What is a Frenum?
A frenum / frena / frenulum is a soft tissue / connective tissue attachment that guides the motion of a specific anatomic feature. Everyone has several frenum’s in their mouths. Each frenum is not always restrictive. The correct diagnosis of a frenum as either normal or restrictive is where an experienced practitioner comes into play.
What is a Tongue Tie?
Ankyloglossia, more commonly known as a tongue-tie, is when the soft tissue attaches from the floor of the mouth to the tongue- lingual frenum. It can restrict proper extension, movement, and functioning of the tongue. It is not only an issue of function for the tongue, but depending on the severity or type of attachment, it can also affect nursing, feeding, speech, sleep, breathing, and facial growth and developmental patterns.
What is a Lip-Tie?
A lip-tie is an abnormally tight/restrictive soft-tissue attachment extending from the gums on the upper jaw to the lip (labial frenum). This condition can make it harder to brush teeth and lead to a significant gap between the top front teeth.
What is a Frenectomy?
A frenectomy is a procedure that directly addresses restrictive or tethered oral tissues through the surgical removal of one or more frenums from a patient’s mouth. The goals of a frenectomy are to increase the range of motion of an area of the mouth in hopes of gaining mobility along with minimizing or eliminating potential problems the restrictions may be contributing to.
Does My Infant Need a Frenectomy?
Tongue and lip-ties are often overlooked. However, they can be the underlying cause of feeding struggles that affect a baby’s weight gain and cause many mothers to stop breastfeeding. This being said just because a child has a frenum does not mean it is restrictive. At Where Smiles Grow, we pride ourselves in being selective with what patients we recommend frenectomy for and will sometimes not recommend it if we are not confident your child will see a benefit.
Here are just some of the signs that you may want to inquire if your child may benefit from a frenectomy:
- Painful Nursing
- Creased, flattened, blistered or cut nipples
- Plugged ducts or mastitis
- Poor or incomplete breast drainage
- Decreasing milk supply
- Poor latch
- Poor or slow weight gain
- Falls asleep in the middle of a feed
- Baby is frustrated with nursing or a bottle
- Gagging, choking, or coughing when eating/feeding
- Dribbling milk out of mouth
- Clicking or smacking noises when feeding
- Gassiness/ upset stomach
- Frequently spits up/ reflux
- Colic symptoms/ baby cries a lot
- Fussiness/ difficulty sleeping
- Baby is always hungry due to inability to successfully feed
It is not uncommon for tongue and lip-ties to go unnoticed until later in life. If your child is struggling with speech delay or other speech issues, difficulty eating, or sleeping issues, speech issues that don’t resolve with speech therapy they should be evaluated for tethered oral tissue.
- Gaps or spaces between teeth
- Narrow and/or vaulted top jaw/palate
- Picky Eaters / Digestive Issues / G.E.R.D
- Sleep Disordered Breathing / Behavioral Issues
How is a Frenectomy Performed?
If your child is diagnosed with a restrictive oral tissue attachment, and that they may benefit from surgical intervention, a frenectomy will be recommended. A frenectomy will be performed with an oral laser. This is much different than the classic snip/ clip with scissors or scalpel. A laser is used because less bleeding, minimal scarring, faster healing less risk for reattachment.
This quick and easy procedure is done in our office and often only take a few minutes. We remove the restrictive tissue being careful not to disrupt adjacent healthy tissue, giving your child the best chance at an improved function and a quick healing process.
What happens after the frenectomy procedure?
After the procedure is complete, parents and newborns are encouraged to nurse if possible. Kids will typically go back to school or continue on with their normal daily routine.
We will provide post-op instructions that will include stretching procedures that function to minimize re-attachment and get the best possible results from the procedure. It will also include pain-relief recommendations. Every child heals at a different rate, but usually after 24-48 hours, they are back to their old selves.
Your child’s dental and overall health is the main goal of our practice. That’s why we use the latest and most minimally invasive techniques available to help improve your child’s care and provide them the best experience possible.
If your child’s pediatrician/lactation consultant/medical provider/orthodontist has recommended them to be evaluated for a frenectomy or you have concerns that they may be a candidate for evaluation for restrictive/tethered oral tissues, contact us! We’re more than happy to talk with you about whether or not they will benefit from treatment and if they are candidates for the frenectomy procedure.