A frenum is a fold of tissue or muscle connecting the lips cheek or tongue to the jawbone. A frenectomy is the removal of one of these folds of tissue.
Sometimes a frenum can be attached too high on the gums causing either recession or spaces between teeth. The procedure to remove this is a called labial frenectomy and involves the removal of tissue attachment between the two front teeth as the gap between the teeth can again pushed apart by the frenum even after it being initially corrected via a different procedure. The frenum can be attached in such a way that it prevents the baby teeth from coming through.
A lingual frenectomy removes the fold of tissue under the tongue. Some people have a large frenum that limits tongue movement and can interfere with speech.
The condition of limited tongue mobility is called ankyloglossia or tongue tie.
Tongue-tie is generally diagnosed in childhood and symptoms include:
Interference with feeding in infants. Problems with speech at 12 to 18 months.
Some older children or teenagers may notice that the frenum under their tongue becomes stuck between their front teeth or that they can’t stick their tongue out as far as their friends can.
Adults receiving dentures may need a frenectomy if the position of a frenum (usually one between the cheek and gum in the back of the mouth or in the middle of the upper or lower lip) will interfere with the proper fit of the denture.
Before recommending a frenectomy in a child a dentist will consider several factors including the probability that the condition eventually will resolve itself without surgery.
If a child has tongue-tie he or she will receive speech therapy first to see if that can correct the problem. The therapy will involve special exercises to increase the tongue’s mobility.
To complete a frenectomy a surgeon can use a scalpel or a laser. A laser minimizes bleeding reduces the need for sutures and causes less postoperative pain. If a scalpel is used sutures will be needed after surgery.
People receiving a laser frenectomy must remain completely still during the operation so younger children may require general anesthesia. In older children and adults the procedure can be done with local anesthesia with or without nitrous oxide. The surgery itself takes very little time and can be completed in as little as 10 to 15 minutes.
A frenectomy can take several weeks to heal completely. Rinsing with salt water helps keep the area clean. Brush and floss carefully around the area. Depending on the type of stitches your dentist uses you may need to return to the dentist to have your stitches removed or they may dissolve on their own.
If the operation does not solve the problem it may need to be redone. Redoing a lingual frenectomy is somewhat common. Few labial frenectomies need repeating.
Any surgery carries a risk of bleeding. Because of the many blood vessels in the tongue lingual frenectomies are more likely to result in bleeding although this complication is quite rare.
In adults receiving a frenectomy in the lower jaw to correct the fit of dentures there is a risk of bruising the nerve that provides sensation to the lower lip and chin. This will cause numbness in the area that can last at some level for several months. However your lip will not droop as the nerve does not affect movement only sensation.
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