A guide to Frenectomy
What is a frenectomy?
A frenum is a fold of tissue that adjoins the lips, tongue, and cheeks, to the jawbone. Frenectomy involves the removal of one of the folds of tissue.
What is a frenectomy used for?
There are people with large frenums beneath their tongues. This prevents their tongue to move freely. This will interfere with their speech. The condition of limited tongue mobility is referred to as ankyloglossia or tongue tie. Lingual frenectomy will remove the fold of tissue so that the tongue can move freely once again. There are several periods in your childhood where you can notice symptoms of ankyloglossia like
- as infants, tongue tie will interfere with feeding although this is very uncommon
- when your child starts to talk at twelve to eighteen months, you may notice that they are having a hard time talking
- older children and teenagers may notice that the frenum under their tongues gets stuck in between their teeth
- children may notice that they can not stick their tongue out as far as their peers could
- your dentist may see that the frenum is pulling the child’s gum tissue away from the lower front teeth and it is already causing periodontal trouble
There are times where the frenum is attached between the two upper front teeth. In order to remove it, a procedure called a labial frenectomy is performed. This condition is usually seen in children after their permanent upper front teeth have erupted in their mouths. It may also be seen earlier. Sometimes it can be spotted before the baby teeth have come in. If the tissue is attached too far down on the gum then space may be created between the two front teeth. Even if an orthodontist closes this gap, the frenum can still push the teeth apart once more. The frenum can also be attached in such a way that the baby teeth can not erupt into the mouth. If this is the case then your will notice the abnormal frenum sooner.
Adults who are getting dentures may need a frenectomy is the position of the frenum interferes with the way the denture will fit. Sometimes this will happen between the cheek and the gum in the back of the mouth or in the middle of the lower lip and the upper lip.
How do you prepare for a frenectomy?
Before you recommend a frenectomy on your child, your dentist will weigh several factors including the possibility that the condition may eventually correct itself even without surgery. If your child has tongue tie then your child may have to see a speech therapist first and find out if the problem can be corrected. Therapy will include tongue exercises that increase the tongue’s mobility.
How is a frenectomy done?
Your surgeon will use a scalpel or a laser to remove the frenum. Take note that the laser will minimize bleeding, reduce the need for sutures, and cause less pain although it is more expensive. On the other hand, if the scalpel is used, you may need more sutures.
People who go through a laser frenectomy must remain completely still during the operation. Younger children may need general anaesthesia while older children and adults may opt for local anaesthesia with or without nitrous oxide. The whole surgery can be completed in a quarter of an hour.
What are the follow-up procedures for a frenectomy?
Frenectomies will take a couple of weeks to completely heal. You may have to take over-the-counter non-steroidal anti-inflammatory drugs like ibuprofen, Advil, and Motrin to relive pain. You can rinse with saltwater in order to keep the area clean. You should brush carefully around the area and floss as well. If your stitches have to be removed then you must return to the dentist after a week or two. Otherwise, if your sutures are dissolvable then you do not have to worry.
What are the risks involved in a frenectomy?
If the operation does not solve the problem then it has to be done all over again. Redoing a lingual frenectomy is common whilst labial frenectomies are less likely to be repeated. Any surgery will carry a risk of bleeding. There are several blood vessels in your tongue so lingual frenectomies are more likely to have excessive and prolonged bleeding than the labial frenectomies. Excessive and prolonged bleeding isn’t a very common complication.
Adults who are getting a frenectomy in their lower jaw so that their dentures will fit properly will risk bruising the nerves that cause sensation in the chin and in the lower lip. This may cause numbness in the area and can last for several months. Your lip will not droop and the nerves will not affect the movement, only the sensation is affected.
After a frenectomy, you should contact your dentist if you continue to experience bleeding or numbness in the area for more than a day. If you are having trouble moving your tongue freely after a month then you should contact your dentist. In some cases, you may have to wait longer to heal completely so contact your dentist when you have to.