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Protruding tongue in a 19 month old. Normal tongue movement and pronunciation. Watchful waiting advised. Second opinion?

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Orthopaedic Surgeon
Practicing since : 1994
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my 19 month old daughter has had a protruding tongue pretty much from birth. when at rest, her mouth is slightly open with her tongue protruding and when she is intently concentrating on something, her tongue sticks out even more. she stopped using a pacifier and stopped nursing at 11 months old. she seems to have a very good range of movement with her tongue and has pretty normal word pronunciation for her age. she has a large vocabulary and a great memory and in all respects seems advanced for her age. she is able to close her mouth when we remind her to, but this lasts only a few seconds, and she has started drooling a lot in the last month. our pedi thinks that she will grow out of it and advises watchful waiting, but i'm worried about this and would like to know which medical professional (speech therapist, dentist?) can further evaluate her so that we can get a second opinion.

everything i read on the internet mentions mosaic down syndrome or possible physical disorders. please advise.
Posted Sat, 28 Apr 2012 in Growth and Development in Children
 
 
Answered by Dr. Praveen Tayal 6 hours later
Hello,

Thanks for posting your query.

I have seen all the photographs attached here. The large tongue your daughter is having is usually genetically related. For a better evaluation you can see an orthodontist and a speech therapist.

Usually if this large tongue does not interfere with the alignment of the teeth then no treatment is needed.

Surgical reduction in the tongue mass is the only treatment.

It is recommended that she has regular orthodontic checks and speech therapy assessments to monitor the development of her dentition, speech, feeding, oro-motor skills and facial growth until facial growth is completed in late to mid teens.

It is usually associated with Beckwith Wiedemann Syndrome and any associated neurological deficit and mental development also needs assessment.

I hope this answers your query effectively.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health.
Regards.
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