Orthodontic Information

What is frenum and frenectomy?

a girl undergoing fixed orthodontic treatment

As a tiny muscle coated with a mucous membrane, frenulum attaches lips and tongue, into the mandible and maxilla. The main mission of frenum during fetus growth period is to keep a harmony between lips and tongue as well as the growing oral bones. An oversized frenulum would cause several problems. For example, an oversized lingual frenulum would cause problems with tongue movements and speech disorders. On the other hand, an oversized labial frenum would cause gaps between anterior teeth, malocclusion and hence an ugly smile. Moreover, it would cause a recession of the gums and bones, because it lifts the gums upward constantly. In general, there are two types of frenum in our mouths, which will be analyzed later in this article.

1- Labial Frenum

The labial frenulum attaches the gum’s tissue into the lips. A small connective tissue would limit the movement between lips and gums(if its length is very short). This type of frenum may not let lips move to their full capacity. Although, both lower and upper lips would be involved by this disorder, most problems are seen in the upper lip. In this condition, speaking would be very difficult. As the disorder develops further, patients even would find eating difficult, and after a while gums would recess.

labial frenum

Labial Frenum

2- Lingual Frenum

This type of frenum connects the tongue into the lower part of the mouth. A very short frenulum would limit such movements. The disorder may cause problems with newborns’ eating mechanisms. It is amongst the most common disorders related to breastfeeding, which makes kids’ feeding difficult and even impossible.

Suffering from this type of problem, such kids fail to drink enough milk, which in turn will be followed by severe weight loss; thus, it is highly recommended to visit a therapist upon noticing such problems with your kids. Lingual frenectomy solves movement problems and allows your kid to drink and eat again as much as they need.

Abnormal frenum causes problems. An oversized lingual frenum, for example, causes problems with tongue movements and speech disorders. On the other hand, an oversized labial frenum would cause gaps between anterior teeth, malocclusion and hence an ugly smile. Moreover, it would cause a recession of gum and bones, because it lifts gums upward constantly. To resolve these problems, it is necessary to remove frenum through frenectomy.

boy with labial frenum

Boy with labial frenum

What is Frenectomy?

Frenectomy is a surgery used for removing frenum. Sometimes, frenum may have an abnormal shape and cause negative consequences, thus, in such cases, it must be removed by a therapist. Frenum is able to  be removed fully or partly. If done correctly, frenectomy can solve many patients’ problems.

Advantages of Frenectomy

Frenectomy is possible both in children and in adults. After the treatment period, all patients would take advantage of various advantages of this surgery. Here, some advantages of frenectomy are discussed succinctly.

Improved Chewing and Swallowing Abilities

Frenectomy allows jaws to move further, and it helps lips’ level to happen more naturally. Frenectomy also allows chewing and biting to happen without imposing too much pressure. Likewise, by improving the function and movement of the tongue, frenectomy facilitates chewing and swallowing and would solve many gastrointestinal problems and acid reflux (heartburn).

Improved Status of Teeth, Oral Health and Refined Smile Design

As a result of frenectomy, teeth do not hurt any more by the constant labial frenum contraction and the severe pain someone would have felt by chewing food will be resolved.  Frenectomy also improves the teeth’s status. An abnormal frenum even affects the tongue. The oral environment would be polluted, if the tongue fails to move and rotate inside the mouth. Resolving abnormal lingual frenum using frenectomy will help to control such cases and prevent tooth decay.

If the labial frenum imposes a gap between two front teeth, having a beautiful smile will be impossible. By removing frenum, a labial frenectomy will award a nice smile to patients.

Improved Speech and Enhanced Self-reliance in Patients

The ability to talk fluently through pronouncing words and sentences eloquently can enhance people’s self-reliance considerably. By removing an abnormal frenum, frenectomy will help you in this regard.

Frenectomy Mechanism

Frenectomy is a simple surgery which needs to be conducted by gum specialists. Initially, the gum specialist puts anesthetic substances around the frenum letting the patient feel less pain. Then, using the surgical device or laser, the appendage tissue is removed. Depending on the surgery’s extent, sometimes stitches will be necessary after the surgery. Generally, using a laser to cut the tissue has decreased frenectomy’s side effects and has lessened bleeding.

labial frenectomy surgery

Labial frenectomy surgery

Necessary Cares after Frenectomy

Frenectomy surgery takes ten to twenty minutes. Since it is a simple surgery, usually it will be recovered quickly. Dentists may prescribe antibiotics to prevent infection or other side effects of this surgery. After 2–3 days, you must be able to continue your routine work and eating habits.

One of the important after-frenectomy cares for newborn kids is to keep the incision site clean. Initially, this site would be vulnerable a bit. For adults, besides following oral and dental hygiene instructions, normally some alterations in the diet are necessary to avoid a condition in which food would be caught in the incision site.

Following the surgery completion, after-surgery care must be followed. Important items that must be considered are keeping the incision site clean and washing it using mouthwash and diluted saltwater and using soft brushes. In the case of using stitches in the surgery, absorbable suture usually is used, which is absorbed by the body over time. In the first days following the surgery, solid foods must be avoided. In the case of feeling pain and inflammation after frenectomy, you must know that they are normal to some extent, however to alleviate them, under your therapist supervision, you can take some painkillers.

The Relationship between Orthodontics and Frenectomy

When a patient needs both frenectomy and orthodontic treatment, they need to visit an orthodontist to consult with them about the best time for doing surgery. However, principally most orthodontists believe that patients need to wait until the growth of their permanent teeth is completed, which in turn would lead to closure of the gap between the teeth. In cases in which the gap is not filled after the full growth of teeth, the fixed orthodontic treatment is recommended. In most cases, the full growth of the permanent teeth will fill the gap between them automatically. At the end of orthodontic treatment, if there is a frenum it must be removed using frenectomy.

After orthodontic treatment and aligning the teeth, if there is a big gap between the teeth in the maxilla, frenectomy is presumably necessary. Because, a frenum causes muscular tension, which will in turn lead to recurrence of pre-orthodontic condition and formation of new gaps between teeth. To gain information about the necessity of doing a frenectomy, you need to visit and consult an orthodontist.

What is important about frenectomy is that orthodontic treatment must be conducted before frenectomy, because the scar left after frenectomy would act as a hindrance against the closure between the teeth and block a correct and complete orthodontic treatment.

Frenum and Frenectomy FAQ

1- Is a frenectomy necessary?

Yes, an abnormal frenum causes several problems with swallowing, speech and smiling. Using frenectomy, you can get rid of all of these problems through only a simple surgery.

2- Can teens use frenectomy too?

Yes, there is no limitation for using frenectomy, however, depending on the condition, it is different in children, teens and adults.

3- What are the side effects of frenectomy?

Frenectomy would have no side effects, if it is performed correctly; however, a common side effect after this surgery is a short-term bleeding in mouth.

4- How long does the frenectomy recovery last?

There is a direct relation between the frenectomy surgery’s recovery and the patient’s condition; however, most patients will resume their routine life and work after about two weeks.

5- When is the best time for removing kids’ abnormal frenum?

You need to visit a specialist as soon as possible, if your newborn kid suffers from various problems including breastfeeding and/or swallowing foods.

Dr Abdolreza Jamilian Orthodontist

About Dr Abdolreza Jamilian Orthodontist

Dr. Jamilian, an orthodontist, has a specialized fellowship in orthodontic surgery and maxillofacial abnormalities and is a professor in the orthodontics department of the Dentistry School of the Islamic Azad University. He is member of Iranian and European Board of Orthodontics (EBO) and is a member of the Iranian, American and European Orthodontists Association.

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