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Congenital or Developmental, continued
Congenitally short lingual frenulum that ties the tongue to the floor of the mouth, decreasing its mobility. Noted in 4% to 5% of newborns.
Clinically, tongue mobility is restricted and it appears notched or heart-shaped at the tip.
May interfere with breastfeeding or bottle-feeding, but this generally only occurs if the baby cannot protrude the tongue past the front teeth ridge.
Ankyloglossia: A congenital defect characterized by limited mobility of the tongue due to shortness of its frenulum.
ankyloglossia may result in speech articulation difficulties, specifically with "s" and "t" sounds.
In general, no intervention is recommended. Treat with
Frenectomy: Excision of a frenulum.
frenectomy if severe enough to interfere with breast or bottle-feeding. A severity scale, called the Hazelbaker Assessment Tool for Lingual Frenulum Function, was developed but it has not received universal acceptance because it is not well-validated.

Cleft Lip/Palate
Cleft lip, including cleft lip with palate, is the most common craniofacial anomaly at a rate of 1 to 2 cases per 1,000 births.
A cleft may be an isolated occurrence or arise in association with a syndrome and may result from teratogen exposure, insufficiency of an essential nutrient, or be genetic or syndromic.
Cleft lip and/or palate may cause feeding, swallowing, and respiratory difficulties in infancy, along with speech and cosmetic concerns
later on.
Surgical repair is typically approached in a step-wise fashion, with initial repair in the first 3 to 6 months of life.

Enamel: Intensely hard calcareous substance that forms a thin layer partly covering the teeth; the hardest substance of the animal body; consists of minute prisms arranged at right angles to the surface and bound together by a cement substance.

A notched or heart-shaped tongue tip indicates ankyloglossia.
A frenectomy may improve feeding success.
Cleft lip is the most common congenital craniofacial anomaly.

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