title: Lingual frenulum: classification and speech interference.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: CEFAC--Specialization Center in SLP, São Paulo, SP, Brazil. Irene@cefac.br
authors.forename: Irene
authors.initials: I
authors.lastname: Queiroz Marchesan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002965:Classification; D004065:Digestive System Abnormalities / Q000150:complications; D005260:Female; D006801:Humans; D008035:Lingual Frenum / Q000002:abnormalities* / Q000033:anatomy & histology / Q000503:physiopathology*; D008297:Male; D019767:Maxillofacial Abnormalities / Q000150:complications; D008875:Middle Aged; D013064:Speech Disorders / Q000209:etiology* / Q000503:physiopathology*; D014059:Tongue / Q000002:abnormalities*