Lingual frenulum: classification and speech interference

Int J Orofacial Myology. 2004 Nov:30:31-8.


Purpose: To propose a classification of the different lingual frenulum and to relate them to speech disorders.

Methods: We evaluated 1402 patients' frenulum with an age range of 5 years 8 months to 62 years 10 months between 1978 and 2002. Pictures were taken of the altered frenulum. Measures of maximal mouth opening, with and without tongue suction, were taken with a sliding caliper. Speech samples were also taken. Frenulum were then classified as normal; short; with anterior insertion, and short with anterior insertion.

Results: From the 1402 patients evaluated, 127 (9%) presented with an altered frenulum insertion. For this study we considered only those with short or with anterior insertion. For those who had an altered frenulum, 62 (48.81%) presented with speech disorders. The more frequent speech disorders were: omission and substitution of /r/; {R}, and consonant clusters with /r/, and of /s/ and /z/. Frontal and lateral lisps also occurred. The frenulum of 21 patients was classified as short and of these, 12 patients (57%) presented with speech disorders. Of the 106 patients with anterior insertion, 50 (47.2%) presented with a speech disorder. After statistical analyses the relation between altered frenulum and speech disorders was considered significant with p<0.001.

Conclusion: The lingual frenulum was classified as normal, short and with anterior insertion. An altered frenulum may predispose the individual to exhibit an accompanying speech disorder.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Classification
  • Digestive System Abnormalities / complications
  • Female
  • Humans
  • Lingual Frenum / abnormalities*
  • Lingual Frenum / anatomy & histology
  • Lingual Frenum / physiopathology*
  • Male
  • Maxillofacial Abnormalities / complications
  • Middle Aged
  • Speech Disorders / etiology*
  • Speech Disorders / physiopathology*
  • Tongue / abnormalities*