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 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. 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.

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.”

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.
Breast feeding—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 cause 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 and makes an incision to relax the frenum – release it from being so tight or typically fully remove it. Sutures are only necessary depending on the size and severity of the frenum issue. A more modern “surgery” technique 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.

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.

It is still widely under debate exactly when the best time to get a frenectomy. At the end of the day, we know that the state of your smile goes beyond your teeth. The way you swallow/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.