A frenectomy is a minor surgical procedure designed to release a frenulum, a small band of soft tissue connecting two parts of the mouth. The two most common frenulums requiring release are the lingual frenulum (under the tongue) and the maxillary labial frenulum (under the upper lip). When these tissues are too short or thick, they create conditions known as tongue-tie (ankyloglossia) or lip-tie, which restrict normal oral function. These restrictions may interfere with a child’s ability to breastfeed effectively and can sometimes lead to speech articulation difficulties.
Identifying Restricted Frenulums
The diagnosis of a restrictive frenulum in infants and young children is primarily based on functional assessment rather than just visual inspection. The most common indicator prompting parents to seek treatment is significant difficulty with breastfeeding. In infants, a tongue-tie prevents a proper latch, leading to poor milk transfer and frequent, prolonged feedings, which may result in poor weight gain for the baby or pain for the mother.
Parents may notice their baby making a distinct clicking sound during feeding, suggesting the baby is losing suction. For a lip-tie, the upper lip may not be able to flange outward sufficiently to create an effective seal. Beyond feeding issues, a restricted lingual frenulum limits the tongue’s ability to lift, which is necessary for proper resting posture and for clearing food from the teeth.
The Pediatric Dentist’s Role in Treatment
Pediatric dentists are highly qualified and frequently perform frenectomies, making them a primary resource for parents seeking this procedure. These specialists receive focused training in treating infants and children, giving them the skills necessary to manage a young patient’s needs and temperament. They often utilize advanced techniques like soft-tissue lasers for this specific oral procedure.
Before intervention, the pediatric dentist conducts a thorough consultation to determine if the frenulum restriction is symptomatic and warrants release. Not all tight frenulums require surgery, so the dentist ensures the procedure is likely to resolve the patient’s specific feeding or oral function challenges. While ENT physicians and oral surgeons also perform frenectomies, pediatric dentists incorporate the procedure into a comprehensive approach to infant oral health and development.
Details of the Frenectomy Procedure
Frenectomies are typically quick procedures, often completed in minutes. The two main methods employed are the traditional surgical release and the laser frenectomy. The traditional method uses a scalpel or surgical scissors to snip the restrictive tissue, which may require sutures and can result in more bleeding.
The laser frenectomy is increasingly common, especially in pediatric settings. This technique uses a concentrated beam of light to precisely vaporize the tissue, which simultaneously cauterizes the blood vessels. The laser approach results in minimal to no bleeding and often eliminates the need for stitches. For infants, local anesthetic is usually sufficient, often applied topically, and general anesthesia is not required because of the procedure’s speed.
Ensuring Successful Healing and Recovery
The immediate post-operative period focuses on managing minor discomfort and preventing the released tissue from reattaching. The wound site will initially form a soft, white or yellow patch, which is a normal part of the healing process. Managing pain is usually straightforward and can involve over-the-counter pain relievers or topical application of frozen breast milk for infants.
The consistent performance of post-frenectomy stretching exercises is essential for successful recovery. These exercises involve gently lifting the lip or tongue to stretch the surgical site multiple times a day for several weeks. The goal is to encourage the wound to heal open, maximizing the new range of motion and preventing restrictive scar tissue. Follow-up appointments monitor healing, and collaboration with a lactation consultant is often recommended to establish optimal feeding patterns.