{"id":11348,"date":"2020-09-11T16:25:39","date_gmt":"2020-09-11T14:25:39","guid":{"rendered":"https:\/\/www.zungenbandzentrum.de\/lip-frenulum\/"},"modified":"2024-04-04T15:07:37","modified_gmt":"2024-04-04T13:07:37","slug":"lip-frenulum","status":"publish","type":"page","link":"https:\/\/www.zungenbandzentrum.de\/en\/lip-frenulum\/","title":{"rendered":"Lip frenulum"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-cslpm-6d501b60086430cf509875e90f2ce34a\">\n.flex_column.av-cslpm-6d501b60086430cf509875e90f2ce34a{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-cslpm-6d501b60086430cf509875e90f2ce34a av_one_full  avia-builder-el-0  el_before_av_one_fourth  avia-builder-el-first  first flex_column_div av-zero-column-padding '     ><section  class='av_textblock_section av-k9zszeiq-16e5aeee6ff5f5ecc78fb2b095a88281'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h2>What is a frenulum or labial frenulum that is too short or symptomatic?<\/h2>\n<p>A symptomatic frenulum that is too short usually occurs in the maxilla. One speaks of a symptomatic labial frenulum when <span class=\"ILfuVd\"><br \/>\n  <span class=\"hgKElc\">the connective tissue fold covered with oral mucosa.<\/span><br \/>\n<\/span>which connects the upper lip with the upper gum, restricts the mobility of the lip because it is too short, too thick, too tight. This is called a frenulum labii breve and the condition is called ankylolabis.<\/p>\n<p>Kotlow LA. Diagnosing and understanding the maxillary lip-tie (superior labial, the maxillary labial frenum) as it relates to breastfeeding. J Hum Lact. 2013 Nov;29(4):458-64. doi: 10.1177\/0890334413491325. Epub 2013 Jul 2. PMID: 23821655.<\/p>\n<h2 class=\"citation-text\" data-citation-style=\"nlm\">How does a frenulum that is too short or symptomatic develop?<\/h2>\n<p>There is no concrete data explaining why <a href=\"https:\/\/www.zungenbandzentrum.de\/en\/begin\/\">lip tie<\/a> occurs. A hereditary component is suspected. There is emerging evidence that the MTHFR gene plays a role in the formation of the mouth, including the lips. This study reports that people with certain MTHFR mutations have a sevenfold risk of developing cleft palate. There is still much to learn about MTHFR mutations, but researchers believe this specific genetic mutation is more common in Caucasian and Asian populations. It appears to be somewhat less common in the Native American population, and significantly less common in the black population.<\/p>\n<h2>How common are lip ligaments that are too short or symptomatic?<\/h2>\n<p>Dr. Ghaheri, an otolaryngologist at the Oregon Clinic, says a restrictive lip tie is much less common than a symptomatic <a href=\"https:\/\/www.zungenbandzentrum.de\/en\/tongue\/\">tongue<\/a> tie, in which a short, tight piece of tissue under the tongue limits its range of motion. A symptomatic lingual frenulum is also more likely to interfere with breastfeeding because the tongue cannot move upward. Nevertheless, a baby with a tongue-tie may have trouble breastfeeding because it is more difficult or impossible to apply the upper lip without stress and to form or hold a vacuum.<\/p>\n<h2>If your baby has a frenulum that is too short, does it automatically have a frenulum that is too short, or vice versa?<\/h2>\n<p>If a baby has a shortened labial frenulum, it does not mean that he or she also has a shortened lingual frenulum. Even children with a shortened frenulum do not automatically have a frenulum that is too short. In the womb, the area under the tongue and the area between the upper lip and the gumline develop at different times and through different processes. The belief that most babies always have both a symptomatic labial and lingual frenulum probably stems from the observation that infants often retract the upper lip to compensate for a shortened lingual frenulum, making it difficult for a baby to move one independently of the other. The two conditions should be assessed separately.<\/p>\n<h2>How can you tell if your baby has a shortened frenulum?<\/h2>\n<p>If your baby has not yet been evaluated for a labial frenulum, talk to a specialized professional if you notice the following signs of a shortened labial frenulum:<\/p>\n<h2>If your baby has a symptomatic frenulum<\/h2>\n<ul>\n<li>it is unable to turn up the lips, grasp breast tissue with the mouth wide open and hold the vacuum.