A frenectomy is a simple surgical procedure performed to release the connection of the “frenum,” a connective muscle between two tissues.
A lingual frenectomy may also be referred to as the release of tongue-ties (ankyloglossia). This procedure is performed on the connective tissue under the tongue. The procedure is often performed on neonatal patients to assist with nursing or on toddlers or older patients who need the surgery to help correct speech issues caused by limited movement due to the frenum.
A labial frenectomy is performed on the tissue that connects the lip to the gums. This may be performed on children or adults to aid with orthodontic treatment or even help with the proper fitting for a denture or appliance.
A frenum is the piece of tissue that connects the lip or tongue to the jaw. A frenectomy is a procedure that cuts this piece of tissue with a scalpel, scissors, or laser.
Some people need a frenectomy when the piece of skin connecting the lip or tongue to the jaw is too short, too tight, or attached in a poor place. Poor placement may cause problems with dental health, feeding, speech, or even sleep.
A frenectomy may be needed when the abnormal attachment of the lip or tongue prevents proper latch while breast or bottle feeding.
Our doctors are specially trained in using soft tissue lasers for frenectomies and have years of experience performing the procedure. Our doctors have completed very specific training and meet frequently with pediatricians and lactation consultants. We offer a supportive nonjudgmental atmosphere for honest and open communication and guidance. Importantly, we view the entire child and often don’t recommend a frenectomy or suggest other solutions to resolve issues. The choice is the parents along with their support network including lactation consultants, pediatricians, and other providers. There is no pressure to perform any procedure in our office
Typically, in our office, we do not place stitches for infant frenectomies but may at times for older children and young adults.
Many older children need a frenectomy when the tissue connecting the lip or tongue pulls improperly on the gums. This may result in gingival (gum) recession and difficulty brushing. Some children need a frenectomy in conjunction with orthodontic treatment to allow adult teeth to come together for better esthetics. Other children need a frenectomy to aid in proper speech and swallowing.
Sometimes due to a tight frenulum (the piece of tissue under the tongue), children can’t move their tongue to the correct posture to make certain sounds. Often removing this tissue can aid in speech therapy.
A lingual frenectomy should be done when the tissue under the tongue causes problems with feeding, speech, or swallowing. A frenectomy should not be done just because one may see the frenum. Often our doctors suggest not doing the procedure, waiting, or following up with a lactation specialist or speech therapist.
Frenectomies can be performed in many ways: scalpel, scissors, diode laser, or CO2 laser. When we perform a frenectomy with the CO2 laser at Adelberg Montalvan Pediatric Dental, it is virtually painless and very quick. For some older children, we may numb the area first.
Because a laser frenectomy can be done very quickly, children are not typically put to sleep in our office.
With the use of a CO2 laser, a frenectomy is almost painless and has very little bleeding.
Many providers can perform a frenectomy and it is a common procedure for a dentist. Our pediatric dental office has been performing laser frenectomies for over 20 years.
While some patients can overcome the physical limitations of tethered oral tissues, a simple procedure may make it much easier to resolve speech and feeding issues. Frenectomies can also be an important part of orthodontic treatment as the dentist moves teeth closer together. An unusual tissue attachment may impact gingival health and oral hygiene too.
Most children heal in a few days and all children can go back to normal activities in a few hours. Some babies may be fussy for a few days. You will also see a wet scab for a week or more. Complete healing may take a few weeks.
Typically the procedure is covered under your insurance, so individual costs can vary. Our laser frenectomies are very affordable and we offer payment plans if needed. Call our office so we can confirm coverage and benefits.
Babies are actually encouraged to breastfeed immediately after a frenectomy, which can promote healing and comfort the baby. Many families breastfeed immediately after the procedure. Older children who are numb may have to wait to eat for about one hour. When you do give your child food again, steer clear of rough foods like chips, pretzels and hot, spicy foods. For older children, ice pops are a good post-procedure treat that also feels great!
Frenectomies remove tissue that may be in the wrong place, pushing teeth apart or not allowing proper tongue movement for eating and speech.
While many dentists can perform a frenectomy, we believe that a pediatric specialist with years of extra training working with children is best. Our team is trained and experienced in lasers and knowledgeable about breastfeeding.
After a laser frenectomy procedure, patients report less postoperative pain and better function. Since patients generally don’t need anesthesia, there’s also less downtime after the frenectomy with a laser. And, the laser itself encourages healing of the tissues in the mouth.
Two to three days following surgery, hard white tissue may be seen in the surgical site. This is a sign that the tissue is healing normally. Complete healing of the extraction site may take several weeks.
Infants typically do very well after this short, easy procedure. It is best to breastfeed immediately after; we can provide a comfortable private room to do so. Sometimes we ask the family to do some stretching exercises after the procedure. We also suggest the use of Tylenol as needed and as appropriate for the child’s weight. Some children are fussy for a few days, but usually, it’s short-lived. For older children, we recommend myofunctional therapy for the best outcomes.
There may be many reasons for having trouble achieving a good latch. One reason may be due to tethered oral tissues (TOTS). This means that your baby’s lip or tongue may be attached too tightly to the jaw. This can interfere with the proper tongue position required for a good seal for feeding.
Tongue-tied is a common way to refer to ankyloglossia, or when the tongue is abnormally attached with a thicker or tighter band of tissue that does not allow for normal tongue movement.
Babies are tongue- tied from the time they are born. There is no known cause, but it is a variation from normal. Some children can do well with a tie and for others it makes feeding difficult.
While some ties are obvious and clear to see, some can be difficult to diagnose and less visible. These may still cause feeding issues and should be treated.
If your baby is having feeding issues, they may benefit from a frenectomy. Lip and tongue tie can interfere with both breast and bottle feeding by preventing a baby from being able to latch properly.
We use soft tissue lasers for frenectomies instead of scalpels because laser frenectomies involve less bleeding, little to no scar tissue, and heal faster.
If your child’s pediatrician or lactation consultant believes tongue or lip tie is causing problems with breastfeeding, then a laser frenectomy can help. Some signs of lip or tongue tie in breastfeeding babies include fussiness, gassiness, and falling asleep during feeding.