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

Lingual frenulum: classification and speech interference.

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CEFAC--Specialization Center in SLP, São Paulo, SP, Brazil.



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


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.


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.


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.

[Indexed for MEDLINE]

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