc Ngoc, a second-degree specialist at the Ear, Nose, and Throat Center, Tam Anh General Hospital, Ho Chi Minh City, explained that this condition is often detected shortly after birth or when a child begins to eat and speak.

The condition restricts tongue movement, preventing it from extending fully and significantly affecting pronunciation. For Nam, this resulted in a prolonged lisp and difficulty with sounds requiring tongue curling. Over time, untreated tongue-tie can cause the frenulum to thicken, spread, and adhere more firmly to the underside of the tongue, exacerbating symptoms.

Early intervention for tongue-tie is crucial, as a frenectomy performed at a young age significantly aids language development, according to Doctor Ngoc. However, milder forms of the anomaly may not severely impact eating or pronunciation, often leading to them being overlooked or misidentified as a general speech impediment. This often results in the condition only being diagnosed in adulthood.

Doctor Ngoc is consulting with Nam. Photo: Tam Anh General Hospital

Nam underwent a frenectomy, where Doctor Ngoc used a bipolar electrocautery device to cut the mucosal tissue. This method effectively stopped local bleeding, and the procedure was completed in approximately 5 to 10 minutes.

Post-procedure, Nam's condition was stable, allowing for same-day discharge. He could resume normal eating and drinking without speech restrictions. Patients receive daily oral hygiene instructions, including rinsing with saline solution after meals to maintain a clean oral cavity. They are also advised to brush gently, avoiding the surgical site, and to drink water frequently to promote cleanliness and aid recovery.

Doctor Ngoc emphasized that long-term tongue-tie often leads to ingrained incorrect pronunciation habits due to prolonged restricted tongue movement. While the tongue gains flexibility post-procedure, the brain and muscles need time to adapt to new movement patterns. Consequently, Nam must continue with specific tongue exercises and pronunciation drills to refine his speech.

Simple exercises are key to this adaptation: extending the tongue and holding it for several seconds; moving the tongue from side to side for increased flexibility; and touching the tongue tip to the roof of the mouth or the inner surface of the front teeth. Practicing sounds that require tongue curling, such as l, n, t, d, and r, further helps the tongue muscles adapt to their new range of motion.

Doctor Ngoc strongly recommends performing a frenectomy within the first 3 to 6 months after birth or before a child starts speaking. Delaying the procedure increases the risk of speech impediments and unclear pronunciation. Infants with tongue-tie frequently struggle with feeding, exhibiting difficulties moving their tongue from side to side, lifting it to the upper jaw, or extending it beyond the lower jaw. A characteristic sign is the tongue tip being pulled downwards when the infant cries or attempts to stick it out.

Uyen Trinh

*Character's name has been changed