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Frenectomy

If you have a challenge in saying these words fast, or slur or trip on saying these words attached.

It's time you think about getting a frenectomy or frenectomy procedure done. It's a simple, easy, and quick in-office procedure that takes less than 20 minutes to complete.

Do you speak in front of an audience? Do you want to speak in front of an audience without slurring your speech? Do you have a challenge in speaking, catching yourself slurring your words? Have you been to speech therapy to fix your pronunciation of R's, S's, Th's, T's, X's, Ch's, etc?

See the list of words here.

 

A frenectomy is the surgical alteration of a frenum which is a fold of tissue that restricts movement. In the mouth, this is generally a small portion of tissue related to the upper lip, the tongue, or the lower lip. Usually, one end of the frenum is connected to a muscular part of the body, like the tongue or lip, and the other to a relatively static part such as the floor of the mouth in the case of the tongue, or to the gums in the case of the upper lip. Too much restriction of movement of the tongue, for example, is not necessarily a good thing since it can interfere with normal function and this is why a frenectomy may be required. 
 

Three Types

There are three types, that vary on the location of the problem in the mouth:

1. Sometimes the frenum associated with the upper lip, which is in the midline, tends to cause or exacerbate spacing between the upper two front teeth (central incisors) and this may be considered unpleasant to the eye. Such a marked frenum extending well down into the gum can also be a barrier to an orthodontist being able to close up a mid-line gap between the front teeth and so a ‘maxillary’ frenectomy would be indicated.

2. There is sometimes a similar situation in the lower jaw where an extensive frenum can be associated with the separation of the incisor teeth or can cause the gum to pull away (recede) from the neck of one or more lower front teeth. This would invite food debris to lodge and gum disease to follow, so is again an indication for a frenectomy.

3. The third most common type of undesirable frenum in the mouth is that which connects the underside of the tongue to the floor of the mouth. If this is extensive, running almost up to the tip of the tongue, it can seriously restrict its movement, causing speech difficulties and adversely affecting oral hygiene. This condition is termed ankyloglossia, or more commonly being “tongue-tied”. The condition is usually noticed in the young child when difficulty feeding or learning to speak becomes apparent. A ‘lingual’ frenectomy is required here.

The surgery is a straightforward and quite common dental procedure performed both on children and sometimes adults. A child might receive speech therapy first before resorting to the procedure although it is not a major operation by any means.

Adults who have no natural teeth remaining and require full dentures may need a frenectomy in one or more locations if a marked frenum is tending to unseat a denture. This is more common in the lower jaw where the amount of bony ridge to hold a denture is much less than in the upper jaw.

The frenectomy procedure

A frenectomy may be done with a scalpel or a laser. The latter causes less bleeding reduces the need for stitches and minimizes post-operative discomfort (and has a faster recovery), but it does require that the patient be very still throughout.

If the patient is young this may necessitate a general anesthetic. In the older patient, local anesthesia is quite sufficient. The procedure only takes about 15 minutes and stitches are placed if it’s done in the traditional. The surgery is a straightforward and quite common dental procedure performed both on children and sometimes adults. A child might receive speech therapy first before resorting to the procedure although it is not a major operation by any means.

Adults who have no natural teeth remaining and require full dentures may need a frenectomy in one or more locations if a marked frenum is tending to unseat a denture. This is more common in the lower jaw where the amount of bony ridge to hold a denture is much less than in the upper jaw.

Post-operation instructions

After the operation, it’s essential to keep the area clean with gentle saltwater mouth rinses for the best recovery. If at all possible, the patient should carry out careful tooth brushing with a fairly soft brush, to remove plaque on the teeth without irritating the gums. Stitches may dissolve by themselves in time or may need to be removed by the dentist. It can take one to three weeks to achieve complete healing, so care is needed when eating, and very hard foods should be avoided.

Pain can be controlled with over-the-counter pain killers such as ibuprofen or other NSAIDs (non-steroidal anti-inflammatory drugs) and doesn’t usually last for more than one or two days.


What are the risks and/or side effects?



Our team will discuss the risks and potential side effects before the procedure. Common risks of a lingual frenectomy may include1 or more of the following:

- General risks from anesthesia (if used during the procedure)
- Bleeding
- Infection
- Swelling
- Pain or Discomfort
- Nerve damage to the mouth and tongue (rare)
- Re-attached frenulum (rare)

 

Lingual Frenectomy

The lingual frenum connects the tongue to the floor of the mouth, and its size and flexibility vary from person to person. These variations mean that some people will have a lingual frenum that restricts the movement of the tongue. This is sometimes referred to as a “tongue-tied.” Infants with this condition can have difficulty with nursing and, eventually, with speaking. A lingual frenectomy is a quick procedure that reduces the size of the frenum, allowing the tongue to move freely. If restricted tongue movement is discovered early, a frenectomy can be performed as early as the first few weeks after birth.

