A frenectomy is a small surgery that removes or changes a piece of tissue in the mouth called a frenulum. A frenulum is a thin band of tissue that connects two parts of the mouth. There are two main types in the mouth:
- The labial frenulum connects the lips or cheeks to the gums.
- The lingual frenulum connects the tongue to the bottom of the mouth.
These tissues help keep the lips, cheeks, and tongue in place.
Why might someone need a frenectomy?
A frenectomy is done when the frenulum is too short, too tight, too thick, or attached in the wrong place. This can cause issues such as:
- Difficulty with feeding (especially in babies)
- Trouble speaking
- Poor oral hygiene or infections
- Gaps between teeth
- Problems with wearing dentures
- Discomfort or difficulty using the mouth properly
When is a frenectomy needed?
In babies, a short or tight frenulum under the tongue (tongue-tie) or upper lip (lip-tie) can make breastfeeding hard. The baby may struggle to latch properly, which can also affect speech later on. These issues are usually picked up by a doctor or lactation nurse before the baby goes home from hospital.
A tight upper lip frenulum can also cause a gap between the two front teeth. This is called a maxillary median diastema. In most cases, this gap closes as the child grows and their adult teeth come through. That’s why doctors usually recommend waiting until all the front teeth have come out before doing a frenectomy. If done too early, it can cause scar tissue, making the gap harder to fix with braces later.
A wrongly placed frenulum can also pull on the gums and cause gum recession—this is when the gum moves away from the tooth, exposing its roots. This can lead to sensitive teeth, a higher risk of infection, and possible bone loss.
How is a frenectomy done?
For babies:
If a baby has a tongue tie, a doctor (like a paediatrician or ENT specialist) can quickly cut the frenulum using clean scissors, a blade, or a laser. It’s a fast procedure, usually done without any injection or sedation, and the baby can breastfeed immediately.
For children and adults:
The method of frenectomy depends on the type and position of the frenulum. A local anaesthetic is used to numb the area. The surgeon removes the whole frenulum, including any tissue attached to the bone beneath. They can use various cutting methods, including a scalpel (with different techniques), laser, or electrocautery (electric heat).
If gum recession is present, the dentist may also do a procedure to cover the exposed roots and close any spaces between teeth.
When to speak to your dentist
If your child is having trouble with feeding, speaking, or oral hygiene, or if you have a visible gap between your teeth or receding gums, it’s a good idea to talk to your dentist. Early advice can help prevent long-term problems.
Thanks to Dr. Shaun Rossouw, Dentist at Intercare Linden, for the contribution.
Sources:
Ahn, J. H., Newton, T. and Campbell, C. (2022). Labial frenectomy: current clinical practice of orthodontics in the United Kingdom. Angle Orthodontist, 92(6): 780-786.
Baiju, C. S., Joshi, K., Virmani, R., Gupta, G. and Kaur, P. (2021). Surgical Techniques for Correcting Aberrant Frenal Attachment: A Clinical Review. Dental Journal of Advanced Studies, 9(3): 111-115.
Hartiza, M., Pasangalo, A., Adam, M. A. and Oktawati, S. (2024). Gingival recession caused by aberrant frenum traction: A case report. Journal of Dentomaxillofacial Science, 9(3): 222-224.
Mehta, N. S., Vats, N., Thind, S. and Jindal, S. (2021). An overview of frenectomy: A review. International journal of Medical and Health Research, 7(4): 13-15.
Srinivasan, A., Khoury, A. A., Puzhko, S., Dobrich, C., Stern, M., Mitnick, H. and Goldfarb, L. (2018). Frenotomy in Infants with Tongue-Tie and Breastfeeding Problems. Journal of Human Lactation, 1-7.
Vandana, K. L., Aditya, V. and Lakhani, N. (2024). An Insight into the frenum. RGUHS Journal of Dental Science, 16(4): 1-8.
