A frenum is a small muscle attachment in the mouth that extends from the lips to the gums and from the tongue to the floor of the mouth. A frenum attaching the lips to the gums is called a labial frenum. The frenum attaching the tongue to the floor of the mouth is called the lingual frenum. You can probably detect your maxillary labial frenum by placing your tongue in the space between your upper lip and your upper front teeth.
There a several situations where a frenum may create problems and frenectomy (frenum removal) should be considered.
In certain cases after orthodontic treatment, a maxillary labial frenum may contribute to relapse, pushing teeth apart after they have been orthodontically moved together. Surgical removal of the maxillary frenum will help to reduce the risk for relapse after the braces have been removed.
In cases where there is a large diastema (space) between the maxillary central incisors, removing the frenum before the maxillary canines erupt may help promote closing of the space prior to orthodontic therapy. As the canines erupt they exert forward pressure on the incisors pushing the incisors together and closing spaces. A large frenum may prevent the incisors from moving together.
A large maxillary labial frenum can destabilize a maxillary denture. When a denture patient's lips move, a large frenum can pull and loosen the denture. A maxillary labial frenectomy can help to improve the fit and performance of a maxillary denture.
When the lingual frenum is too short it will restrict normal tongue mobility causing ankyloglossia (tongue tie). The treatment for ankyloglossia is lingual frenectomy.
The frenum is released with a small incision. Removal of the small underlying muscle may be required. The incision is closed with dissolvable sutures which fall out in approximately one week. A follow-up examination is required approximately one week after surgery. Frenectomy can be accomplished under local anesthesia, intravenouse general anesthiesia (asleep), intravenouse conscious sedation, nitrous oxide gas anesthesia with local anesthesia, oral sedation with local anesthesia.
Drs. Gulley and Gomez will help you to choose the technique that is best for you or your child during the consultation visit.