Does My Child Need a Frenectomy?

oral surgeonPush your tongue up over your front teeth and against your gums. Between your gums and your upper lip, you’ll feel a taut band of tissue. This is called a frenum, and there are several in your mouth. When this tissue is too tight, it can interfere with speech, comfort and even tooth alignment. Your dentist, orthodontist or speech therapist might refer you or your child to an oral surgeon for a frenectomy to clip the tissue and give the mouth some relief.

What is a Frenum?

A frenum, also called a frenulum, is an elastic flap of tissue that connects a stable body part to a mobile organ. You can think of them like an anchor. They help secure and restrict the movement of the organ. You have them in your brain, mouth, digestive tract and even reproductive system.

There are two frena in your mouth that are common troublemakers:
• Lingual Frenum: The tongue anchor. Secures your tongue to the floor of your mouth.
• Maxillary Labial Frenum: The lip anchor. Secures your upper lip to your gums.

The Lingual Frenum: Difficulties and Frenectomy

The lingual frenum varies in shape and size from person to person. A well-functioning lingual frenum allows you to move your tongue freely, speak clearly and swallow comfortably without overextending or swallowing your tongue.

If you have a restrictive labial frenum, also called being “tongue-tied,” the frenum runs too far up the tongue. It can even go all the way to the tip, giving the tongue a heart-shaped appearance. With the tongue trapped, speech and swallowing are difficult and uncomfortable. Mild cases are common in young children, but they adapt wonderfully and can grow out of it without surgical intervention. In more severe cases, a frenectomy can free up the tongue and allow proper function.

Your dentist might recommend lingual frenectomy to:
• Improve speech and speech development
• Reduce discomfort and difficulty when eating
• Improve oral hygiene
• Allow an infant to breastfeed
• Improve confidence and communication skills

A lingual frenectomy is a simple procedure. The oral surgeon thoroughly numbs the area with a local anesthetic. He then makes a small incision along the excess tissue to release the tongue and allow free movement. The incision is sewn up along the underside of the tongue and floor of the mouth to help it heal. If the surgeon uses dissolving stitches, they’ll fall out on their own within two weeks.

The Labial Frenum: Difficulties and Frenectomy

The maxillary labial frenum, which secures the lip to the upper jaw, attaches to the gum right above your two front teeth. Just like the lingual frenum, it varies in size from person to person. It can even start between the front teeth instead of above it. Many children with a persistent gap between their front teeth have a prominent labial frenum.

Prominant labial frena rarely interfere with eating or speaking, but they’re caught early when they do. Children that are “lip tied” can have difficulty breastfeeding. Most children that get a labial frenectomy are older and referred by an orthodontist. The excess tissue interferes with orthodontic work, especially braces, and could prevent a gap between the front teeth from closing.

Your dentist might recommend labial frenectomy to:
• Reduce discomfort
• Improve the appearance of the teeth
• Enhance bite function
• Stabilize dentures for denture users
• Allow an infant to breastfeed
• Help discourage mouth breathing
• Help discourage receding gums
• Improve confidence

Labial frenectomy is almost identical to its lingual counterpart. However, the oral surgeon is likely to remove the entire frenum instead of just reducing it. The surgeon will stitch along the inside of the lip and down the gums to facilitate healing.

Recovering from a Frenectomy

Frenectomy is well-tolerated in most children and adults. Post-surgical pain and swelling is minimal, and the patient can usually eat, drink and talk unimpeded. Because the mouth is rich in blood vessels and kept moist by saliva, it also heals faster than other areas of the body. Recovery typically takes less than a week.

Until the incision has healed, it’s important to follow a soft food diet and keep food away from the incision while chewing. Brittle foods like chips, sticky foods like caramel and hard foods like ice cubes should be avoided. Spicy and acidic foods can also aggravate the incision. It may be more comfortable to avoid hot foods for the first day to two as well.

When to See An Oral Surgeon

Most people know a frenectomy is necessary when they get a referral from their dentist, orthodontist, pediatrician or speech therapist. Difficulties breast feeding, tooth gaps, mouth breathing, a chronically sore frenum and the ‘heart-shaped tongue’ are among the most common reasons for referral.

If you’ve received a referral for a frenectomy, Desert Valley Oral Surgery can help. Call and schedule your consultation today.

Scroll to Top