| Frenulum of tongue | |
|---|---|
| The mouth cavity. The apex of the tongue is turned upward, and on the right side a superficial dissection of its under surface has been made. (Frenulum labeled at center right.) | |
| Sagittal section of nose mouth, pharynx, and larynx. (Frenulum linguae is topmost label at right.) | |
| Latin | frenulum linguae |
| Gray's | subject #242 1125 |
| MeSH | Lingual+Frenum |
The frenulum of tongue (or lingual frenulum) is a small fold of mucous membrane extending from the floor of the mouth to the midline of the underside of the tongue.
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The tongue starts to develop at about 4 weeks. The tongue originates from the first, second, and third pharyngeal arches which induces the migration of muscles from the occipital myotomes. A U-shaped sulcus develops in front of and on both sides of the oral part of the tongue. This allows the tongue to be free and highly mobile, except at the region of the lingual frenulum, where it remains attached. Disturbances during this stage cause tongue tie or ankyloglossia. During the sixth week of gestation, the medial nasal processes approach each other to form a single globular process that in time gives rise to the nasal tip, columella, prolabium, frenulum of the upper lip, and the primary palate.[1] As the tongue continues to develop, frenulum cells undergo apoptosis, retracting away from the tip of the tongue, and increasing the tongue's mobility.[2]
During early gestation (as early as 4 weeks) the lingual frenulum serves as a guide for the forward growth of the tongue. After birth the tip of the tongue continues to elongate, giving the impression of the frenulum retracting, though in reality this has been going on for some time before birth. This is what gives the impression that the frenulums of some previously tongue-tied infants will "stretch" with age and growth. In reality the tongue often just grows beyond the frenulum, although some do also stretch and/or rupture after mild accidents. Many others continue to cause problems throughout life, unless corrected.[3]
The thin strip of tissue that runs vertically from the floor of the mouth to the undersurface of the tongue is called the lingual frenulum. It tends to limit the movement of the tongue, and in some people, it is so short that it actually interferes with speaking.
The base of the frenulum contains a "V" shaped hump of tissue in the floor of the mouth which houses a series of saliva gland ducts. The two largest ducts are in the center just in front of the attachment of the lingual frenulum and are called Wharton's Ducts. They empty the submandibular (submaxillary) and sublingual salivary glands. These ducts can be quite active in some persons, and upon occasion, a "fountain" of saliva may erupt from them during speech. The sublingual saliva glands empty through a series of tiny ducts in the tissue on either side of Wharton's ducts.
Superficial veins run through the base of the frenulum known as varicosities. Their presence is normal, becoming more and more prominent as the patient ages.[4]
Ankyloglossia, also known as tongue-tie, is a congenital anomaly characterised by an abnormally short lingual frenulum; the tip of the tongue cannot be protruded beyond the lower incisor teeth.[5]
Additionally, an abnormally short frenulum in infants can be a cause of breastfeeding problems, including sore and damaged nipples and inadequate feedings.[6] The resultant trouble breastfeeding results in slower weight gain in affected infants.[7]
The absence of the inferior labial (100% sensitivity; 99.4% specificity) and lingual frenulum (71.4% sensitivity; 100% specificity) was found to be associated with classical and hypermobility types of Ehlers-Danlos syndrome.[8]
Most oral jewelry comes in the form of studs, hoops or barbell- shaped devices that can be purchased commercially. Surgical-grade stainless steel, 14-karat yellow or white gold or niobium oral jewelry is recommended. Regardless of the jewelry the recipient chooses, it should be removable.
In tongue piercing, a clamp, or hemostat, is used to stabilize the tongue while piercing is done with a needle of the same or similar gauge as the device being inserted into the oral tissues. Postplacement healing usually occurs in about 4 to 6 weeks, barring complications. Common symptoms after piercing include pain, swelling, infection, increased salivary flow and gingival injury.
Health care practitioners have recognized various adverse incidents associated with the piercing of oral structures. In a survey of 438 pediatric dentists, nearly one-fourth acknowledged treating patients for oral piercing-related complications. The most prevalent injury seen with oral jewelry is damage to the teeth, including chipping of the enamel, cuspal fractures and deep-seated cracks extending to the pulp.[9]
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