<\/li>\n<li>milk runs out of the corners of the mouth and air is sucked in and swallowed.<\/li>\n<li>Swallowing air can often cause flatulence, colic or even <a href=\"https:\/\/www.zungenbandzentrum.de\/en\/?page_id=11324\">reflux<\/a> .<\/li>\n<li>it has a dominant sucking vesicle on the center of the lips<\/li>\n<li> <a href=\"https:\/\/www.zungenbandzentrum.de\/en\/breastfeeding-problems\/\">breastfeeding<\/a> may be impaired as a result.<\/li>\n<\/ul>\n<h2>If your baby has a symptomatic frenulum, the mother can:<\/h2>\n<ul>\n<li>Have pain when feeding.<\/li>\n<li>have damaged or deformed nipples (often a lipstick shape can be seen)<\/li>\n<li>Develop constipation, clogged milk ducts or mastitis<\/li>\n<li>have problems with the milk supply.<\/li>\n<\/ul>\n<h2>Can a frenulum cause speech problems?<\/h2>\n<p>A labial frenulum rarely causes speech problems later in life. It&#8217;s rare, but Dr. Ghaheri says, &#8220;In some severe cases, if the lip frenulum causes the child discomfort when opening the mouth because of the tension, it may alter their oral anatomy to minimize the pain, which can affect speech.&#8221; If you suspect that a lip tie is affecting your child&#8217;s speech development, seek consultation with a speech therapist(s).<\/p>\n<h2>Can a frenulum cause tooth decay?<\/h2>\n<p>Breast milk does not produce caries, dirt niches and insufficient care do.<br \/>\nIn babies, an uncorrected frenulum can lead to tooth decay, especially in the baby&#8217;s upper front teeth.<br \/>\nAccording to Dr. Lawrence Kotlow, a lip frenulum prevents residual milk from draining from the area between the upper lip and gums when drinking from a bottle, which eventually leads to bottle decay.<br \/>\nTo prevent tooth decay, Dr. Kotlow recommends that parents pay special attention to oral hygiene as soon as the upper front teeth erupt and make sure there is no milk residue in the baby&#8217;s mouth after feeding.<br \/>\nIf your child shows signs of enamel wear &#8211; white spots or discoloration &#8211; see a dentist to create an action plan for better oral hygiene and to determine if corrective treatment is needed.<\/p>\n<h2>Can a frenulum that is too short lead to a gap between the permanent anterior teeth?<\/h2>\n<p>Gaps between the milk teeth are normal and desirable, as the future permanent teeth need more space.<br \/>\nA labial frenulum can cause a gap between the two permanent front teeth if the labial frenulum is so strong that there is an indentation at the gumline.<br \/>\nIf the labial frenulum is less pronounced, the gap may be temporary and close as other teeth move in.<br \/>\nTooth gaps have complex causes. A labial frenulum separation does not guarantee that there will be no gap between the front teeth or that an existing gap will be closed.<br \/>\nIn case of doubt, if there are no problems with breastfeeding, we recommend waiting until all the teeth are in before doing a lip frenulum revision and assessing the condition at around 6 years of age if necessary.<\/p>\n<h2>What do lip frenulum look like?<\/h2>\n<p>Kotlow (2015) describes his classification system as follows: The upper lip can be classified by assessing the inner mucosal attachment of the lip. If the labial attachment inserts in the zone where the two upper anterior teeth will emerge and extends beyond the alveolar ridge into the palatal area, the labial frenulum is classified as Class IV, insertion in the zone directly in front of the palatal area between the area of the future two anterior teeth is a Class III frenulum, insertion in the border area of the free (dark pink) and attached (pale pink) gingiva is identified as a Class II frenulum, and if the attachment is above this area, it is identified as a Class I.<\/p>\n<table width=\"0\">\n<tbody>\n<tr>\n<td colspan=\"2\" width=\"614\">Classification of the upper labial frenulum according to Kotlov<\/td>\n<\/tr>\n<tr>\n<td width=\"102\">Class<\/td>\n<td width=\"512\">Description<\/td>\n<\/tr>\n<tr>\n<td width=\"102\">I<\/td>\n<td width=\"512\">High attachment point of the labial frenulum with no connection between lip and gum<\/td>\n<\/tr>\n<tr>\n<td width=\"102\">II<\/td>\n<td width=\"512\">Attachment point of the labial frenulum at the border between unattached (red) and attached (pale pink) oral mucosa.