A fraenum, also known as a frenulum, is a small, band-like fold of connective tissue that restricts the movement of an organ or structure in the body. While fraena are present throughout the body, those in the mouth are often discussed due to their impact on oral function and development.
Where Fraena Are Found
Within the mouth, several fraena serve specific anatomical roles. The lingual fraenum is positioned underneath the tongue, extending from the underside of the tongue to the floor of the mouth. You can often see this thin band of tissue by lifting your tongue.
Two labial fraena are present, one connecting the center of the upper lip to the gum tissue above the front teeth, and another doing the same for the lower lip and gum. These are visible by gently pulling your lips away from your gums. Buccal fraena are found in the cheek area, attaching the cheeks to the gums.
What Fraena Do
Fraena stabilize structures within the mouth, such as the tongue and lips, helping to maintain their proper position and alignment.
Properly formed fraena contribute to the normal development and positioning of teeth. They also support various oral functions, including clear speech, efficient chewing, and swallowing.
When Fraena Cause Problems
Sometimes, a fraenum can be unusually short, thick, or positioned in a way that restricts normal movement, leading to various issues. A common condition involving the lingual fraenum is known as tongue-tie, or ankyloglossia. This occurs when the lingual fraenum is too short or tight, limiting the tongue’s range of motion.
In infants, tongue-tie can interfere with breastfeeding, causing difficulties with latching, poor weight gain, and audible clicking sounds during feeding. For older children and adults, a restricted lingual fraenum may lead to speech impediments, challenges with oral hygiene due to limited tongue mobility, and potential dental issues.
A prominent or restrictive labial fraenum can also cause problems, often referred to as a lip-tie. In infants, this can hinder a proper breastfeeding latch. For both children and adults, a restrictive labial fraenum might pull the gum tissue away from the front teeth, leading to gum recession or creating a noticeable gap between the upper front teeth, known as a diastema.
Addressing Fraenum Issues
When a fraenum causes problems, healthcare professionals assess the situation. Pediatricians, lactation consultants, dentists, and ear, nose, and throat (ENT) specialists can diagnose these issues. They evaluate the fraenum’s attachment and its impact on oral function.
The most common surgical procedure to address a restrictive fraenum is a frenectomy. This procedure involves releasing or removing the problematic tissue to improve mobility. A frenectomy can be performed using various methods, including surgical scissors, a scalpel, or a laser.
Following a frenectomy, especially for infants, post-procedure care often includes specific exercises or stretches. These movements are important to help prevent the fraenum from reattaching and to support proper healing.