Beverly Hills Periodontal Institute

Frenectomy

The human body has several frena, with a few in the oral cavity and even in the genitalia. An oral frenum is a band of tissue in the mouth located in and around the gums and teeth. Consider it a type of harness to restrict movement. You can have three basic types of oral frenum: lingual, labial, or buccal. A lingual frenum is between the tongue’s base and the mouth’s floor, while the tissue connecting the gum to the lip is the labial frenum. A buccal frenum is a thin band of tissue that connects the inside of the cheeks to the gums. The frenum may be too tight, short, or sturdy, and may do its work too well. Or it may be too high up on your gum, causing recession or gaps between teeth. Frenectomy is a simple oral surgical procedure that removes a frenum in the mouth. There are various ways to do a frenectomy. All the methods are low impact and require only a brief recovery period. We can reduce the size of the frenum with a laser made to cut soft tissue, or with a scalpel. The instrument used will depend on the patient, and on the limitations of the procedure. The procedure usually bears fruit right away. The advantage of laser surgery is higher precision compared to other surgical methods. Laser surgery also results in less bleeding, pain, swelling, and scarring. It’s easy to perform in an outpatient setting and takes very little time. It also does not need sutures, which reduces the risk of postoperative infection.

Why is a Frenectomy Performed?


Sometimes our team may recommend a frenectomy for one of our patients. We need to chat a bit about the mouth’s structure before we can dive into the treatment itself. The benefits of a frenectomy depend on which frenum needs treatment.   Everyone has a lingual frenum, but when it is high or extends to the tip of the tongue, a problem arises. This condition, known as ankyloglossia, restricts the movement of that muscle. Some people call this condition “tongue tie.” A lingual frenum may extend all the way to the tip of the tongue. It can sometimes prevent the patient from speaking or eating. Medical practitioners usually diagnose tongue tie in childhood, and these are some of the symptoms:

  • Interference in breast- and bottle-feeding in babies
  • Issues with speech when at age 12 to 18 months
  • In some children, the lingual frenum becomes wedged under the front teeth. Or they might observe that they can’t poke their tongues out like their friends can.

A labial frenum can make a massive gap as extended tissue comes between the two front teeth in the upper jaw. This type of frenum can also bring about recession of the gums by drawing them off the jaw bone. Another issue is the potential for orthodontic problems. In children, the treatment is best avoided until the permanent teeth have erupted. If the gap is very prominent, we can perform the frenectomy on eruption. The limiting of mouth movement can also lead to mouth breathing.   A maxillary frenectomy is the removal of the tissue attaching the top gums to the front teeth.  This condition is often called lip-tie. Everyone has a maxillary frenum, but most problems arise when it is too tight or large in children. A newborn who cannot curl or flare its lips will have difficulties latching on, leading to problems when breastfeeding.   When doing a frenectomy, we cut away the frenum from either the gum line or the mouth’s floor. When we do a lingual frenectomy, we remove the fold of tissue under the tongue. You may need a few stitches, and the treatment is complete.   Why is frenectomy needed? We may recommend frenectomy if you have an elongated frenum. We do the procedure here at our clinic, depending on the need. It can be preventive or part of the treatment for a condition.   The general awareness and treatment of lip- and tongue-ties has increased. It is particularly notable in breastfeeding babies. Removing the tongue tie is a simple procedure that you can do at any age.   You may need a frenectomy if you’re getting dentures. Sometimes the frenum position interferes with how they fit. You might also need a frenectomy in some cases when you’re getting braces. New technologies have made frenectomies a convenient and safe option. Patients can do this procedure at any age.

Frenectomy Baby

For babies, the procedure is simple. The medical practitioner holds the tongue up to the top of the palate to make the frenum taut. We then cut through the pale, fascia-like membrane on a line parallel with, and near to, the tongue. We make the cut in one motion, taking less than a second. No anesthesia is unnecessary. The only danger is excessive bleeding. The usual amount of blood loss is a drop or less.

Frenectomy Tongue

Ankyloglossia is hard to measure and define. It exists in about 4%-5% of the pediatric population.   The tongue is an essential muscle for speech and swallowing. A short frenum can make it hard to swallow and speak. Children and infants are the most affected.   Dentists can diagnose tongue-tie during a physical examination. Treatment is controversial. Some lactation experts and doctors advocate rectifying it immediately. The pediatrician can do it even before discharging the baby from the hospital. Others favor a wait-and-see approach. The procedure only takes a second, and the discomfort is minimal. There are few blood vessels and nerve endings in the lingual frenulum. The baby can breastfeed immediately after.   The lingual frenectomy procedure comes with some hazards, including

  • bleeding
  • side effects of anesthesia
  • nerve damage to the mouth, especially the tongue
  • infection
  • pain
  • swelling
  • reattached frenulum

Benefits include

  • quick procedure
  • quick recovery
  • repairs problems with eating and nursing
  • improvement in speech.