<\/td>\n<\/tr>\n<tr>\n<td width=\"102\">III<\/td>\n<td width=\"512\">Attachment point of the labial frenulum between the eruption point of the future incisors and the center of the alveolar ridge<\/td>\n<\/tr>\n<tr>\n<td width=\"102\">IV<\/td>\n<td width=\"512\">Point of attachment of the labial frenulum between the center of the alveolar ridge and the hard palate<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><em>Kotlow L TOTS-Tethered Oral TissuesThe Assessment and Diagnosis of theTongue and Upper Lip Ties in BreastfeedingGeneral Dentistry March 2015.<\/em><\/p>\n<p>Townsend et al (2013) writes, the median upper lip frenulum (MMLF) is a mucosal fold on the underside of the middle of the upper lip associated with the midline of the attached gingiva between the central incisors. As the primary teeth erupt, the height of the alveolar structures usually increases and the attachment of the labial frenulum moves upward with the alveolar ridge.<\/p>\n<p>TownsendJA, BrannonRB, CheramieT, HaganJ, Prevalence and variations of the median maxillary labial frenum in children, adolescents, and adults in a diverse populationGeneral DentistryMarch\/April 2013.<\/p>\n<p>These anatomical descriptions do not indicate whether the labial frenulum will cause problems during drinking or future problems as the anatomy changes due to the growth of the alveolar ridge.<\/p>\n<p>Therefore, in 2020, Dr. Darius Moghtader developed the Mobility-Scale Lip Band (M-S-L) for lip mobility to better classify and assess the potential impact of upper lip mobility on breastfeeding.<\/p>\n<p><a href=\"https:\/\/www.zungenbandzentrum.de\/en\/mobility-scale-lippe-msl\/\">Mobility-Scale Lippe (MSL)<\/a><\/p>\n<\/div><\/section><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-njof6-2232bb558520dcbd9ef9f3f811459355\">\n.flex_column.av-njof6-2232bb558520dcbd9ef9f3f811459355{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-njof6-2232bb558520dcbd9ef9f3f811459355 av_one_fourth  avia-builder-el-2  el_after_av_one_full  el_before_av_one_fourth  first flex_column_div av-zero-column-padding column-top-margin'     ><section  class='av_textblock_section av-kjfwgftm-c5ec57abb9d37df2dcdf6268e57d510e'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3 style=\"text-align: center;\">Lip with M-SCALE 3 (large restriction)<\/h3>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-sub-av-kcfywpnf-ec35996d77531e61f8b21b99a6be108e\">\n.av-hotspot-image-container .av-image-hotspot.av-254223f-6e5e5ed7937964cee828a9b3c60ed901{\ntop:55%;\nleft:47.5%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-1imvttn-30065057cdba0a5de90484f261932d2a{\ntop:29.1%;\nleft:30.5%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-11u3piz-4fc5b79570b0053ddc0a96e6c69eba12{\ntop:44%;\nleft:65.2%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-mbp997-497eaf5d43c231c4b30992144dacf612{\ntop:29%;\nleft:63%;\n}\n<\/style>\n<div  class='av-hotspot-image-container av-kcfywpnf-ec35996d77531e61f8b21b99a6be108e  avia-builder-el-4  el_after_av_textblock  avia-builder-el-last  av-hotspot-numbered av-close-on-click-tooltip av-mobile-fallback-active  av-non-fullwidth-hotspot-image'  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class='av-hotspot-container'><div class='av-hotspot-container-inner-cell'><div class='av-hotspot-container-inner-wrap'><div class='av-image-hotspot av-254223f-6e5e5ed7937964cee828a9b3c60ed901 av-image-hotspot-1 av-close-on-click-tooltip' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  av-close-on-click-tooltip-single  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The labial frenulum attaches to the masticatory ridge up to the palate and has created an indentation in the masticatory ridge due to the strong traction.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>1<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-1imvttn-30065057cdba0a5de90484f261932d2a av-image-hotspot-2 av-close-on-click-tooltip' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  av-close-on-click-tooltip-single  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The upper lip cannot be turned up over the nostrils.