Answer:

The lingual frenulum (tongue-tie) is a thin membrane located under the tongue, with one end connected to the floor of the mouth. Tongue-tie is a condition where the frenulum is short or attached to the tip of the tongue, hindering tongue movement and affecting the child's ability to speak, breastfeed, etc. The shorter the frenulum, the more severe the tongue-tie.

Tongue-tie in children is classified into 4 levels:

Level one, mild tongue-tie, the frenulum is about 12-16 mm long. The child's tongue can perform movements such as sticking the tongue out, touching the upper palate, and moving the tongue to the sides.

Level two, moderate tongue-tie, the frenulum is 8-11 mm long, limiting tongue movement, the tip of the tongue may not reach the upper palate.

Level three, severe tongue-tie, the frenulum is 3-7 mm long, the tongue has limited mobility. The child cannot stick their tongue out, move it to the sides, or lift the tip of the tongue.

Level four, complete tongue-tie, the frenulum is less than 3 mm long, the tongue is almost attached to the floor of the mouth.

Doctor Huong consults a parent. Illustration: Tam Anh General Hospital

Not all cases of tongue-tie require surgery. Children with level one and two tongue-tie are advised to be monitored as it does not significantly affect their daily life. Over time, the tongue may grow longer, the frenulum may thin, and the severity of the symptoms may decrease.

If the child's symptoms do not improve and progress to affect speech, breastfeeding, etc., the doctor will recommend a tongue-tie release. The timing of the procedure depends on factors such as the severity of the tongue-tie, difficulty breastfeeding, impact on pronunciation, lisping, delayed speech, and the child's overall health. With severe tongue-tie, parents should not wait too long, especially before the child starts speaking, as it can affect their pronunciation later on.

Typically, there is no age limit for a tongue-tie release. Children three months and older who are in good health may be candidates for the procedure. Currently, doctors use bipolar electrosurgery to perform the release, cauterizing the wound to minimize damage to healthy tissue and promote quick recovery. The entire process, from putting the child to sleep to completion, takes less than 10 minutes. You can take your child to an ENT (Ear, Nose, and Throat) doctor for an assessment and appropriate recommendations.

MSc. MD. CKI Nguyen Thi Huong

ENT Center

Tam Anh General Hospital, Ho Chi Minh City