Frenulum linguae
Encyclopedia
The frenulum of tongue is the frenulum
of the tongue
, a small fold of mucous membrane
extending from the floor of the mouth to the midline of the underside of the tongue.
. 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, and the primary palate. As the tongue continues to develop, frenulum cells undergo apoptosis, retracting away from the tip of the tongue, and increasing the tongue's mobility.
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.
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.
, 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.
Additionally, an abnormally short frenulum in infants can be a cause of breastfeeding problems, including sore and damaged nipples and inadequate feedings. The resultant trouble breastfeeding results in slower weight gain in affected infants.
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
.
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.
Frenulum
A frenulum is a small fold of tissue that secures or restricts the motion of a mobile organ in the body.-In human anatomy:...
of the tongue
Tongue
The tongue is a muscular hydrostat on the floors of the mouths of most vertebrates which manipulates food for mastication. It is the primary organ of taste , as much of the upper surface of the tongue is covered in papillae and taste buds. It is sensitive and kept moist by saliva, and is richly...
, a small fold of mucous membrane
Mucous membrane
The mucous membranes are linings of mostly endodermal origin, covered in epithelium, which are involved in absorption and secretion. They line cavities that are exposed to the external environment and internal organs...
extending from the floor of the mouth to the midline of the underside of the tongue.
Development
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 ankyloglossiaAnkyloglossia
Ankyloglossia, commonly known as tongue tied, is a congenital oral anomaly which may decrease mobility of the tongue tip and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth...
. 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, and the primary palate. As the tongue continues to develop, frenulum cells undergo apoptosis, retracting away from the tip of the tongue, and increasing the tongue's mobility.
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.
Anatomy
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)
Submandibular gland
The paired submandibular glands are salivary glands located beneath the floor of the mouth. In humans, they account for 70% of the salivary volume and weigh about 15 grams. Unstimulated in humans, the percentage contribution to whole saliva; ~25% Parotid, Submandibular and Sublingual ~ 67% and...
and sublingual
Sublingual gland
The sublingual glands are salivary glands in the mouth.They lie anterior to the submandibular gland under the tongue, beneath the mucous membrane of the floor of the mouth.They are drained by 8-20 excretory ducts called the ducts of Rivinus....
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.
Disorders
AnkyloglossiaAnkyloglossia
Ankyloglossia, commonly known as tongue tied, is a congenital oral anomaly which may decrease mobility of the tongue tip and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth...
, 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.
Additionally, an abnormally short frenulum in infants can be a cause of breastfeeding problems, including sore and damaged nipples and inadequate feedings. The resultant trouble breastfeeding results in slower weight gain in affected infants.
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
Ehlers-Danlos syndrome
Ehlers–Danlos syndrome is a group of inherited connective tissue disorders, caused by a defect in the synthesis of collagen . The collagen in connective tissue helps tissues to resist deformation...
.
Piercing and complications
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.
See also
- AnkyloglossiaAnkyloglossiaAnkyloglossia, commonly known as tongue tied, is a congenital oral anomaly which may decrease mobility of the tongue tip and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth...
- Lingual frenectomy
- Frenuloplasty of tongue
- Ludwig's anginaLudwig's anginaLudwig's angina, otherwise known as angina ludovici, is a serious, potentially life-threatening cellulitis, or connective tissue infection, of the floor of the mouth, usually occurring in adults with concomitant dental infections. It is named after the German physician, Wilhelm Friedrich von Ludwig...