A frenectomy (also known as a frenulectomy, frenulotomy or frenotomy) is the removal of a frenulum, a small fold of tissue that prevents an organ in the body from moving too far. It can refer to frenula in several places on the human body. It is related to frenuloplasty, a surgical alteration in a frenulum. Done mostly for orthodontic purposes, a frenectomy is either performed inside the middle of upper lip, which is called labial frenectomy, or under the tongue, called lingual frenectomy. Frenectomy is a very common dental procedure that is performed on infants, children, and adults.
A frenectomy is the removal of a frenum in the mouth. A frenum is a muscular attachment between two tissues There are two frena (the plural of frenum) in the mouth that can sometimes obstruct normal function and are candidates for frenectomies. These frena are called the lingual frenum, which connects the tongue to the floor of the mouth, and the maxillary labial frenum, which connects the inside of your upper lip to your gums just above your upper two front teeth.
A frenum has no purpose and removing one causes no loss of function. A frenectomy is done when a frenum is too tight, in the wrong place or otherwise causes problems. In most cases, an oral and maxillofacial surgeon performs the surgery.
- Some people have a tight frenum under the tongue. This may prevent the tongue from moving freely. The condition is called tongue tie or ankyloglossia. Tongue tie may interfere with feeding in infants. Later, it can cause problems as a child learns to talk.
- Sometimes a frenum is attached between the upper front teeth (incisors). This may cause problems when a child’s permanent teeth come in around age 6 or 7. The teeth may not be able to come in, or there may be a gap between them.
- Less often, a frenum inside the lower lip may pull the gum away from the lower front teeth (incisors). This may result in gum problems.
- A frenum also can interfere with the fit of a denture. This may occur anywhere in the mouth. However, it is seen more often on the sides of either the top or bottom jaw.
The lingual frenum connects the tongue to the floor of the mouth. Sometimes, the lingual frenum can run all the way to the tip of the tongue, causing a person to be “tongue-tied.” A restrictive lingual frenum is a common occurrence in young children. Normally, children are able to accommodate well to a prominent lingual frenum and can surprisingly eat and speak normally. If the attachment extends all the way to the tip of the tongue, then a frenectomy may be the only choice to give the child normal tongue function.
A lingual frenectomy is a simple procedure and involves numbing the tongue with an anesthetic. A small incision is then made which will free the tongue from the floor of the mouth. The incision then will be sewn up to allow the tissue to heal.
The maxillary labial frenum attaches the upper lip to the gums just above the upper two front teeth. If you move your tongue up between your upper lip and your teeth, you will feel this thin band of muscle. A prominent maxillary labial frenum can cause a large gap to occur between the upper two front teeth. This can be a concern for parents. However, unless the frenum is causing a lot of pain on the upper lips and gums, immediate treatment is not necessary. Treatment should be delayed until the upper permanent teeth have come in. Many times, the replacement of the baby teeth with permanent teeth will naturally close the gap between the two front teeth. If the gap doesn’t close, then it can be treated using braces.
If the teeth begin to drift apart again after the braces have moved them together, then a maxillary labial frenectomy can be considered if it is determined to be the cause of the gap. A maxillary labial frenectomy should not be attempted before the gap is closed, because scar tissue can form, making it impossible to get rid of the space between the upper two front teeth.
It is only recommended to get a frenectomy when the frenum is obviously causing pain or impeding normal function. A lingual frenectomy should be considered if a child is having trouble eating, swallowing, or speaking. A maxillary labial frenectomy should be considered during the “baby teeth years” only if it is causing the child pain. If the maxillary labial frenum is causing a gap between the two upper teeth, then a frenectomy should be considered only after closing the gap with braces. If a maxillary labial frenectomy is performed before the upper two front teeth are moved together, then the subsequent scar tissue could make it impossible to move the upper two front teeth together, leaving the child with a permanent gap between their two front teeth.
You may have a lot of questions about frenectomies after reading all about them, but the Pediatric Dentistry of Central Florida is more than happy to help soothe any nerves or concerns you may be having about the procedure and what’s best for your child. Contact us today!