A frenulectomy (or Frenectomy) is a scary and intimidating sounding word for a common and simple procedure performed to address a number of medical problems, most often in the mouth of children and sometimes adults. Also referred to as a frenectomy or frenotomy, a frenulectomy is an outpatient surgical procedure where your frenum is clipped or removed.
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What is a Frenum?
Your frenum (also called frenulum) is the little piece of tissue that connects your cheeks, tongue or lips to your gum area. You have several frenums in your body. However, the ones that typically require frenulectomy are inside your mouth.
Two of the most common frenums include your:
Lingual Frenum. This is the frenum that connects your tongue to the floor of your mouth. It can sometimes run up to the tip of your tongue causing you to be "tongue-tied."
Maxillary Labial Frenum. This frenum attaches your gums and upper lip right above your upper two front teeth. You can feel it when moving your tongue up between your teeth and upper lip.
These frenums have no distinct purpose and removing it causes no loss of function.
Reasons for a Frenulectomy (frenectomy)
Common frenectomies involve your upper lip and tongue. The frenum, sometimes, is too tough, short, or tight. It can inhibit movement, which causes you to find regular tasks, such as talking and eating, difficult to do. It can also hinder the development in children, resulting in aesthetic issues.
A frenulectomy is a simple procedure where your Houston doctor severs your frenulum and often removes it to free up more movement. This outpatient procedure is low-risk and often solves the problem successfully the first time.
Frenectomy in Adults
Adults who have an over-sized frenulum can experience a number of problems that an elective frenectomy can fix. These common problems include:
If you’re experiencing any of these symptoms below, your issue might not be the often diagnosed condition, temporomandibular joint (TMJ). These symptoms include:
Soreness in your jaw
Sensation of "clicking" while opening and shutting your mouth
When you have a tight frenulum, it can cause you to develop different chewing and talking patterns that can cause you pain later on. If you've received a TMJ diagnosis and are currently receiving treatment that doesn't seem to work, have your doctor check and see if your frenulum is the problem.
A tight frenulum can interfere with your eating. While chewing, food gets pushed towards your esophagus automatically, but to do this, your tongue needs to move freely in your mouth. When you have limited tongue movement, the food you eat isn't moving on the regular path it should be, causing you to have difficulty swallowing. This can keep you from eating the foods you enjoy or even lead to malnutrition. A frenectomy can fix this problem.
When a frenulum problem keeps your food from moving through your mouth quickly as it's supposed to, it can cause poor dental health. You're not able to clean your molars with a swipe of the tip of your tongue between meals, and this leads to food particles sticking around in your mouth and on your teeth longer. Rinsing your mouth after you eat can help. However, it's much easier to have your frenulum fixed.
If your frenum is pulling at your gums and causing them to recede, a frenectomy can help to halt this oral issue.
You may need a frenectomy if you're getting dentures and your frenum position is interfering with how your dentures fit. In some cases, a frenectomy is needed when you’re getting braces.
As a child with frenulum issues that didn't get addressed, you may have learned how to speak around your tongue limitations. But, these tongue limitations can make it hard for you to remain audible and for people to understand you when you're talking at higher or lower volumes than normal.
Problems with Kissing
If you feel you're not skilled enough or don't enjoy kissing, it could just be that you’re facing physical limitations. When your frenulum is too tight, it can make it difficult to kiss properly.
Difficulties Playing Certain Instruments
You may decide to get a frenectomy if frenulum issues are interfering with playing certain musical instruments, such as the trumpet, where you lips and tongue tip are involved.
Frenectomy in Children
Some children have large frenums under their tongues, preventing them from moving their tongue freely. This often interferes with their speech and causes them to be tongue-tied (ankyloglossia).
Children may experience ankyloglossia symptoms such as:
Nursing/breastfeeding interference as an infant
Frenulum beneath tongue getting stuck between teeth
Difficulty sticking tongue out far
Receding gums that cause periodontal issues
Your Houston ear, nose and throat (ENT) doctor also can perform a labial frenectomy when a child's frenum is connected to their two front, upper teeth. This can happen in children once their permanent front upper teeth have come through in their mouths.
An attached frenum can also prevent baby teeth from erupting at all.
Indications of Frenectomy
There are several indications you might require a frenectomy:
1. Your two upper front teeth have a lot of spacing between them. Your frenum may have excess fibrotic tissue that prevents space closure or opens the space again after it's been closed.
2. The position of your labial frenum is close to the edge of your gum tissue where it causes tension and will cause gum recession or loss if you don't have it corrected.
3. You are tongue-tied or have a high lingual frenum attachment which restricts tongue movement that affects your speech, eating and swallowing abilities.
Frenulum problems are typically corrected when you’re a baby or child when you start showing speech impediments and feeding issues. However, it’s not uncommon for children with tongue tie to reach their adulthood years before receiving any type of corrective surgery for the problem, even though their restricted tongue movement causes them an array of problems.
Indications Children Need a Frenectomy
An infant or child may need the procedure performed if they show any signs of tongue-tie that is causing issues for them such as difficulty with breastfeeding. If the child’s speech is being affected by their condition, it is likely an indication they need a frenectomy.
Children who are complaining of tongue issues that are interfering with their speaking, eating or having the ability to reach back to their teeth may need the procedure done.
Some lactation consultants and doctors recommend having an abnormal frenulum corrected right away once it’s noticed in a newborn before they're discharged from the hospital. Others recommend waiting to see what happens with it. The problem could correct itself and resolved tongue-tie or the problem could persist but not cause problems.
Sometimes, tongue tie surgery is needed. A frenectomy or frenotomy can fix an abnormal frenulum. The doctor removes the frenum and its attachment to your underlying bone during a frenectomy. Your physician makes an incision during a frenotomy and relocates the frenal attachment. Babies, children, and adults can have tongue tie surgery.
If you suspect that you or your child are tongue-tied or have frenulum problems that might require the frenotomy procedure, contact Houston ENT & Allergy at one of our 10 locations today. We can provide expert treatment for to allow normal tongue and mouth function for opti0mal quality of life.
She completed her undergraduate education at the University of Notre Dame in South Bend, Indiana. She moved to North Carolina to attend the Wake Forest University School of Medicine for her medical degree. She then went on to complete her residency at the University of Texas Health Science Center- Houston in 2001.