An upper lip frenectomy is a minor surgical procedure designed to address issues with the frenum, a small band of tissue connecting the upper lip to the gum. This common operation aims to improve oral function and comfort by modifying or removing this tissue when it restricts lip movement. It is a straightforward procedure often performed in a dental or medical office setting.
Understanding the Upper Lip Frenum and Its Indications
The upper lip frenum is a mucosal fold that extends from the inner surface of the upper lip to the gum tissue between the two front teeth. This tissue provides support to the upper lip, facilitating movements involved in speaking, eating, and sucking. The frenum’s size and thickness can vary among individuals.
When the upper lip frenum is restrictive, it can limit the upper lip’s mobility, a condition sometimes referred to as a “lip-tie.” In infants, this restriction can lead to feeding difficulties, including issues with latching, suckling, or clicking sounds during feeding. These challenges may result in poor weight gain for the baby and discomfort for the breastfeeding mother.
For older children and adults, a restrictive frenum can manifest in various ways. It can contribute to speech impediments by interfering with articulation, making it difficult to pronounce certain sounds. A prominent frenum can also create a noticeable gap between the two upper front teeth, known as a diastema, by pulling on the gum tissue and preventing the teeth from coming together. It can also lead to gum recession or make oral hygiene more challenging.
Performing the Upper Lip Frenectomy
An upper lip frenectomy is a quick outpatient procedure, often completed within 15 minutes. Prior to the procedure, the area is numbed using a local anesthetic to ensure patient comfort.
The procedure can be performed using different techniques. A traditional scalpel method involves excising the frenum with a surgical blade. Alternatively, laser frenectomy is a common modern approach. Laser techniques often result in less bleeding due to the laser’s ability to cauterize as it cuts, potentially leading to reduced swelling and a quicker initial healing process. In some instances, particularly with complex lip ties, stitches might be needed, though laser procedures often do not require sutures.
Navigating Recovery and Aftercare
Immediately following an upper lip frenectomy, mild discomfort, swelling, and minor bleeding are common and typically subside within a few days. A white or yellowish patch may appear at the surgical site as part of the normal healing process, which is a wet scab and not an infection.
Pain management involves over-the-counter pain relievers such as acetaminophen or ibuprofen, as directed by a healthcare provider. For infants, freezing a thin layer of breast milk and placing a small piece on the wound can offer a numbing effect, and skin-to-skin contact is also beneficial for comfort.
Dietary modifications are recommended for the first few days. Patients should stick to soft, cool foods like yogurt, mashed potatoes, pureed fruits, and soups to avoid irritating the surgical site. Hot, spicy, salty, or crunchy foods, as well as those with small seeds, should be avoided as they can cause discomfort or disrupt healing. For infants, breastfeeding or bottle-feeding can often resume immediately after the procedure, as the sucking motion can aid in healing and provide comfort.
Oral hygiene is important to prevent infection. Gentle brushing can begin the day after the procedure, avoiding the surgical area for a couple of days. Rinsing the mouth several times a day with a warm saltwater solution is recommended to help keep the area clean and soothe tissues. Alcohol-containing mouthwashes should be avoided as they can irritate the healing site.
Stretching exercises are recommended to prevent reattachment of the frenum and promote healing and increased mobility. These exercises, which vary by patient age, often involve gently lifting the upper lip towards the nose and sweeping it side-to-side to stretch the tissue. For infants, parents may be instructed to place a clean finger under the lip and gently lift it until resistance is met, holding the stretch for a few seconds.
These stretches should be performed consistently, multiple times a day for several weeks, as instructed by the dental professional. Follow-up appointments are important to monitor healing and address concerns. Complete healing occurs within 1-4 weeks, with laser procedures often resulting in faster recovery times.