Frenectomy - is the removal of a frenulum (small fold of tissue that prevents an organ in the body from moving too far). It can refer to frenula in several places on the human body. In dentistry, this procedure is routinely done for orthodontic purposes but can also be done for other functional reasons.
Types Of Frenectomy As Used In Dentistry
-Lingual Frenectomy – This refers to the frenum attachment between the tongue and the floor of the mouth. When this tissue is too tight, restricting movement of the tongue, it is referred to as ankyloglossia, “tongue-tied”. It is easily identified by having the patient lift their tongue up and if it is too tight you will see a heart shape form from the pulling of the tongue. Ankyloglossia comes in varying degrees from mild to one where the tongue is completely attached to the floor of the mouth. As you can imagine this restricts movement of the tongue in all directions. Ankyloglossia can have far reaching effects to include speech, oral hygiene, swallowing, and even eating.
-Labial Frenectomy – This refers to the attachments on the inside of the upper and lower lips. Most commonly, the upper frenum attachment causes a large gap (also called a diastema) to appear between the upper two central incisor teeth as well as gum recession by pulling the gum tissue away from the bone. The frenectomy procedure is generally done on two populations of patients:
Orthodontic Patients – This procedure assists in closing the front gap between the 2 front central incisor teeth. The frenum attachment will prevent the teeth from closing on their own through normal orthodontic procedures.
Denture Patients – This attachment can and often will become uncomfortable as a patients lips move through eating and talking. This will become irritated as it rubs against the dentures and often will not allow the denture to be as stable as it should be. The frenectomy in this case will remove the discomfort and allow the dentures to fit better than before.
The labial frenectomy procedure should not be done until the permanent central incisors have erupted at least 3/4 of the way into the mouth. The timing can be delicate because scar tissue can develop in this area following the frenectomy making it much harder to close the gap between these teeth through orthodontics.
How Is A Frenectomy Performed?
A frenectomy is a fairly, simple straightforward procedure, usually taking less than fifteen minutes from start to finish. The surgeon can choose to use a scalpel or a laser to excise the frenum. The laser has distinct advantages over the scalpel. The use of the laser tends to cause minimal bleeding, does not require the use of sutures, and is usually noted with little to no post operative discomfort. A frenectomy is usually done using only local anesthesia. Very small children will probably have to use general anesthesia to tolerate the frenectomy surgery.
A frenectomy is only necessary when the frenum attachment is causing pain, discomfort, difficult speech, eating difficulty, or a cosmetic issue. Of course, in cases of speech and eating, it is definitely recommended as it will affect a child’s development over time. Without the procedure, they will have trouble saying certain words and many children also will have trouble breast/bottle feeding. This can be a very serious matter in children with a severe form of attachment. It is important to have your child seen regularly by a dentist so that they can monitor their development and ensure these issues can be taken care of at their proper stage.
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