Frenectomy | Why It’s Needed and When | Fixing Your Frenum
Sometimes dental issues have causes beyond our teeth. Maybe your dental problem involves your gums, jawbone, facial muscles, tongue, surrounding tissue… the list goes on. A lot is going on in and around your mouth that helps it function properly throughout day and night. Every tooth, bone, and tissue has a job to contribute. This is where the frenum comes into play and the surgical procedure known as a frenectomy.
What is a Frenum?
A frenum is a fleshy piece of soft tissue. It is comprised of elastic and striated muscle fibers attached between the lips and gums. Frena (i.e., plural for frenum) are located in the top, bottom, sides of the mouth, and underneath the tongue. The primary function of frena is to secure the motion of the mobile organ. This muscle-to-organ attachment allows proper swallowing, speech, and mouth movement. Not all frena are the same—they often vary in length and thickness with different people. The mouth consists of three different types of frena: labial, lingual, and buccal.
Types of Frenum
Labial Frenum:
The labial frenum is located in the front of the mouth and is the band that connects the upper lip to the upper gums and the lower lip to the lower gums just in front of your teeth. This is sometimes called a lip frenum. If compromised, the limited movement of the lip can lead to a wide range of complications.
- Mouth breathing—the tight labial frenum does not allow the lips to seal and causing open mouth posture, irregular airway development, and abnormal jaw growth.
- Diastema—diastema is a large gap in between any teeth. In the case of labial frena, tight or low frena tissue develops a gap between your central incisors.
- Gum tissue—As your lips move, the constant tug from the labial frenum pulls away gum tissue from your tooth and exposes the root.
- Poor Oral Care—if you have a tight or low labial frenum, then you are at risk for developing other oral issues like tooth decay or gingivitis.
- Lip ties— A lip tie can make breastfeeding for a new baby difficult. A tight frenulum makes latching difficult for many babies.
What Happens If a Lip Tie Goes Untreated?
If a lip tie remains untreated, it can lead to various issues. For infants, it can cause breastfeeding difficulties due to poor latching, which can affect the baby’s nutrition and growth.
As children grow, an untreated lip tie can contribute to gaps between teeth, speech difficulties, and challenges with oral hygiene, leading to potential dental problems.
Will A Frenectomy Alone Resolve Breastfeeding Issues?
While a frenectomy can significantly improve breastfeeding by allowing better latch and suckling, it may not resolve all breastfeeding issues alone. Other factors, such as milk supply, infant health, and breastfeeding technique, also play critical roles.
Consulting with a lactation specialist is often recommended alongside the frenectomy procedure to address all potential breastfeeding challenges.
Lingual Frenum:
The lingual frenum tissue is located beneath the tongue and ties your tongue to the floor of your mouth. The most common condition associated with the lingual frenum is “tongue-tie.”
Superior Labial Frenulum
Another type of frenum is the superior labial frenulum, which is the soft tissue attaching the upper lip to the maxillary gingiva.
Inferior Labial Frenulum
This type of tongue-tie involves the frenulum that connects the lower gums with the lower lip.
What is a tongue-tie?
This condition, also known as ankyloglossia, restricts the tongue’s range of motion. It is formed before birth and limits the tongue from its normal functions due to the abnormally thick, short frenum. Because the lingual frenum is short, it may exceed the job it was intended for and cause these other dental issues.
Breastfeeding—Tongue-tie can create a low tongue position and hinder the baby’s ability to keep his or her tongue over the lower gum to breastfeed. In severe cases, this causes malnutrition.
- Speech difficulty—Tongue-tie causes speech impediment and interfere with your child’s ability to pronounce specific letters like “l,” “t,” “s,” “z,” “d,” and “th.”
- Swallowing—The tongue should rest against the roof of your mouth when you swallow, but a short frenum may not be able to reach that far and cause tongue thrusting.
- Other challenges—Tongue-tie can make simple tasks like talking and eating painful. At the same time, spaces between teeth and other aesthetic issues may also interfere with your day-to-day life and the level of your overall confidence. Thick frena can even cause parents to have a hard time helping their children brush their teeth without hurting the surrounding soft tissue.
How to tell if your baby is tongue-tied:
- Difficulty lifting the tongue up toward the gums or moving it side to side.
- Issues sticking the tongue out past the lower gums.
- The tongue looks heart-shaped or notched when stuck out.