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>2<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-11u3piz-4fc5b79570b0053ddc0a96e6c69eba12 av-image-hotspot-3 av-close-on-click-tooltip' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  av-close-on-click-tooltip-single  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The upturning of the upper lip creates stress in the tissue, which can be recognized by the white coloration, i.e. the reduced blood flow.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>3<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-mbp997-497eaf5d43c231c4b30992144dacf612 av-image-hotspot-4 av-close-on-click-tooltip' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  av-close-on-click-tooltip-single  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The upper lip shows a dip in the middle when lifting or fish mouth and turns white as a sign of stress.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>4<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><img decoding=\"async\" class='wp-image-11137 avia-img-lazy-loading-not-11137 avia_image' src=\"https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband1.jpg\" alt='' title='lippenband1'  height=\"500\" width=\"495\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband1.jpg 495w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband1-297x300.jpg 297w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband1-80x80.jpg 80w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband1-36x36.jpg 36w\" sizes=\"(max-width: 495px) 100vw, 495px\" \/><\/div><\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-1 av-close-on-click-tooltip'><div class=\"av-hotspot-fallback-tooltip-count\">1<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe labial frenulum attaches to the masticatory ridge up to the palate and has created an indentation in the masticatory ridge due to the strong traction.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-2 av-close-on-click-tooltip'><div class=\"av-hotspot-fallback-tooltip-count\">2<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe upper lip cannot be turned up over the nostrils.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-3 av-close-on-click-tooltip'><div class=\"av-hotspot-fallback-tooltip-count\">3<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe upturning of the upper lip creates stress in the tissue, which can be recognized by the white coloration, i.e. the reduced blood flow.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-4 av-close-on-click-tooltip'><div class=\"av-hotspot-fallback-tooltip-count\">4<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe upper lip shows a dip in the middle when lifting or fish mouth and turns white as a sign of stress.<\/p>\n<\/div><\/div><\/div><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-4snh5u-1cb2cbe0600db8267c582054dde2f533\">\n.flex_column.av-4snh5u-1cb2cbe0600db8267c582054dde2f533{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-4snh5u-1cb2cbe0600db8267c582054dde2f533 av_one_fourth  avia-builder-el-5  el_after_av_one_fourth  el_before_av_one_fourth  flex_column_div av-zero-column-padding column-top-margin'     ><section  class='av_textblock_section av-kjfwgftm-c5ec57abb9d37df2dcdf6268e57d510e'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3 style=\"text-align: center;\">Lip with M-SCALE 2 (medium restriction)<\/h3>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-sub-av-kcfywpnf-eac15b0a8bcf61d00a88568d9e13bcb8\">\n.av-hotspot-image-container .av-image-hotspot.av-4dboj7f-104899e5f59a55e7a1a1ab0e98f71c3c{\ntop:57%;\nleft:47.5%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-3vlqkij-d824bf61f14bcc3467ee62b93808cb0b{\ntop:26.1%;\nleft:31.4%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-3c0vhff-412895dad812f5568f096e282a0b9cca{\ntop:42%;\nleft:63.2%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-1mwjt23-329b4523dd1abd898bf8226d0bf79400{\ntop:26%;\nleft:61.1%;\n}\n<\/style>\n<div  class='av-hotspot-image-container av-kcfywpnf-eac15b0a8bcf61d00a88568d9e13bcb8  avia-builder-el-7  el_after_av_textblock  avia-builder-el-last  av-hotspot-numbered av-mobile-fallback-active  av-non-fullwidth-hotspot-image'  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class='av-hotspot-container'><div class='av-hotspot-container-inner-cell'><div class='av-hotspot-container-inner-wrap'><div class='av-image-hotspot av-4dboj7f-104899e5f59a55e7a1a1ab0e98f71c3c av-image-hotspot-1 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The labial frenulum attaches to the chewing surface.