Sunday, February 3, 2008
Tongue Clipping
Okay, everyone. Why is it that people like to ask me the difficult questions that I don't really remember learning except that it is controversial? My VT companion was asking my advice as a speech pathologist, on whether or not she should get her daughter's tongue clipped. Her tongue is "tied" to the point that her tongue tip is shapped like the end of a heart. She said that she didn't have problems nursing and that she thinks she is able to put it to the top of her mouth (for the alvelors) and stick it out a little. She would prefer not to clip it but I think she is willing to do whatever is best! As any mom would. So would do you know about it? I told her I would ask you all and do some research, so if you have any knowledge in this area, please, please enlighten me
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9 comments:
Have you heard her little girl talk? Well I don't know if this is right, but I don't think it would be necessary unless it is negatively affecting her speech. So if she move her tongue far enough to make the sounds correctly, I don't think I would recommend it.
this is so ironic! i was just reading a breastfeeding book about this. literally. seconds before i saw this post. i tend to agree with suzy (go suzy!). if it's not bothering her, why bother? oh, and the book i was reading said that this condition can make breastfeeding VERY painful, so i'm surprised that it didn't hurt her. it also said that many pediatricians are unwilling to do the clipping when the child is very young, but that the procedure is very short and only like a few drops of blood (for babies at least). hope you find your answer!
I don't really have much to back up my opinion, but I agree with the previous comments in that if it is not causing a problem then why fix it? Is she old enough to talk yet? My cousin has a pretty long lingual frenulum (she can barely stick her tongue out between her teeth) and she doesn't have any speech problems. As a side thought, does anyone else feel totally wierd when people ask them questions "as a speech pathologist"? I still sometimes feel like I am not the real deal :)
Hi guys,
I've done a bit of research on this since my oldest is tongue-tied. He failed at breast-feeding because 2 pediatricians told us not to clip. I wish we had.
For someone who CAN bf, there's no solid research saying that it's better to clip, but it's worth reading this pediatric dentist's observations: http://www.brianpalmerdds.com/. He's made a life study out of frenulums. frenuli. What would that plural be, anyway?
He says that a shortened frenulum can lead to all sorts of problems in dentition (crooked teeth surrounding the tie)and claims that it can even affect eating and digestion later on. He also notes that clipping doesn't alway solve ankyloglossia issues b/c the tie can just be a manifestation of a deeper musculo-structural problem (I think he said that main fan-shaped tongue muscle is sometimes too short. What's that called again? - sorry Dr. Nissen)
Here's a link to a full study in the Journal of Pediatrics (or whatever the AAP's Journal is called): http://pediatrics.aappublications.org/cgi/content/full/110/5/e63.
It has a cool full-scale test you can do on an infant to evaluate tongue-tie severity. It helped when my 2nd was born b/c he had feeding issues but was not TT'd like his brother, according to the test.
Oh, and one more note about TT and structural stuff is that often you can have co-occurring labial tie on the top or bottom labial frenuli or on both. My sons both have it, and it stinks b/c the frenulum actually runs from the top point of connection all the way down and between their two front teeth on the top and bottom (or down around the top gums in little Oliver's case - no teeth yet, thankfully!). They say that the frenulum being out of place there can cause suction issues for babies feeding, too.
It's not too big of a deal if the baby can feed, and lots of tt'd adults can speak w/o impediment, I think the only other main issues are dentition, playing certain wind instruments, and licking ice cream cones :)
Anyway, I hope some of this helps.
LMK if my quick explanation didn't make sense. I'm not used to talking about stuff like this anymore :)
-Tiff
Oh, and one more residual issue of not clipping that I remembered is a possible swallowing issue. If the frenulum doesn't loosen up enough, the person is usually not able to pull the tongue up and back during a swallow and ends up presenting with tongue-thrust. Clipping when an infant is the best time to do it since there are nearly no nerve endings and is barely even vascularized at that point. After infancy if the need becomes apparent for it to be clipped it gets a bit more invasive with anesthetics and stuff. So since you don't know if the child will need it or not in the future, it's kind of safer to clip it early while it's not painful and very inexpensive. The only problem is finding a pediatrician that will do it b/c they seem to be sadly undereducated on TT. (the only longevity study I found was the observational one from the pediatric dentist).
Wow Tiffany you sure know your stuff! Living proof that the experience of being a mom makes you 10x smarter than grad school ever will! Once again an affirmation to my daily thoughts of "what am I doing"? (In reference to being an SLP rather than a mom right now :)
i wish i felt like I knew that much about any subject. kudos tiffany.
Thanks for the input. I will definitely pass it along.
So I know this is an old thread, but I wanted to add that a lot of Dan's relatives have upper labial tie and it causes the adult teeth to grow in around it, either leaving a big gap or, as in my mother-in-law's case, a funky little hole where the teeth grew around the frenulum and met again a bit below it. They've all said they'd rather it wasn't there. I also know a woman in my ward who got it scraped out -yikes!- as an adult and said it was pretty painful but that she was glad she did it.
Anyway, I'm taking both my boys to a pediatric oral surgeon soon here to see what it would be like to have both of their ties fixed, so I can update later with that info if anyone's interested.
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