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Please can you help me, how do I start, which hospital can it be done and the cost involved please?

Worried lady.

 Dear worried lady, I reproduce the article on tongue tie for your benefit. It is difficult to determine where your problem actually lies- speech? Lisping? Oral hygiene challenges or gap in your teeth?

Tongue-tie is a tight piece of skin that hang between the underside of their tongue and the floor of their mouth. It is medically known as ankyloglossia, and the piece of skin joining the tongue to the base of the mouth is medically called the lingual frenulum.

It is a frequent complaint encountered at the newborn clinics where mothers always ask on way forward. It is a birth defect that affects approximately 10 per cent of newborn babies. It is more common in boys than girls statistically.

A lot of babies with tongue tie grow normally without any problems but in a few, the thick short frenulum impairs their ability to protrude the tongue.

These babies tend to have problems with breastfeeding. To successfully breastfeed, the baby needs to latch on to both breast tissue and nipple, and the baby's tongue needs to cover the lower gum so the nipple is protected from damage.

Babies with severe tongue-tie are not able to open their mouths wide enough to latch on to their mother's breast properly. They tend to slide off the breast during feeding and bite on the nipple with their gums for support.

This is very painful and the mother's nipples can develop sores as a result. In most cases, the feeding difficulties result in failure for the baby to gain weight.

Tongue-tie can also interfere with the ability to make certain sounds and I believe this where your interest lies — such as "t," "d," "z," "s," "th" and "l."

It can be especially challenging to roll an "r" making it difficult to pronounce certain words. In addition, the clarity of speech becomes a problem. Children with severe tongue tie usually lisp when speaking with its resultant psychological effects on a growing child.

For an older child or adult, tongue-tie can complicate oral hygiene — making it difficult to sweep food debris from the teeth. These debris stay in the teeth, are acted on by bacteria and contribute to tooth decay and inflammation of the gums and in some cases bad breath results.

Tongue-tie can also lead to the formation of a gap or space between the two bottom front teeth (lower central incisors). This may cause aesthetic problems in later life particularly in females.

Tongue-tie can also interfere with activities such as licking an ice cream cone, licking the lips, kissing or playing a wind instrument.

For an older child or adult, tongue-tie can complicate oral hygiene 

At your age, if the tongue tie needs to be dealt with, you would need a procedure called frenuloplasty. Frenuloplasty is done under general anesthesia with surgical tools. After the frenulum is released, the wound is usually closed with sutures that absorb on their own as the tongue heals. Complications of the procedure includes bleeding and infections.

Now to your specific questions. If your problem with tongue tie is about speech and lisping, then you may need an Ear, Nose and Throat surgeon who would evaluate your speech and chart the best way forward.

On the other hand, if it is issues with dental hygiene or gap in the tooth, then the dentist office would be the best place to start from.

No specific hospital is best poised but you can start with a general doctor who can then direct you to appropriate subspecialty after assessment. Unfortunately, I cannot help with the cost as different specialties charge differently.

astom2@yahoo.com
A member of the Paediatric Society of Ghana.