Frenectomy: What it is and when it is needed

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Oral frenula are soft folds of tissue found in the mouth. The labial frenulum attaches the inside of the upper lip to the gums between the two front teeth, while the lingual frenulum connects the underside of the tongue to the floor of the mouth.  

Lingual frenectomy

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Some people are born with a lingual frenulum that prevents normal movement of the tongue, resulting in a condition called ankyloglossia, or “tongue-tie.” This sometimes occurs when the lingual frenulum is too short or is located too far down the tongue.

Infants with tongue tie often experience difficulty in nursing and could grow up to have speech difficulties or a protruding tongue. If left untreated, ankyloglossia can also cause caries amd gingivitis, due to food particles not being swept away because of the tongue's limited range of motion, and can negatively affect a child's self esteem. A child with a severe case of tongue-tie can have an unusual heart-shaped tongue.

Labial frenectomy

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A labial frenum which is too thick or tight can cause a gap to form between the two upper front teeth. A labial frenectomy can address this problem, but it is generally not recommended for young children. Orthodontics can often address the gap between the upper front teeth, unless the pain is severe or impedes normal eating and speaking functions, or if the gap widens once again after being corrected by braces.

Unlike frenotomy, which only removes a portion of the tissue under local anesthesia and is often referred to as “tongue-clipping,” a frenectomy entails the surgical removal of the lingual frenulum and is performed with general anesthesia.

Those who believe they are candidates for a lingual or labial frenectomy should consult with an oral surgeon on how to proceed.

Dr.. John Pasqual is an oral and maxillofacial surgeon and a clinical associate professor at the University of Florida School of Dental Medicine. For more articles on oral surgery and dental procedures, subscribe to this blog.