Kids 360 Pediatric Dentistry

Richmond, TX 77406 | Dr. Mayuri Appareddy

11131 Harlem Rd. Suite 120
Richmond, TX 77406

(832) 271-6114
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Treatment of Tongue, Lip, and Buccal Ties (Frenectomy)

What is a Frenum?

The Frenum is a piece of tissue which connects the base of the tongue to the floor of the mouth or connects the upper lip and/or cheeks to the gum tissue.  

This tissue is an embryonic remnant in the mouth that did not dissipate in utero and may be causing a tight restriction. 

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What is a Frenectomy?

A Frenectomy is a simple procedure done to remove this connective tissue to create more mobility of the tongue, lip, or cheeks.

Why are they necessary?

For a tight piece of tissue to qualify as a “tie” or “restriction,” it must have a functional impact on the patient.

There are various reasons why a lingual (tongue), maxillary labial (lip), or buccal (cheek) frenectomy may be recommended for your child.

Some indications for tongue tie release (lingual frenectomy) include difficulty with speech, sleep, or swallowing.

A lip tie can also cause difficulty with oral hygiene or spacing between the two front teeth due to a thick or tight frenum.

Tongue, Lip, and Buccal (Cheek) ties can also cause difficulty with breastfeeding.  Newborns may have trouble latching and creating an adequate seal while breastfeeding.  This can cause infants to swallow air (causing excessive gassiness or reflux).  Difficulty with sleep and excessive mouth breathing are also caused by tight restrictions in the mouth.

What types of Frenectomies are there?

There are three types of relatively routine Frenectomies treated in our office:

  • Lingual Frenectomy (“tongue tie release”): These are performed to remove tissue that connects the underside of the tongue to the floor of the mouth.
  • Maxillary Labial Frenectomy (“Lip Tie Release”): Removing a piece of tissue that connects the upper lip to the upper gums. It may involve removing tissue between the two front teeth
  • Maxillary Buccal Frenectomy (“Cheek Tie Release”): If there is a tight restriction, this procedure would remove a piece of tissue that connects the cheeks to the upper gums.   “Cheek Tie Release” is uncommon but is sometimes indicated.

When should they be done?

Frenectomies can be done at any age.  If a child is symptomatic, it is ideal to complete the procedure when a child is younger to avoid long term consequences.

There are instances in which a Frenectomy isn’t recommended until later in life if there are no functional issues or concerns in infant/toddler years.  In these cases, the effects of the frenum problem may not have been severe enough to cause a nursing or speech issue, but come to light when teeth or jaw is affected or there are concerns with adequate sleep and breathing.

Many adults who have not previously been diagnosed are advised that the procedure will improve their speech and/or eating abilities.

In some cases, speech and/or myofunctional therapy may be recommended before and after treatment to help retrain the intraoral muscles.

How is this procedure accomplished?

In our office, a soft-tissue CO2 LightScalpel laser is used to remove the frenum.  This method causes minimal discomfort and very little bleeding. Healing time is typically short and without complication.

What are the risks involved?

Risks are few and very rare.  A few complications which can occur are:

  • Temporary soreness
  • Bleeding
  • Infection
  • Development of scar tissue (rare)
  • Reattachment of the frenum.  Stretching exercises are critical to prevent this and avoid a 2nd procedure.

Post Op Care:

After frenectomy, a diamond shaped wound will be present in the mouth and will take at least 3 weeks to heal

Dr. Appareddy will provide detailed instructions for post-op care.  It is especially critical to perform post-op stretches for your child 4 times a day for at least 3 weeks to prevent reattachment of the frenum.

It may also be necessary to follow up with a speech therapist, myofunctional therapist, or chiropractor depending on your child’s symptoms.

Additional Information and Articles:

Video of the procedure and healing period

https://www.lightscalpel.com/co2-laser-videos/laser-frenectomy-healing-photos/

Breastfeeding improvement following tonguetie and liptie release: A prospective cohort study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5516187/

Tongue Ties and Sleep Issues (and More)

https://www.lightscalpel.com/publications/tongue-ties-and-sleep-issues/

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