Frenectomy

Definition: a surgical procedure performed to cut and remove the frenulum, a muscular attachment between two tissues, in cases when it causes pain or its function is decreased.

There are three frena in the mouth:

• Upper labial frenulum - connects the inside of the upper lip with the center of the gum between the two front teeth;
• Lower labial frenulum - connects the inside of the lower lip with the center of the gum between the two front teeth;
• Lingual frenulum - connects the base of the tongue with the floor of the mouth.

The lingual frenulum sometimes extends to the tip of the tongue, a condition called “tongue-tie” or ankyloglossia, which causes troubles with eating in infancy, and later difficulties with speaking. The lingual frenectomy is recommended as soon as possible to reduce the problems with latching adequately and to ensure efficient breastfeeding. 

The upper labial frenulum is often the cause of the gap between the two front teeth, which can disappear once the permanent teeth erupt. If the space between the front permanent teeth remains, then it’s better to first solve the problem with braces. If the gap starts to form again and the orthodontist considers that the frenulum is the problem, then the frenectomy will be required. Otherwise, the upper labial frenectomy is recommended in childhood only if the frenulum causes pain and is often traumatized. 

The lower labial frenulum is usually a problem for adults that decide to get dentures. 

How does it work?

After numbing the area (the tongue, upper or lower gum tissue) the doctor will cut and remove the frenulum. The procedure can be done using a scalpel or a laser blade and is finished by applying sutures.
In infants, the lingual frenectomy could be performed using scissors, and if the cut is small it doesn’t even need stitches. 

What are the risks?

• Infection
• Bleeding
• Reattachment of the frenulum to the tissues
• Unsuccessful procedure

How to prepare for the procedure?

There is no special recommendation other than brushing your teeth.

How long does the procedure take?

The procedure takes only a couple of minutes. 

How to recover after the procedure?

• During the first couple of days, there will be some minor discomfort or even pain that can be managed with medication
• Breastfeeding infants are considered to have mild analgesic and calming effects
• Proper oral hygiene is required to prevent further infection
• Tongue exercises and massage of the mouth with the finger in the area between the excised parts of the frenulum are required to prevent reattachment
• Avoid solid and spicy food, hot or cold drinks during the healing period
• Remember your regular visits to the dentist.

For more about dental surgical procedures, our articles on Wisdom Tooth Extraction and Oral Maxillofacial Surgery could be enlightening.