This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Tongue Exercises for Restricting Frenum
By Pam Marshalla
Q: Are there any exercises one can give to extend the tongue frenum instead of having the client get a frenectomy? Are these exercises are proven scientifically?
From long ago, therapists have said that “tongue exercises” could stretch the frenum, but I have never seen anyone spell out what those exercises would be, nor have I seen any data that would prove that any certain exercises do help.
My own personal experience is this: Clients tend to move their tongues less than they actually could when they have a restricting lingua frenum. In other words, the frenum restricts their movement, and they move it even less than that. Perhaps it actually hurts to move the tongue much when a frenum is tight because of the pull it puts on the skin.
In my experience, activities to get the tongue to move more actually do work. But they only help the client stretch his tongue as far as he actually could, given his structural restriction.
In my experience, only the frenectomy completely frees the tongue.
Pam, this has been my experience as well. I see many OMT pt.s with this problem and always refer them to either an ENT or Oral Surgeon. Unfortunately, the doctors never see the problem, even if the child has an obvious tongue thrust in speech and tongue thrust swallow secondary to a restricted frenum. Any thoughts about how to better educate MDs without stepping on their toes?
Getting Docs to open their eyes is a lifelong endeavor. I have done some basic in-servicing with some docs that helped, and what they responded to the most was photographs of tongues. Over the years I have collected dozens of photos that show how the tongue should work and what the tongue looks like when it is restricted. Go on-line and simply google “tongue” and “retstricting lingua frenum” and click on “images” to begin to collect pics you can use. These along with actual sound production activities can help doctors, nurses, dentists, orthodontists, parents, and other begin to understand what you are talking about. The info has to be visual, not just auditory.
Great ideas, Pam! What I think is important to point out too, is that just because a restricted frenum is not deemed “severe” that it can still significantly impact speech and swallowing. With my patients’ permission and authorization, I would love to show the docs via video just what happens. Thanks for your input and your wonderful work.
I’m working with a 3 year old student who is able to articulate speech sounds and is making nice progress in therapy (she’s been in therapy for 5 months). Her dentist is wondering if a frenectomy is needed, however he also was surprised at her ability to move her tongue tip. Are you saying surgery is still recommended? It doesn’t look pretty, but seems to be functional?
Speech isn’t the only reason for a lingua frenectomy. A sample letter I wrote might help you think this through. Go to–
http://www.pammarshalla.com/blog/2009/02/frenectomy-sample-physician-referral-letter/
For years I have had a gap between my front tooth since a child, and now that I have grown up the gap is stll there, even thuogh I haven’t had any surgery or braces to close up the space. But now i’m very insecure with this problem, especially when I smile (I hate to open my mouth up because of this) So what I want to know is how can I treat this problem? I’m 27 years old and I know braces getting braces are to old for me, so can veneers work, and if it does what it prices to getting/having a dentist put them in my mouth(if this is the proper procedure in doing this). Also, what I wanted to know is does a gap spread as you get older?