The labial frenum connects the inside upper lip to the gum area near the front teeth, posing potential orthodontic and hygiene issues. When the labial frenum extends too near the gum line, it can affect the spacing and growth of a patient’s upper two front teeth. Although many parents and patients worry about the gap for cosmetic reasons, extra space between the teeth can make it easier for food to become stuck and contribute to gingivitis.

What is Lingual Frenectomy?

A frenectomy is the removal of a frenulum, a small fold of tissue that prevents an organ in the body from moving too far. It can refer to frenula in several places on the human body. It is related to frenuloplasty, a surgical alteration in a frenulum. Done mostly for orthodontic purposes, a frenectomy is either performed inside the middle of the upper lip, which is called a labial frenectomy or under the tongue, called a lingual frenectomy. Frenectomy is a very common dental procedure that is performed on infants, children, and adults. A similar procedure frenectomy is where a tight frenulum may be relieved by making an incision in the tight tissue.

A lingual frenectomy is a surgical procedure that removes a band of tissue that connects the underside of the tongue with the bottom of the mouth. This procedure treats patients having difficulty eating or speaking. These patients are often referred to as being tongue-tied. Learn more about lingual frenectomy.

Some children are born with a short frenulum (FREN-yuh-Bluhm). The frenulum is the thin tissue that connects the tongue to the bottom of the mouth. The tongue is one of the most important muscles for speech and for swallowing. Having a short frenulum can make it difficult to swallow — especially for infants and children — and speak. Newborn babies with a short frenulum may struggle to nurse, which can make it difficult to gain weight. These patients are often referred to as being tongue-tied, a condition known as ankyloglossia [ang-kuh-loh-GLOS-ee-uh]. The condition may also cause dental problems in children. One way to treat tongue-tied patients is with a procedure called lingual frenectomy [fren-EK-tuh-mee].

A lingual frenectomy is a surgical procedure that removes the frenulum. During the operation, the surgeon makes a small cut on the frenulum to free up the tongue. The procedure may also be referred to as a frenuloplasty [FREN-yoo-loh-plass-tee]. An Ears, Nose, and Throat (ENT) surgeon or oral surgeon will perform a lingual frenectomy.

What are the benefits?

Benefits of a lingual frenectomy include:

- Quick procedure. It takes only a few minutes.
- Quick recovery. You may experience some discomfort, but most experience no discomfort at all.
- Improvement in speech; less slurring of words, easier to pronounce certain words and letters, can speak faster, can stick your tongue out more, frees up the movement of your tongue in many directions, and you can touch the roof of your mouth with your tongue easier.
- Corrects problems with nursing and eating (in infants). 
 

How do I prepare?

Your physician will provide instructions to help prepare for the procedure. You may be asked to avoid food or water a few hours beforehand, depending on whether or not anesthesia will be used for the procedure. Fill any prescriptions ahead of time, so that they are ready once you return home.

How is it done or administered?

- Numbing the area around the frenulum with a local anesthetic.
- Using either a laser or a scalpel. The dentist will make a small cut on the frenulum to free up the tongue. This procedure will be done using a laser, instead of with a blade or scalpel, for faster recovery, and less trauma.
 

When will I know the results?

You should notice the results almost immediately. Wait after the numbing effect of the local anesthetic wears off before you notice any results. Thereafter, you can practice speaking “normally”.

What are follow-up requirements and options?

Following a lingual frenectomy:


- Children should not be placed on their tummies. This will put pressure on the jaw and could interfere with healing.
- Rinse with a Perio-medicated Rinse two (2) times a day for 10 days, AFTER brushing your teeth. 
- You will have a follow-up appointment. You will meet with our Dentist in about a week.

 

What should I expect during recovery?

During recovery:

 

There may be bleeding from the surgical site. If you notice that the bleeding won’t stop, place a 2x2 gauze or Q-tip, soaked with Perio-medicated rinse, and apply a light pressure to stop the bleeding.
- You may experience swelling and pain. Advil and Tylenol together should suffice, as needed.
- Resume normal activities the same day the typical recovery time is the same day if not, a day or 2. 

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