A frenectomy or a frenuloplasty is a surgical procedure that loosens or removes one or more of several bands of tissue that are present inside the mouth, connected to the lip, cheeks or floor of the mouth. Called “frenum” attachments, these bands of tissue sometimes develop abnormally, interfering with oral function or causing dental problems, discomfort, pain, difficulty in fitting dentures, orthodontic problems and/or aesthetic issues, problems that are often treated via frenectomy or a frenuloplasty procedure.
Frenectomy is a relatively minor surgical procedure that is performed by an oral and maxillofacial surgeon. Loosening or removing a problematic frenum may be done with a scalpel or via laser surgery, with the goal of removing excess or poorly positioned tissue. Once that tissue has been removed, the wound will typically be sutured. Frenectomy is a quick procedure, generally taking less than 30 minutes, and is often performed with just local anesthesia or local anesthesia combined with nitrous oxide.
Lingual frenuloplasty differs from lingual frenectomy in that the correction of the abnormally attached frenum or frenulum is performed by surgically repositioning the tissue using plastic surgery techniques.
Most thin frenulums can be done with a simple frenectomy. If additional repair is needed, or the lingual or labial frenulum is too thick for frenectomy, a this more extensive procedure known as frenuloplasty may be required.
Frenectomy or frenuloplasty is often performed to correct an overly large, tight, or poorly positioned lingual frenum – a condition commonly referred to as being “tongue-tied” or “ankyloglossia” – which can cause speech impediments and difficulties with chewing, swallowing and other aspects of oral function. In infants, this condition can impair feeding, and for some older children, teens and adults, cause daily discomfort and/or pain. In children, with the exception of infants with feeding difficulties, speech therapy and other non-surgical interventions are usually attempted before frenectomy or frenuloplasty is recommended.
Frenectomy or frenuloplasty may also be used to alleviate problems caused by an overly large, tight or poorly positioned maxillary labial frenum. A labial frenum that is attached to the gum too close to the front teeth can cause orthodontic issues as the adult teeth come in, creating a large gap between them. In such cases, frenectomy is generally recommended only when the gap cannot be closed through orthodontic care alone. More rarely, a problematic labial frenum can cause gum tissue to pull away from the teeth, requiring frenectomy to ensure dental health. In some cases, an abnormally sized or positioned labial frenum can also cause pain or discomfort when a person smiles or speaks, and may be the source of aesthetic issues for patients.
Frenectomy may also be necessary when a patient’s mouth is being prepared for dentures. While frenulums in any area of the mouth may be problematic in terms of denture fit, those that run between the cheek and gum tissue at the back of the mouth on both the top and bottom jaw are the areas that most often require attention.
After a frenectomy or frenuloplasty procedure, patients can expect some swelling, pain and discomfort. Generally, this is fairly mild and can be controlled with over-the-counter pain medications. Patients are generally required to rinse with salt water several times daily to keep the wound clean and reduce infection risk. Oral hygiene, such as normal brushing and flossing, is also important after surgery, but patients must be careful to avoid irritating surgical sites. Patients who have traditional sutures, rather than dissolvable ones, will need a follow-up visit within a week or two to have them removed. Healing is generally complete within 10 to 14 days.
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