Tongue-stick disease: what you need to know

Tongue adhesions in children is a birth defect that is not uncommon in infants. However, this is an abnormality that is often not detected early. Babies are often not detected early in the first months after birth. When parents find the baby difficult to suckle, difficult to pronounce or gain weight slowly, they will gradually detect it. So let's learn with SignsSymptomsList about tongue-sticking to detect it early if your loved one has it.

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• 1. General information about tongue-tie 
• 2. Epidemiological features of tongue-brain adhesions
• 3. Graduation of tongue brake
• 4. Characteristics that can be encountered in people with tongue-tie
• 5. How to diagnose a tongue tie?
• 6. How will tongue adhesions be treated?
• 7. Do you need to worry too much about your tongue sticking?
• 8. When do you need to see a doctor for advice on tongue adhesions?

1. General information about tongue-tie 

Tongue adhesions is a small birth defect in the lingual brake (or tongue brake, tongue brake). In this case, the lingual cord will be abnormally short, thick, or strong, limiting the tongue's movement or pulling the tongue close to the floor of the mouth.

Tongue adhesion can affect eating, speaking and swallowing in children. This malformation occurs in 1-10% of the population.

2. Epidemiological features of tongue-brain adhesions

Adhesions of the tongue are more common in boys than in girls (from 1.1:1 to 3:1). Most cases are thought to be random rather than genetic. It is also often present alone, although it is sometimes associated with other abnormalities such as cleft palate or mutations in the TBX22 gene.

3. Graduation of tongue brake

There is currently no precise definition for tongue-tie and many grading tables exist. Among them, Kotlow's grading table is the easiest to use and the most popular. Specifically, the length of the movable tongue part in a normal newborn will be more than 16mm. From there, Kotlow's grading table divides into the following forms:

• Grade I: mild tongue adhesion when the tongue is moved from 12 to 16mm
• Grade II: moderate adhesion when the blade moves from 8 to 11mm
• Grade III: severe adhesion when the tongue is moved from 3 to 7mm
• Grade IV: complete adhesion when the movable blade part is less than 3 mm

However, Kotlow's grading scale is not useful in older children, when tongue function also needs to be assessed. There are children with tongue adhesion according to Kotlow classification but function is completely unaffected. Since then, Hazelbaker has graded tongue adhesions based on anatomy and function to make recommendations on whether to perform the procedure or not for each case. 

4. Characteristics that can be encountered in people with tongue-tie

Clinical manifestations of tongue adhesions are quite diverse. Some of the typical signs in children with tongue-tie can help you recognize them early, such as:

• Baby has difficulty suckling
• The child's tongue is abnormally short
• My tongue can't move side to side
• Unable to raise tongue to reach upper jaw
• When a baby cries, the tip of the tongue often has the shape of the letter V
• Your baby's tongue can't come out from the lower jaw by about 1–2mm.

Tongue adhesions not detected early can cause disadvantages for children. The ability to suckle milk is the most concerned issue. Babies may suck less due to prolonged sucking time, difficulty latching on to the nipple, milk flow when suckling, leading to delayed weight gain. Besides, it also increases the risk of nipple pain for the mother.

The baby has difficulty suckling because the tongue is stuck.

As children get older, tongue-tie can affect speech development. Children will have difficulty pronouncing words such as: l, r, t, d, n.

It is not yet possible to predict the effects of tongue adhesions or which patients will be affected by it. Other problems in patients with sticky tongue include difficulty eating certain foods such as ice cream (not lickable), playing certain musical instruments (flute, trumpet, etc.), and some dental problems.

5. How to diagnose a tongue tie?

Diagnosing tongue adhesions is not difficult. However, the issue of treatment is controversial, which also makes it difficult for young parents to have many opinions. The best approach for the clinician is to assess the benefit of this treatment for the patient. If tongue adhesions do not cause any problems during infancy and infancy, follow-up observation is the best option. If tongue sticking is the cause of difficulty eating and sucking in children, the tongue brake should be cut for the child. For older children, problems with pronunciation, making treatment decisions will be more difficult, children need further evaluation with a speech therapist.

6. How will tongue adhesions be treated?

6.1 Follow-up evaluation

The biggest question for doctors when treating patients with sticky tongue is whether to treat it or not. There is a lot of evidence that supportive treatment is also effective in patients with sticky tongue. Doctors need to rule out other possible causes of poor feeding or delayed weight gain in babies.

6.2 Performing minor surgery

Once a decision has been made to treat rather than observe, the patient will undergo a tongue brake – the most common procedure used to treat tongue adhesions. Applicable to outpatients.

The doctor can conduct tongue cutting for pediatric patients to treat

Complications and risks of tongue brake ablation are rare. Bleeding after resection is the most common complication but is easily stopped with local compression.

Another treatment for tongue adhesions is tongue brake orthotics. However, this procedure is rarely performed and requires anaesthesia.

6.3 Care after surgery

Parents need to monitor

• Usually, after surgery, there is usually a white spot at the spot where the tongue is cut, which is a normal development after laser surgery, parents should not be too worried, these phenomena will go away and the lesions will disappear. heal after a few weeks.
• It is necessary to monitor the child's care, do not let the child suck or bite hard objects to avoid bleeding, do not let the child touch the surgical area to avoid infection. Give your child the medicine prescribed by the doctor.

Nutrition for babies

• After surgery, the child can drink milk or eat liquid, soft and cold foods.

Clean your mouth after eating and practice tongue movements

•  Let your child drink plenty of water to clean his mouth
•  Older children: Instruct children to move their tongue right after surgery, bend their tongue upwards, and stick their tongue out.
•  Young children: Sanitize under the tongue, raise the tongue upwards
• After the wound heals, the child should be guided to perform tongue movements, helping the tongue to move well.

7. Do you need to worry too much about your tongue sticking?

Tongue adhesions generally have a good prognosis, patients can develop completely normally. In some cases, children may have low self-esteem, but they are also easily treated with psychotherapy.

8. When do you need to see a doctor for advice on tongue adhesions?

Please take your baby to the doctor and consult with the doctor when you see

• Your baby is having trouble sucking because a sticky tongue tie becomes a hindrance.
• The baby has difficulty speaking because the tongue is not flexible
• The baby's eating, drinking, swallowing... is having problems.

Thus, through this article, SignsSymptomsList hopes to provide useful information to help you identify children with tongue-tie. Adhesions on the tongue can affect a child's nutrition and speech if not detected early. Surgery is not the only indication in the treatment of laryngeal adhesions. Therefore, when your child has a tongue tie, take him or her to a medical facility right away. Doctors will give advice and solutions that are best for your child.

See more: When is vomiting in babies unusual?

Dr. Huynh Thi Nhu My