Frenectomy

When an oral frenulum--a fold of tissue or muscle connecting the lips, cheek, or tongue to the jawbone--causes impairment, a frenectomy, which is the removal of the extra tissue, might be required.

Types

• A labial frenectomy may be needed when a frenulum is attached too high on the gums causing space between the teeth. The tissue attachment between the two teeth is removed since it can continue to push teeth apart.
• A lingual frenectomy is when the large fold of tissue under the tongue is removed.

Reasons for Removal

• The frenulum could be attached in such a way that it prevents the baby teeth from coming through, in which case a frenectomy would be imperative.
• A large frenulum can limit tongue movement thereby cause eating problems and interfering with speech. This condition is called ankyloglossia, or tongue tie, and is usually diagnosed in childhood.
• Adults receiving dentures may need a frenectomy if the position of a frenulum (usually one between the cheek and gum in the back of the mouth or in the middle of the upper or lower lip) interferes with the proper fit.

Treatment

Before recommending a frenectomy in a child, a dentist will consider the possibility that the condition will resolve itself without surgery. For example, in tongue tie, a child might receive speech therapy first to see if that could correct the problem. Therapy would involve exercises that would increase the tongue’s mobility.

If a frenectomy is needed, a surgeon will use a scalpel or a laser. A laser minimizes bleeding, does not usually require sutures, and causes less postoperative pain. If a scalpel is used, sutures will be needed after surgery. The surgery is very short and can be completed in about 10 to 15 minutes.

Aftercare

A frenectomy can take several weeks to heal completely. Because of the many blood vessels in the tongue, lingual frenectomies can result in bleeding, although this complication is rare. Rinsing with salt water will keep the area clean and swelling to a minimum. Brush and floss carefully around the area. 

If you think you might be a candidate for a frenectomy, consult a dentist for a diagnosis.