Buccal Frenum:
The buccal frena are the soft tissue strands that connect your gums to your cheeks. These tissues are primarily in the premolar area of the mouth. Buccal frena allow your mouth to move while talking and chewing freely. When compromised, it can tautly pull the cheeks inward, giving way to the possibility of basic oral dysfunction. The consistent strain of the buccal frenum could damage the tissue around your teeth, resulting in deep pockets.
As you can see, the frenum can do a lot of harm and cause a lot of pain if overlooked. If you or your child is experiencing any of the oral concerns listed above, a frenectomy may be a necessary measure to consider.
How a Frenectomy Works
A frenectomy is a surgery for removing frenum tissue, including the attachment to the underlying bone. The purpose of a tissue removal frenectomy is to correct unwanted tissues that are causing a dysfunctional frenum. Typically, a frenectomy suggests a small reduction of a frenum that is too short or tight. A lingual frenectomy would remove tissue from under the tongue, which is a simple procedure.
In short, the pediatric dentist numbs the area with a local anesthetic and makes an incision to relax the frenum, allowing for greater mobility. Depending on the patient, the dentist may fully remove the frenum. Sutures are only necessary depending on the size and severity of the issue and incision. A more modern procedure utilizes laser surgery, causing less tissue damage and less bleeding for improved healing post-surgery.
Thankfully, most people experience immediate benefits following a successful frenectomy. The actual dental process usually only takes a few minutes and is pretty simple to complete. Though it is a surgery, the patient is in and out in no time with minimal discomfort in the days following.
Recovering from a Frenectomy
In adults, it’s crucial to adopt good oral hygiene habits, such as brushing your teeth gently and using a saline rinse to preserve the cleanliness of the surgical site. Steering clear of either spicy foods or foods that are challenging to chew for a few days post-surgery can significantly reduce discomfort.
When it comes to the little ones, they require additional tenderness and care. It’s beneficial to encourage ample fluid intake and provide them with soft, kid-friendly foods such as yogurt or pureed potatoes. Keep a close eye on their oral hygiene and avoid tampering with the healing area. Often, habits like pacifier use or thumb sucking can slow the healing process.
Adhering to the tailored guidance offered by your dentist while keeping up with scheduled follow-up visits is critical for adults and children to guarantee a recovery without complications.
When to Get a Frenectomy
For young children without permanent teeth yet, a frenectomy may be possible as a preventative measure. For others with incisors or all permanent teeth – not all diastemas are caused by tight frena and not all gaps can be closed by orthodontic procedures. Having a frenectomy will not make your already-spaced teeth come together. This reason is why we recommend completing orthodontic or aesthetic treatment before getting a frenectomy. Once the diastema has been closed, your dentist can re-evaluate your frenum to see if it was the problem.
Frenectomy Frequently Asked Questions
What Are the Risks Involved with a Frenectomy?
Frenectomy is generally a safe procedure, but like all surgical interventions, it carries some risks. These can include bleeding, infection, pain, swelling, and, in rare cases, injury to salivary ducts near the site or allergic reactions to anesthesia. There’s also a slight chance of the frenum reattaching after the procedure.
Who Performs a Frenectomy?
Dentists, including pediatric dentists specializing in treating children, oral surgeons, and ENT specialists, typically perform frenectomies. The choice of professional may depend on the individual’s specific needs and the complexity of the frenum issue.
Patients often opt for dentists and pediatric dentists for their expertise in oral structures, especially for children who may require a gentle and specialized approach.
Will My Child Be Awake or Sedated?
The need for sedation during a frenectomy depends on the individual’s age, the complexity of the procedure, and their comfort level. Infants may not require sedation due to the quickness and minimal discomfort of the procedure.
Dentists may give older children and adults local anesthesia to numb the area. Sometimes, sedatives like nitrous oxide or oral sedation ensure comfort during the procedure.
Is There an Age Limit for a Frenectomy?
There’s no strict age limit for undergoing a frenectomy. Dentists perform the procedure at any age, from infancy to adulthood. In infants, frenectomies can be done a few weeks after birth with little discomfort and quick recovery.
Determining the timing for older children and adults can depend on the issues the frenum is causing on a patient-by-patient basis.
At the end of the day, we know that the state of your smile goes beyond your teeth. The way you swallow or use your tongue, the tissue in your mouth, the amount of bone supporting your teeth… all of these come together to give you your smile. Are you looking to improve your or your child’s grin? Please request an appointment with us online or give us a call! At Snodgrass-King in Tennessee, we can help you and your family with all of your pediatric and adult oral health needs.
