Lingual frenectomy

Lingual frenectomy is a simple surgical procedure that involves the removal of one or both frena from the mouth. The frenum (frena) is a connective tissue that attaches one surface in the mouth to another. The primary frena in the mouth are:

• Lingual Frenum – The vertical band of thin tissue that connects the tongue to the bottom of the mouth
• Labial Frenum – The connective webbing that attaches the lips to the gum above the top two front teeth and below the bottom two front teeth
• Buccal Frena – The thin strands of tissue that connect the gums to the insides of the cheeks

When is a Frenectomy Needed? In infants, an elongated lingual frenum may make it difficult to nurse or to feed sufficiently from a bottle. A child with this condition is commonly referred to as being “tongue-tied.” If the abnormality is left uncorrected until the patient has reached the toddler years, parents and caregivers may notice that the child affected experiences a more difficult time of speaking than his peers. The condition is not always detected by a pediatrician or general dentist during routine checkups. In fact, it may be first noticed when the child enters pre-kindergarten or elementary school. A child with an elongated frenum may not be able to extend the tongue as would be considered normal. In extreme cases, the child may even experience difficulty and discomfort while swallowing. In some cases, if the frenum attached to the upper lip extends too far down near the gum line, it can interfere with proper growth and spacing of the upper two front teeth. This results in the development of a large gap between these two teeth. Though many parents may worry about this gap from an aesthetic perspective, believing it to signal the need for braces, it is generally recommended that orthodontic procedures be delayed until the child’s permanent teeth have emerged. If, after braces have been placed, the gap remains between two permanent teeth, the labial frenectomy should be considered as a solution to the abnormal spacing. In many cases, the emergence and growth of adult teeth result in a natural closure of the gap caused by the labial frenum’s length.