Frenectomy

A frenum has no purpose and removing one causes no loss of function. A frenectomy is done when a frenum is too tight, in the wrong place or otherwise causes problems. In most cases, an oral and maxillofacial surgeon performs the surgery.

Some people have a tight frenum under the tongue. This may prevent the tongue from moving freely. The condition is called tongue tie or ankyloglossia. Tongue tie may interfere with feeding in infants. Later, it can cause problems as a child learns to talk.
Sometimes a frenum is attached between the upper front teeth (incisors). This may cause problems when a child's permanent teeth come in around age 6 or 7. The teeth may not be able to come in, or there may be a gap between them.
Less often, a frenum inside the lower lip may pull the gum away from the lower front teeth (incisors). This may result in gum problems.
A frenum also can interfere with the fit of a denture. This may occur anywhere in the mouth. However, it is seen more often on the sides of either the top or bottom jaw.

Before recommending a frenectomy, your dentist or pediatrician will consider several factors. One factor is whether the condition is likely to fix itself eventually without surgery. If your newborn is having difficulty feeding because of tongue tie, then a frenectomy is needed.

If your child has tongue tie, he or she will be referred to a speech pathologist. This specialist can determine if your child has a speech impediment and if it will respond to speech therapy. In some cases, this can correct the problem. The therapy will involve special exercises to help the tongue move more easily.

The procedure can be done either in a hospital operating room under general anesthesia or in the office under local anesthesia. During an office procedure, sometimes a sedative drug also is given through a vein. Infants and young children usually have the procedure in a hospital operating room.

A surgeon can use a scalpel or a laser to remove a frenum. While a laser produces less bleeding, it can't always be used. In some cases, stitches are needed.

The surgery can be done in as little as 10 to 15 minutes.

A frenectomy generally heals without problems and with little pain. It usually helps to take over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin and others). Rinsing with salt water helps keep the area clean. Brush and floss carefully around the area. Depending on the type of stitches your surgeon uses, they may need to be removed or may dissolve on their own.

If the operation does not solve the problem, it may need to be redone. Redoing a lingual frenectomy (under the tongue) is somewhat common. A labial frenectomy is done to remove a frenum between the front teeth. This procedure rarely needs to be redone.

Bleeding and infection are a risk of any procedure. However, they are both rare after a frenectomy. Antibiotics are seldom prescribed.

A frenectomy in the lower jaw to correct the fit of dentures can bruise the nerve that gives feeling to the lower lip and chin. This will cause numbness in the area. It can last at some level for several months. However, your lip will not droop. The nerve does not affect movement, only feeling. With careful surgical technique, this is also rare.