My Child’s Dentist is Recommending a Frenectomy

Frenectomies – what you need to know to make an educated decision for your child

If your child’s Pediatrician or Pediatric Dentist has recommended a Frenectomy it’s likely you want more information so you can make an educated decision about his or her care.

Let’s explore Frenectomies – what they are, the reason they can be necessary, the types which may be recommended, and the risks involved.

What is a Frenectomy?

The Frenum is a piece of tissue which connects to the mouth in two places –  the base of the tongue and beneath the upper lip. A Frenectomy is a simple procedure done to remove this connective tissue.

Why are they necessary?

There can be a couple of reasons your Pediatrician or Pediatric Dentist is recommending a Frenectomy for your child.

A condition called Ankyloglossia is most often caused by an unusually thick, short Frenum connecting the underside of the tongue to the floor of the mouth. This condition causes children to have difficulty with speech, and can make it challenging for an infant to breastfeed. If not corrected, children with this condition may change the position of their jaw in an attempt to make speaking easier – but this can result in future orthodontic issues and/or pain.

Another common condition is often referred to as ‘lip-tie’. This can be caused by an excessively large or tight Frenum between the upper gum and front teeth. Newborns may have trouble pursing their lips and staying connected to the breast while feeding, and may suck in air causing excessive gassiness. If not corrected, this condition can push the front teeth apart creating the need for orthodontic intervention.

What types of Frenectomies are there?

There are two types of relatively routine Frenectomies your Pediatric Dentist treats:

• Maxillary Frenectomy. In this instance, your child’s Dentist will remove a piece of tissue that connects the front teeth to the upper inside gums.
• Lingual Frenectomy. These are performed to remove tissue that connects the underside of the tongue to the mouth floor.

Another option in certain cases can be a Frenotomy. This involves a simple ‘snipping’ of the frenum, usually in newborn babies.

When should they be done?

In general, the sooner the better.  Infants and younger toddlers heal more quickly and suffer far less trauma from any procedure, assuming they are healthy. Once the need is assessed, accomplishing the Frenectomy early allows a child to avoid long-term consequences.

There are instances in which a Frenectomy isn’t recommended until a Pediatric Dentist discovers tooth or jaw displacement. In these cases, the effects of the Frenum problem may not have been severe enough to cause a nursing or speech issue, but come to light when teeth or jaw is affected, but are an important part of successful orthodontic care.

Many adults who have not previously been diagnosed are advised that the procedure will improve their speech and/or eating abilities.

In some cases, speech therapy may be recommended to help patients adjust to the physical changes.

How is this procedure accomplished?

In routine Frenectomies, this is a relatively simple procedure done right in your Pediatric Dentist’s office. Most often, a soft-tissue laser is used to focus a beam on the tissue to be removed, and the treatment simply removes specifically targeted tissue. This method causes minimal discomfort and very little bleeding. Healing time is typically short and without complication.

When a child is too young to sit for the procedure, or has physical or emotional issues that make holding still difficult, general anesthesia may be considered.

What are the risks involved?

Risks are few – rarely does a patient have a complication from a frenectomy.  A few complications which can occur are:

• Tongue numbness
• Temporary soreness
• Bleeding
• Hematoma (this is a collection of blood that forms in tissue due to a break in the wall of a blood vessel)
• Infection
• Development of scar tissue (rare)

In all but a small fraction of cases, these complications are temporary and cause no lasting issues.

If it’s recommended that your child have General Anesthesia, the risk increases slightly due to potential complications from Anesthesia. (See our article on the safety of General Anesthesia during dental procedures on young children here:  https://www.caringtreechildrensdentistry.com/how-safe-is-general-anesthesia-in-dental-procedures-for-children/ )

Where can I learn more?

Here is a link to a helpful article:  https://tonguetie.net/surgery/

As always, we are here to talk about your child’s unique oral health issues – we welcome you to make an appointment to discuss any and all needs, no matter how minor – or major –  they may seem.