A frenectomy is a minor surgical procedure designed to release a frenum, a small band of connective tissue that restricts mobility within the mouth. This procedure corrects conditions known as “tongue-tie” or “lip-tie,” which interfere with normal oral function. Releasing this tissue improves the range of motion for better feeding, speech development, or overall oral health. The specialist who performs the procedure depends on the type of frenectomy required and the patient’s age.
Understanding the Different Types of Frenectomy
A frenectomy varies based on the anatomical location of the restrictive tissue. The two most common types are categorized by the frenum being addressed.
Lingual Frenectomy
The Lingual Frenectomy involves the tissue connecting the underside of the tongue to the floor of the mouth, clinically termed ankyloglossia or “tongue-tie.” If this frenum is too short or tight, it limits the tongue’s ability to move forward and upward. This restriction creates difficulties with infant latch during breastfeeding and potentially impacts speech articulation later in life.
Labial Frenectomy
The Labial Frenectomy releases the tissue connecting the inside of the upper or lower lip to the gum line, sometimes referred to as a “lip-tie.” This condition can pull on the gum tissue, possibly contributing to gum recession or causing a large gap between the two front teeth (diastema). Addressing these restrictions is necessary to improve function for feeding efficiency, orthodontic stability, or maintaining healthy gum tissue.
The Primary Specialists Who Perform Frenectomies
Multiple types of trained practitioners routinely perform frenectomy procedures, often utilizing specialized techniques like soft-tissue lasers.
Dentists
Pediatric Dentists and General Dentists frequently perform both lingual and labial frenectomies, particularly those using laser technology. The laser technique cauterizes the tissue as it cuts, minimizing bleeding, and allowing the procedure to be completed quickly in an office setting. Dentists who focus on children have specific training in managing the unique needs of infants and young patients.
Oral and Maxillofacial Surgeons (OMS)
OMS are highly qualified, often handling more complex cases or those that require general anesthesia. An OMS may be preferred when the frenum is particularly thick or fibrous, or when the procedure requires traditional surgical methods involving a scalpel and sutures. Their extensive surgical training makes them suitable for cases involving underlying oral health concerns or when a deeper release is necessary.
Otolaryngologists (ENTs)
Otolaryngologists (Ear, Nose, and Throat specialists) specialize in the anatomy and function of the head and neck, including the oral cavity. They are frequently consulted for infants experiencing feeding difficulties related to a restrictive lingual frenum. A pediatric otolaryngologist has specialized training in managing congenital head and neck malformations, making them a preferred choice for many newborn cases.
Factors Influencing Practitioner Choice
The decision regarding which specialist performs the frenectomy is based on several interconnected factors specific to the patient and the condition.
Patient Age
Patient age is a significant determinant. Infants with severe feeding issues are often directed to specialized Pediatric Dentists or Otolaryngologists experienced with this delicate population. Older children and adults, whose frenum release may be for speech or orthodontic purposes, might be treated by a General Dentist or a Periodontist.
Complexity and Methodology
The complexity and thickness of the frenum influence the referral path; fibrous or deep attachments often require the advanced surgical skills of an Oral and Maxillofacial Surgeon or an experienced ENT. The practitioner’s preferred methodology is another consideration, as some patients may prefer the minimal invasiveness of a laser procedure, commonly employed by many dentists. Initial diagnosis by other healthcare professionals, such as a pediatrician, lactation consultant, or speech pathologist, guides the patient to the most appropriate specialist.