Most patients see improvement in tongue mobility immediately. Frenectomy is usually well-tolerated and done as an outpatient procedure. Postoperative feeding problems are uncommon. Patients must come in for follow-up so we can check symptoms. We also have to look for scar contracture, which causes recurrence of ankyloglossia.   You need to understand two main concepts about oral wounds. The first is that any open oral wound likes to contract toward the center as its healing. The second concept is, if you have two raw surfaces in the mouth close by, they will reattach. The main hazard of a frenectomy is that the mouth cures too fast. This condition causes premature reattachment at the tongue or even the lip site. It produces a new restriction in movement and the return or persistence of symptoms.

What is the Difference Between a Frenectomy and a Frenotomy?

There is no difference, and you can use the terms interchangeably. A frenotomy (or frenectomy) is a scary sounding word for a simple, standard procedure. The procedure is sometimes called frenulectomy or frenulotomy. It removes the frenum (also known as the frenulum). This term can refer to frena in several parts of the human body. It addresses many medical problems in children, and sometimes adults. The term usually refers to the lingual or tongue frenectomy. With tongue-tie, a small, dense, or tight strip of tissue holds the base of the tip of that muscle to the mouth’s floor. Often the lingual frenum releases over time and tongue-tie resolves by itself. The frenectomy procedure held pride at one time. It was one of the most common of soft tissue operations in younger patients. Midwives and family doctors snipped many labial and lingual frena. Today, it is more common for dental surgeons to perform frenectomies.

Is Frenectomy Considered Oral Surgery?

Yes, a frenectomy is oral surgery. Labial frenectomy is a standard procedure in the field of oral surgery. Orthodontists often carry out the procedure when fitting a patient with braces. In most cases, dentists refer patients to oral surgery and orthodontic practitioners. They are the right people to do the procedure. A frenectomy can be a preventive measure for young children with no permanent teeth. It is still debated precisely when is the best time to get a frenectomy. There have been complaints that frenectomy is overdone. It’s a concern, especially for children with mixed dentition. The term “mixed dentition” refers to children with both permanent and baby teeth. The presence of gaps between teeth is common at this stage. These gaps often close on their own as the permanent teeth continue to grow in. Still, there are advantages to doing frenectomy at a young age. Children at the mixed dentition stage are at a phase of rapid orofacial development. If we increase the range of motion of the tongue, it may allow the patient to place that muscle naturally in the palate. Resting tongue placement is essential and can help shape the palate. Proper placement can prevent orthodontic difficulties. It may also reduce in severity the problems that may result from a narrow maxillary dental arch. This problem often occurs as a result of a low tongue posture. Spaces between teeth and other aesthetic matters may affect your day-to-day life. They also affect your general level of confidence. Simple tasks like eating and talking may become painful. Frenectomy is simple – the surgeon numbs the area and makes an incision to relax or remove the frenum. Frenectomy Cost Insurance companies consider frenectomy a medical necessity when newborn feeding difficulties exist. They also consider it necessary to correct childhood articulation problems. For some purposes, they find the procedure “experimental and investigational.” They may apply this consideration when dentists use frenectomy as a preventive measure. In such cases, they may not compensate you.

Frenectomy Recovery

It’s essential that you have a complete and proper recovery to get the full benefits of your surgery. The recommendations offered below apply to both a lingual and a maxillary frenectomy. It takes 3-5 days to recover from a frenectomy. If you or your child had a lingual frenectomy, try to start using your tongue again as soon as possible. Be careful not to damage the surgical site.   Following frenectomy surgery, it’s essential that you:

  1. Maintain constant firm pressure on gauze pads right over the surgical site for half an hour
  2. Wear cold packs for the remainder of the day even if you have no/minimal swelling
  3. Rest at home for the day and keep speaking at a minimum
  4. Do not smoke, spit, brush teeth, or drink from straws for the day
  5. Take medication for discomfort

Do contact us if you observe any of these symptoms:

  • Fluid drainage or heavy bleeding from the surgical wound
  • Worsening pain and swelling
  • nausea, vomiting, or similar symptoms
  • Swollen lips or gums
  • Headache
  • Signs of infection
  • Dizziness
  • Fever or other flu-like symptoms
  • Complications connected with prescription medicines used in the treatment

Some level of pain is standard for all patients after the procedure. Minor oozing of blood from your surgical site is normal for the first day or so after surgery. The saliva in your mouth mixed with a tiny amount of blood may produce a more extreme look than is the actual case. It’s like a drop of food coloring in a glass of water. Some swelling is also quite normal after this surgery. The swelling will peak at about Day 3 after surgery.

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