A frenectomy is a surgical procedure designed to release a frenum, a small fold of tissue that can restrict the movement of an organ. In oral health, a frenectomy addresses issues related to frena located in the mouth. These tissue bands connect the lips to the gums and the tongue to the floor of the mouth. The procedure aims to improve oral function when a frenum is too short, thick, or restrictive.
Types of Frenectomy and Their Indications
Oral frenectomies primarily involve two types: lingual and labial. A lingual frenectomy addresses the lingual frenum, the band of tissue connecting the underside of the tongue to the floor of the mouth. When this frenum is unusually short or tight, it can restrict tongue movement, a condition known as ankyloglossia or “tongue-tie.” This restriction can pose difficulties for infants during breastfeeding, impacting their ability to latch and transfer milk effectively. In older children and adults, a restricted lingual frenum may affect speech articulation, making it challenging to pronounce, and can also hinder eating and tongue mobility.
A labial frenectomy focuses on the labial frenum, the tissue connecting the upper or lower lip to the gum area near the front teeth. This procedure is indicated when the maxillary labial frenum (connecting the upper lip to the gum) is positioned too low or is excessively thick. This can create a gap between the two upper front teeth, known as a diastema. While a cosmetic concern, a prominent labial frenum can also contribute to hygiene issues by making it harder to clean the area, potentially leading to gingivitis or gum recession. Releasing a tight labial frenum can support orthodontic treatment by allowing teeth to move into proper alignment and can improve lip movement and comfort.
The Frenectomy Procedure
The frenectomy procedure is quick, taking 15 to 30 minutes. It involves the precise modification or removal of the problematic frenum. Before the procedure, a local anesthetic is administered to numb the area. For infants, general anesthesia is not needed, and the procedure can be performed in an office setting.
Several techniques are available for performing a frenectomy. Traditional methods involve using a scalpel or surgical scissors to release the tissue. Laser frenectomy utilizes a concentrated beam of light. Laser techniques result in minimal bleeding and faster healing times due to their precision and ability to cauterize as they cut. After the frenum is released, stitches may be required to close the incision, depending on the technique used and the extent of the procedure.
Post-Procedure Care and Recovery
Recovery from a frenectomy is quick and straightforward. Patients, especially infants, can resume normal activities, such as feeding, immediately after the procedure. Some discomfort, swelling, or minor bleeding can be expected in the immediate post-operative period. Pain management involves over-the-counter pain relievers, as recommended by a healthcare provider.
For infants, specific feeding instructions are provided to ensure proper healing and to encourage the newly freed oral structures to function correctly. An important aspect of post-frenectomy care involves performing stretches or exercises. These movements are designed to prevent the frenum from reattaching or healing too tightly, ensuring that the improved range of motion is maintained. The full healing process takes a few days for infants, while adults recover over three to five days. Healthcare providers will offer guidance on when to contact them if concerns arise during the healing period.