A frenum is a tissue attachment of the lip or tongue to the gums. It is like a tether that anchors a moveable tissue to a more stationary one. A frenectomy releases this attachment. In the mouth, frenectomies are commonly performed in three areas. Let’s take a look.

 

If you pull your upper lip up, you can see a small triangular band of tissue that connects your lip to your gum–this is the labial frenum. Now do the same with the lower lip. Last, look under your tongue. The lingual frenum attaches the underside of your tongue to the floor of the mouth.

 

Why would you want to remove the attachment? Good question!

 

  • Increase the movement of the tethered lip or tongue (mouth breathing or tongue tie)
  • Decrease the force of the frenum on the gums (recession)
  • Remove interference with breastfeeding in infants
  • Remove interference with denture wearing

 

Now that you have the idea, we can look at each type!

What is the purpose of a frenectomy?

 

Frenectomies are performed for different reasons depending on the location.

 

Upper Labial Frenectomy

 

  • Under normal conditions, the upper frenum attaches to the gum well above the teeth, but sometimes, the attachment is much lower. When this happens before the eruption of the teeth, bone can fail to form due to the pull of the lip. This can cause a gap between the teeth called a diastema.

 

  • Sometimes, the frenum is attached too closely to the teeth and can actually cause recession of the gums because either
    • There is not enough room to position the toothbrush for plaque removal
    • The pull of the frenum actually deforms the gum around the tooth

 

  • If the frenum interferes with the ability of the upper lip to close properly, problems with mouth breathing can occur that can change the development of the bones of the mouth and face

 

Lower Labial Frenectomy

 

  • This type of frenectomy is performed because the attachment is expected to cause or has caused recession of the gum from the tooth or
  • When the frenum interferes with the wearing of a denture. The frenum can lift the denture out of place during function.

Lower Lingual Frenectomy

 

  • If the frenum extends too far toward the tip of the tongue, it can result in ankyloglossia–another word for being tongue-tied. When this happens, the tongue is unable to move freely and can affect
    • Breastfeeding in infants
    • Chewing and speech
    • Oral hygiene

 

How Do You Know if You Need a Frenectomy?

 

Your dentist and orthodontist are often the ones to recognize the need for a frenectomy, but there are some other indicators you may recognize.

 

  • Nursing mothers who complain of sore, cracked nipples, problems with latching, or problems with the baby sliding off the nipple may have their infants examined for a malpositioned frenum.

 

  • Large space between the front teeth may indicate a malpositioned frenum

 

  • Heart shaped tongue when extended may indicate tongue-tie

 

  • Mouth breathing may be an indication of a malpositioned frenum

 

How is a Frenectomy Performed?

 

Frenectomies are a fairly simple procedure that can be done quickly and with very little discomfort! There are two ways the procedure is done.

 

  • Surgically, using scissors or a blade. The area is numbed and the frenum is removed by incision. Some dissolving stitches will be placed, if necessary. Usually there is little bleeding and just minor discomfort for a few days. Total healing takes about 2 weeks.
  • Laser removal. The area is numbed and a laser is used to remove the frenum. There is little to no bleeding and no stitches are placed. There is very little swelling or pain with treatment.


Your dentist will evaluate your tissues at your exam. If you notice any changes in your gums around your frenum, talk to your dentist!