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>1<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-3vlqkij-d824bf61f14bcc3467ee62b93808cb0b av-image-hotspot-2 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The lip frenulum can only be turned up to below the center of the nostrils.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>2<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-3c0vhff-412895dad812f5568f096e282a0b9cca av-image-hotspot-3 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The upturning of the upper lip creates stress in the tissue, which can be recognized by the white coloration, i.e. reduced blood flow.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>3<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-1mwjt23-329b4523dd1abd898bf8226d0bf79400 av-image-hotspot-4 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The upper lip is straight and may turn white as a sign of stress.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>4<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><img decoding=\"async\" class='wp-image-11136 avia-img-lazy-loading-not-11136 avia_image' src=\"https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband2.jpg\" alt='' title='lippenband2'  height=\"500\" width=\"495\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband2.jpg 495w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband2-297x300.jpg 297w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband2-80x80.jpg 80w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/lippenband2-36x36.jpg 36w\" sizes=\"(max-width: 495px) 100vw, 495px\" \/><\/div><\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-1 '><div class=\"av-hotspot-fallback-tooltip-count\">1<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe labial frenulum attaches to the chewing surface.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-2 '><div class=\"av-hotspot-fallback-tooltip-count\">2<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe lip frenulum can only be turned up to below the center of the nostrils.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-3 '><div class=\"av-hotspot-fallback-tooltip-count\">3<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe upturning of the upper lip creates stress in the tissue, which can be recognized by the white coloration, i.e. reduced blood flow.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-4 '><div class=\"av-hotspot-fallback-tooltip-count\">4<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe upper lip is straight and may turn white as a sign of stress.<\/p>\n<\/div><\/div><\/div><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-20ynmq-b5ed950619d89741b1dbc369949a830d\">\n.flex_column.av-20ynmq-b5ed950619d89741b1dbc369949a830d{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-20ynmq-b5ed950619d89741b1dbc369949a830d av_one_fourth  avia-builder-el-8  el_after_av_one_fourth  el_before_av_one_fourth  flex_column_div av-zero-column-padding column-top-margin'     ><section  class='av_textblock_section av-kjfwgftm-c5ec57abb9d37df2dcdf6268e57d510e'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3 style=\"text-align: center;\">Lip with M-SCALE 1 (small restriction)<\/h3>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-sub-av-kcfywpnf-cea35b87d138d6390d8b48ea23d1d68d\">\n.av-hotspot-image-container .av-image-hotspot.av-342uuez-cb7b761146c85cb6237688673fbc4b4c{\ntop:58%;\nleft:48.5%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-2kq13zv-dd94878e0a919571d974cfda318b8aae{\ntop:25.1%;\nleft:31.5%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-21mo63f-9c72910cd610f40c5a001eea3730803d{\ntop:42%;\nleft:64.2%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-10b7jjv-b8898b57b9f9cdbfdcaa6783b43909d5{\ntop:24%;\nleft:63.2%;\n}\n<\/style>\n<div  class='av-hotspot-image-container av-kcfywpnf-cea35b87d138d6390d8b48ea23d1d68d  avia-builder-el-10  el_after_av_textblock  avia-builder-el-last  av-hotspot-numbered av-mobile-fallback-active  av-non-fullwidth-hotspot-image'  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class='av-hotspot-container'><div class='av-hotspot-container-inner-cell'><div class='av-hotspot-container-inner-wrap'><div class='av-image-hotspot av-342uuez-cb7b761146c85cb6237688673fbc4b4c av-image-hotspot-1 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The labial frenulum attaches below the chewing line.