You've probably just heard the word frenectomy from a doctor, and now your mind is racing. It sounds a little scary and complicated, doesn't it? Take a deep breath. A frenectomy is a common and minor oral surgery that can make a huge difference in someone's life, from a newborn experiencing breastfeeding issues to an adult preparing for a dental implant.
I get it. Any procedure, especially for your child, can bring up a lot of questions and a little anxiety. You're in the right place because we are going to walk through everything you need to know about this procedure, step by step. We will clear up the confusion and show you why a frenectomy is often a simple fix for some surprisingly big problems.
What Exactly Is a Frenum?
Before we discuss the frenectomy procedure, let's identify what a frenum is. A frenum, or frenulum, is a small band of soft tissue that connects and restricts the motion of a mobile body part. This connective tissue is found throughout your body, but two frena in the mouth are most often the source of problems.
The first is the lingual frenum. This is the tissue located under your tongue; the lingual frenum connects the underside of the tongue to the floor of the mouth. While everyone has a lingual frenulum, it can sometimes be too short or tight, leading to a condition known as tongue tie.
The second is the labial frenum. The labial frenum connects your upper lip to the gum tissue right above your front teeth. A similar frenum connects the lower lip, but the frenal attachment on the patient's upper lip more commonly causes dental issues.
Why Would Someone Need a Frenectomy?
So, why would a doctor recommend modifying this small band of tissue? When a frenum is too thick, tight, or short, it becomes a restrictive frenum. This restriction can cause a range of problems, from difficulties with breastfeeding to periodontal problems, depending on the person's age and which frenum is affected.
A restrictive frenum is more than a minor inconvenience. This frenum restricts movement that is essential for basic functions like eating and speaking clearly. Over time, excessive frena can also contribute to more serious issues that impact oral hygiene and overall dental health.
For Infants: The Tongue-Tie and Lip-Tie Challenge
The most common reason for a frenectomy today is to address feeding problems in newborns. A tight lingual frenum results in a tongue tie, medically known as ankyloglossia. A tight labial frenum is referred to as a lip tie, and both conditions can make breastfeeding incredibly difficult for both the baby and nursing parents.
A baby needs full tongue movement to properly cup the nipple and create a strong seal against the breast. If the baby's tongue is held down by a tight frenum, the baby latch may be shallow and ineffective. This can lead to poor milk transfer, slow weight gain, and persistent fussiness from hunger.
These breastfeeding difficulties affect the mother as well. A poor latch can cause significant nipple pain, damage, and even a reduced milk supply due to insufficient stimulation. A lactation consultant is often the first professional to identify a potential lip tie or tongue tie as the root cause of these frustrating breastfeeding issues.
For Children and Adults: More Than Just a Baby Thing
Problems from a restrictive frenum don't always resolve on their own after infancy. As a child grows, a tight lingual frenum can interfere with speech development. The restricted tongue movement can make it difficult to articulate sounds like "t," "d," "z," "l," and "th," which may require speech therapy.
A prominent labial frenum, on the other hand, can create aesthetic concerns. This frenum attachment can exert a constant pulling force that creates a large gap between the two upper front teeth. Even after orthodontic treatment, this small band of tissue can cause the adjacent teeth to drift apart again.
In adults, a tight frenum can contribute to gum recession by pulling the gum tissue away from the teeth, which can lead to root exposure and sensitivity. Correcting the frenum helps prevent further damage and is sometimes a necessary step before placing dental implants. In some cases, an untreated tongue tie may even be a contributing factor to airway issues and sleep apnea due to improper oral posture.
The Frenectomy Procedure: What to Expect
Now that you understand why a frenectomy might be necessary, let's talk about the procedure itself. The good news is that a frenectomy is a very quick and straightforward simple surgical procedure. It is a common procedure performed in a dental or specialist's office and often takes less than 15 minutes from start to finish.
The goal is to release the frenum, allowing the tongue or lip a greater range of motion. To begin, the provider applies a local anesthetic to completely numb the area. While you or your child will be awake, there will be no pain during the quick procedure.
Once the area is numb, the provider will use one of two main surgical techniques to release the frenum. They will either use a traditional scalpel or a soft-tissue laser. Both methods are effective, but laser surgery is becoming increasingly popular for this type of oral surgery.
Scalpel vs. Laser Frenectomy: What's the Difference?
A scalpel frenectomy is the classic method, which involves a simple excision of the restrictive tissue with a sterile surgical blade. Depending on the extent of the release, the surgeon may place one or two small, dissolvable stitches to close the incision. This method is effective and has been used successfully for decades.
