General Information & Overview
A frenectomy is a surgical procedure where a fold of tissue called a frenum is removed or repositioned. The word frenum, or frenulum, describes the tough tissue that attaches any organ to its neighboring tissue to prevent it from moving too much. When any of these frenums are shorter than normal, they can limit the movement of the tissues to which they are attached.
The removal of the lingual frenum, which is under the tongue, is called a lingual frenectomy. A lingual frenectomy is often performed for patients who are “tongue-tied”. Immediately after this minor oral surgery, the tongue has increased mobility and can extend out of the mouth. This procedure can help improve speech and promote proper tooth arch development in growing children.
The labial frenum often attaches to the center of the upper lip between the two front teeth. This can cause a gap or space and result in gum recession due to the frenum pulling the gums away from the teeth. A labial frenectomy removes the labial frenum. This procedure is often performed on orthodontic patients to assist in closing the gap or space between the two front teeth.
The problem of the upper labial frenum is primarily one of aesthetics, but not necessarily. If the frenum is too short or tight, there are a few common issues. For one, the ligament tissue can extend toward the two upper front teeth and cause a diastema, or gap in the teeth. It can also create an “open mouth posture,” by limiting the movement of the lip and preventing the mouth from properly sealing. This leads to open mouth breathing, which in children impairs the development of nose breathing and by extension proper airway and jaw development. It can also cause gum recession.
The Frenectomy Procedure
There are a few different ways to perform a frenectomy, but they are all fairly low impact and heal in a relatively short amount of time. The most basic frenectomy procedure is done with a scalpel or scissors. It is quite simply when a doctor uses an incision to release the frenum and excise it. The immediate area will be numbed usually with a topical anesthetic, and sometimes in young children laughing gas will be used to relax the patient. Depending on how much of frenum is severed or removed, there may be sutures to reposition the tissue. Usually, dissolvable sutures will be sufficient. A true frenectomy describes the removal of the frenum, but in the case of a very young infant, it may be possible to just clip it.
There is another newer, more frequently used the technique involving laser surgery. The procedure performs basically the same tactic but uses a small laser to zap the frenum with pulses, gently severing the tissue. Doctors like this version of the frenectomy, since it tends to reduce bleeding, cause less tissue damage, and improve healing and post-procedure pain.
The benefits of a frenectomy are usually fairly immediate and positive. The procedure usually itself takes only a few minutes and will cause discomfort for just a couple of days. The site will usually heal in a couple of weeks. Aside from the long-term periodontal improvements to remedy the problems described above, in babies, it can solve problems with nursing. When done early on in the case of a lingual frenectomy, it can be a much simpler procedure than waiting until later in childhood or adolescence.