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>1<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-2kq13zv-dd94878e0a919571d974cfda318b8aae av-image-hotspot-2 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The lip can be turned up over half of the nostrils.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>2<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-21mo63f-9c72910cd610f40c5a001eea3730803d av-image-hotspot-3 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;Turning up the upper lip does not create stress in the tissue.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>3<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-10b7jjv-b8898b57b9f9cdbfdcaa6783b43909d5 av-image-hotspot-4 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The upper lip is rounded when raised or fish mouth and remains unchanged in color.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>4<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><img decoding=\"async\" class='wp-image-11135 avia-img-lazy-loading-not-11135 avia_image' src=\"https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband3.jpg\" alt='' title='Lippenband3'  height=\"500\" width=\"495\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband3.jpg 495w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband3-297x300.jpg 297w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband3-80x80.jpg 80w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband3-36x36.jpg 36w\" sizes=\"(max-width: 495px) 100vw, 495px\" \/><\/div><\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-1 '><div class=\"av-hotspot-fallback-tooltip-count\">1<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe labial frenulum attaches below the chewing line.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-2 '><div class=\"av-hotspot-fallback-tooltip-count\">2<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe lip can be turned up over half of the nostrils.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-3 '><div class=\"av-hotspot-fallback-tooltip-count\">3<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nTurning up the upper lip does not create stress in the tissue.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-4 '><div class=\"av-hotspot-fallback-tooltip-count\">4<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe upper lip is rounded when raised or fish mouth and remains unchanged in color.<\/p>\n<\/div><\/div><\/div><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-20ynmq-b5ed950619d89741b1dbc369949a830d\">\n.flex_column.av-20ynmq-b5ed950619d89741b1dbc369949a830d{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-20ynmq-b5ed950619d89741b1dbc369949a830d av_one_fourth  avia-builder-el-11  el_after_av_one_fourth  el_before_av_hr  flex_column_div av-zero-column-padding column-top-margin'     ><section  class='av_textblock_section av-kjfwgftm-c5ec57abb9d37df2dcdf6268e57d510e'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3 style=\"text-align: center;\">Lip with M-SCALE 0 (no restriction)<\/h3>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-sub-av-kcfywpnf-bd0c4d21723f2ed76b89299752b3754a\">\n.av-hotspot-image-container .av-image-hotspot.av-1pd7917-675daf7a8049bc192a47e8d86ee7efd3{\ntop:57%;\nleft:50.5%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-1a5gghn-55db72ef9040654c0650bfb718e00f19{\ntop:18.1%;\nleft:33.5%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-2mjum3-114f909cafb9e0f1721c1fe148e3f339{\ntop:38%;\nleft:64.1%;\n}\n.av-hotspot-image-container .av-image-hotspot.av-rslb0b-5e3b2e724cbd694d435d532397b69bc3{\ntop:17%;\nleft:62.1%;\n}\n<\/style>\n<div  class='av-hotspot-image-container av-kcfywpnf-bd0c4d21723f2ed76b89299752b3754a  avia-builder-el-13  el_after_av_textblock  avia-builder-el-last  av-hotspot-numbered av-mobile-fallback-active  av-non-fullwidth-hotspot-image'  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class='av-hotspot-container'><div class='av-hotspot-container-inner-cell'><div class='av-hotspot-container-inner-wrap'><div class='av-image-hotspot av-1pd7917-675daf7a8049bc192a47e8d86ee7efd3 av-image-hotspot-1 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The labial frenulum attaches below the chewing line.