A frenectomy is a minor surgical procedure that involves releasing a small fold of tissue in the mouth. This procedure is sometimes considered for infants when these tissues, known as frena, restrict normal oral function. For babies, an oral frenectomy can have implications for feeding efficiency and the healthy development of their baby teeth. This article clarifies common questions about the procedure in young children.
Understanding Oral Frena
Oral frena are common anatomical structures, thin folds of mucous membrane, present in everyone’s mouth. These tissues connect less movable parts of the mouth to more movable ones, stabilizing certain structures. Two primary frena discussed in infant oral health are the lingual frenum and the labial frenum.
The lingual frenum is located under the tongue, connecting the underside of the tongue to the floor of the mouth. The labial frenum is positioned behind the upper lip, connecting the inner surface of the upper lip to the gum tissue above the front teeth. Both frena are flexible, allowing a full range of motion for oral functions.
When these frena are short, thick, or tight, they can restrict the normal movement of the tongue or lip. A restrictive lingual frenum is called ankyloglossia, or “tongue-tie”; a restrictive labial frenum is called a “lip-tie.” These restrictions can interfere with the mobility required for proper feeding and oral development.
Reasons for Intervention in Infants
Restrictive oral frena in infants can lead to several functional challenges, primarily impacting feeding. A baby with a tongue-tie may struggle to achieve a deep, effective latch during breastfeeding, as limited tongue movement prevents proper breast cupping and adequate suction. This can result in inefficient milk transfer, prolonged feeding times, poor infant weight gain, and maternal nipple pain or damage. Mothers might also experience reduced milk supply due to insufficient breast drainage.
Similarly, a tight labial frenum can prevent the upper lip from flaring adequately during feeding, necessary for a proper seal on the breast or bottle. This can contribute to clicking sounds, excessive air intake, and symptoms like reflux or gas. These feeding difficulties can cause significant stress for both the infant and the parents.
Beyond feeding, restrictive frena can impact oral hygiene and dental development. A tight labial frenum can make it difficult to clean the gum line behind the upper lip, increasing tooth decay risk. While less common, severe restrictions could influence the spacing or alignment of front incisors as they emerge.
The Frenectomy Procedure
A frenectomy is a quick, minimally invasive procedure for infants. The primary goal is to release tight tissue, allowing improved range of motion for the tongue or lip. The procedure is performed in a medical or dental office, taking only a few minutes.
Different techniques are employed for infant frenectomy. One method uses a traditional scalpel or sterile scissors to snip the restrictive tissue. Another common approach uses a soft-tissue laser, which precisely vaporizes the frenum. Laser frenectomies result in less bleeding due to cauterizing and quicker healing.
Anesthesia considerations are minimal for infants. A topical numbing gel is applied before the procedure for comfort. In some cases, no anesthetic is used, as the procedure is brief. Comfort measures during the procedure include swaddling, parental presence, and immediate feeding afterward to soothe the infant.
Recovery and Long-Term Considerations
Following an infant frenectomy, immediate post-operative care focuses on comfort and proper healing. Parents are advised to provide pain relief, such as infant acetaminophen, if the baby shows discomfort. Gentle pressure can be applied to the site, and immediate feeding is recommended to stretch newly released tissues and provide comfort.
To prevent reattachment during healing, specific stretching exercises are recommended. These exercises involve gently massaging or stretching the area several times daily for weeks. Consistent exercises are important for optimal long-term results and maintaining improved range of motion.
Frenectomy benefits, particularly for feeding difficulties, can be observed quickly. Many parents report an immediate improvement in their baby’s latch and feeding efficiency. In the long term, a successful frenectomy supports healthy oral development by allowing unrestricted tongue and lip function. This contributes to proper jaw growth, more effective oral hygiene, and baby teeth eruption without mechanical interference.