A laser frenectomy is a more modern approach. The practitioner uses a highly focused beam of light to release the connective tissue. The laser instantly vaporizes the tissue while simultaneously cauterizing the blood vessels, resulting in little to no bleeding and an improved patient experience.
Many providers and patients prefer the laser method for labial frenectomies and lingual frenectomy procedures. The laser sterilizes the area as it works, significantly reducing the risk of infection. Because it minimizes bleeding and eliminates the need for stitches, it can be a less intimidating experience, especially for children.
Let's Talk About Recovery
Recovery from a frenectomy is typically fast and uncomplicated. The mouth heals very quickly, and most people feel back to normal within a week or two. Proper post-operative care during the first few days is vital for ensuring the best outcome.
Immediately after the procedure, the site will look like a small, diamond-shaped wound. It is perfectly normal for it to appear white or yellowish as it heals. This is not a sign of infection but is instead a type of oral scab that forms as part of the natural healing process.
The First 24-48 Hours
Some mild discomfort and swelling are to be expected once the anesthetic wears off. Infants might be fussy, but they can usually breastfeed or bottle-feed right after the procedure. In fact, many nursing parents report an immediate improvement in the baby latch and feeding comfort.
For older children and adults, it is best to stick to soft, cool foods for a day or two. Items like yogurt, smoothies, applesauce, and ice cream are good choices. You should avoid anything hot, spicy, or crunchy that could irritate the healing tissue, as maintaining oral comfort is important.
The Importance of Aftercare Stretches
This is arguably the most critical part of the entire process. The mouth's amazing ability to heal can sometimes cause the released frenum to reattach, reversing the benefits of the procedure. Your provider will give you a specific set of simple stretches to perform for several weeks to prevent this.
These exercises are not difficult and involve gently lifting the tongue or lip to keep the wound open as it heals from the bottom up. It is essential to perform these stretches exactly as instructed, several times a day. Consistency is what makes the frenectomy a long-term success and leads to results like improved breastfeeding.
How Long Does It Take to Heal?
The surface of the wound generally heals within about 7 to 10 days. The underlying tissue will continue to remodel and strengthen over the next few weeks. Most people can resume their normal activities and diet within a couple of days, just being careful to be gentle with the healing area.
Does a Frenectomy Hurt?
This is the question on everyone's mind. During the actual frenectomy, you should feel no pain because of the local anesthetic. For infants, a topical numbing gel is often used, and the procedure is so quick they barely have time to notice what happened.
Afterward, some soreness is normal, similar to the feeling of a canker sore or biting your cheek. It is typically more of a mild discomfort than a sharp pain. Your dentist might recommend an over-the-counter pain reliever for the first day or two, but always consult with them first, especially for young children.
With the laser method, many patients report very little pain at all. The brief period of mild discomfort is a small price to pay for the significant, lifelong benefits that the procedure can provide. Your healthcare provider will give you detailed instructions for managing any soreness.
Finding the Right Professional
If you think you or your child might need a frenectomy, the first step is to get a proper diagnosis. This quick in-office procedure is typically performed by a qualified professional with experience in oral surgery. This could be a pediatric dentist, a periodontist, an oral and maxillofacial surgeon, or an Ear, Nose, and Throat (ENT) doctor.
When searching for a provider, ask them how many labial or lingual frenectomy procedures they perform. Inquire about the surgical techniques they use, such as a laser, and why they prefer that method. A great provider, like a maxillofacial surgery specialist, will answer all your questions and make you feel comfortable before proceeding.
Do not hesitate to get a second opinion from another specialist. It is important to feel confident in your decision and the professional who typically performs the surgery. Organizations like the American Association of Oral and Maxillofacial Surgeons can be a good resource for finding qualified practitioners in your area. Call Dr. Ricardo Suarez's dental office at (626) 919-4337 for a free consultation.
Conclusion
The thought of any surgical procedure can be intimidating, but a frenectomy is one of the most minor and impactful treatments available. It's a quick fix that can resolve major issues related to feeding, speech, and dental development. From correcting a tongue tie in an infant to preventing periodontal problems in an adult, the benefits are extensive.
Understanding what a frenectomy is, why it's done, and what to expect can help ease any worries you might have. This simple surgical procedure helps by releasing tissue that restricts movement, allowing for better function and health. If you suspect a lip tie or tongue tie is causing problems for you or your child, talking to an experienced professional is the best next step.