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>1<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-1a5gghn-55db72ef9040654c0650bfb718e00f19 av-image-hotspot-2 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The lip can be put on fully over the nostrils.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>2<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-2mjum3-114f909cafb9e0f1721c1fe148e3f339 av-image-hotspot-3 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;Turning up the upper lip does not create stress in the tissue, blood flow remains unchanged.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>3<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><div class='av-image-hotspot av-rslb0b-5e3b2e724cbd694d435d532397b69bc3 av-image-hotspot-4 ' data-avia-tooltip-position='top' data-avia-tooltip-alignment='left' data-avia-tooltip-class='av-tt-default-width av-tt-pos-above av-tt-align-left  av-mobile-fallback-active  main_color av-tt-hotspot' data-avia-tooltip='&lt;p&gt;The upper lip is relaxed fully rounded and remains unchanged in color.&lt;\/p&gt;\n'><div class='av-image-hotspot_inner'>4<\/div><div class='av-image-hotspot-pulse'><\/div><\/div><img decoding=\"async\" class='wp-image-11134 avia-img-lazy-loading-not-11134 avia_image' src=\"https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband4.jpg\" alt='' title='Lippenband4'  height=\"500\" width=\"495\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband4.jpg 495w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband4-297x300.jpg 297w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband4-80x80.jpg 80w, https:\/\/www.zungenbandzentrum.de\/wp-content\/uploads\/Lippenband4-36x36.jpg 36w\" sizes=\"(max-width: 495px) 100vw, 495px\" \/><\/div><\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-1 '><div class=\"av-hotspot-fallback-tooltip-count\">1<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe labial frenulum attaches below the chewing line.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-2 '><div class=\"av-hotspot-fallback-tooltip-count\">2<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe lip can be put on fully over the nostrils.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-3 '><div class=\"av-hotspot-fallback-tooltip-count\">3<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nTurning up the upper lip does not create stress in the tissue, blood flow remains unchanged.<\/p>\n<\/div><\/div><div class='av-hotspot-fallback-tooltip av-image-hotspot-4 '><div class=\"av-hotspot-fallback-tooltip-count\">4<div class=\"avia-arrow\"><\/div><\/div><div class=\"av-hotspot-fallback-tooltip-inner clearfix\"><p>\nThe upper lip is relaxed fully rounded and remains unchanged in color.<\/p>\n<\/div><\/div><\/div><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kjyjvy15-5853fb6c72c60bdd91061996fc78e220\">\n#top .hr.hr-invisible.av-kjyjvy15-5853fb6c72c60bdd91061996fc78e220{\nheight:50px;\n}\n<\/style>\n<div  class='hr av-kjyjvy15-5853fb6c72c60bdd91061996fc78e220 hr-invisible  avia-builder-el-14  el_after_av_one_fourth  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><\/p>\n<section  class='av_textblock_section av-kjfwgftm-c5ec57abb9d37df2dcdf6268e57d510e'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p class=\"design\" style=\"text-align: right;\">Graphics and design: klossannaliska@gmail.com<\/p>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-11348","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.zungenbandzentrum.de\/en\/wp-json\/wp\/v2\/pages\/11348","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.zungenbandzentrum.de\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.zungenbandzentrum.de\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.zungenbandzentrum.de\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.zungenbandzentrum.de\/en\/wp-json\/wp\/v2\/comments?post=11348"}],"version-history":[{"count":0,"href":"https:\/\/www.zungenbandzentrum.de\/en\/wp-json\/wp\/v2\/pages\/11348\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.zungenbandzentrum.de\/en\/wp-json\/wp\/v2\/media?parent=11348"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}