Tongue Tied?

UNDERSTANDING FRENECTOMIES FOR KIDS AND ADULTS

BY ANNETTE BROOKS

Most of us don’t think twice about the folds of tissue that connect our upper and lower lips to the gums, and our tongue to the floor of the mouth. Called frenum, also known as frenulum, they play a vital role in our health and wellness. By regulating movement of the lips and tongue, they help ensure proper functions when talking, swallowing, breathing, and latching for breastfeeding infants.

The procedure for adults is similar to that for children, although the healing time may be slightly longer. Most people return to normal activities within a week, and pain and discomfort are usually minimal and manageable.

WHAT ARE FRENUM?

Three frenum in the mouth provide stability and support to various oral structures. The maxillary labial frenum connects the upper lip and gums, and the mandibular labial frenum connects the lower lip to the gum tissue. Connecting the underside of the tongue to the floor of the mouth, the lingual frenum enables the tongue to move back and forth for functions like chewing and swallowing while preventing it from moving too far back in the mouth.

WHAT’S A FRENECTOMY?

When frenums are too tight or too short, a minor procedure called a frenectomy may help achieve optimal function. During the procedure, a trained dentist, oral surgeon, pediatrician, or ENT uses a laser or surgical tools to slightly adjust the frenum to increase the range of motion for the affected area.

FRENECTOMIES FOR INFANTS AND KIDS

Pediatric frenectomies are often used to address tongue-tie and lip-tie. Tongue- tie is a condition where the lingual frenum overly restricts the tongue’s movement. When this occurs, speech development may be affected, and it can hinder proper oral hygiene.

Lip-tie occurs when the labial frenum is too tight. It can interfere with breastfeeding, so babies do not get the nourishment they need to thrive, and it may also cause a gap to form between the front teeth. By helping close gaps between front teeth or keeping gaps from forming, the need for orthodontic treatment at a later time may be reduced.

A frenectomy for children and babies, performed after the area is numbed, is typically quick and causes minimal discomfort. Healing is usually fast, often within a few days. Pain can be addressed easily with over-the-counter pain relievers. Children may need a little time to adjust after a frenectomy, but they quickly adapt to the improved mobility and comfort.

FRENECTOMIES FOR ADULTS

While frenectomies are more common in children, adults can also benefit from this procedure. A tight lingual frenum can cause speech impediments, even in adulthood. A restricted labial frenum can pull on the gums, leading to gum recession and discomfort. A restricted frenum can also interfere with the fit and function of dentures and dental implants.

LASER FRENECTOMY ADVANTAGES

While conventional scalpel and laser techniques are used for frenectomies, laser frenectomies are becoming increasingly common. They tend to involve less tissue trauma and seal blood vessels, resulting in less intraoperative bleeding. Patients undergoing laser frenectomies usually experience less discomfort during and after the procedure, fewer complications, and faster healing compared to conventional methods.

NEXT STEPS

If you or a loved one might benefit from a frenectomy, schedule a consultation with a medical professional to explore the best options and address your concerns. When choosing a provider, whether a dentist, oral surgeon, ENT, or pediatrician, ask about their training and experience with frenectomies, their understanding of tethered oral tissues (TOTs), and their approach to the procedure and follow-up care.

Can a Frenectomy Help Treat Obstructive Sleep Apnea (OSA)?

OSA is a serious sleep disorder characterized by repeated interruptions in breathing during sleep caused by a narrowing or collapse of the airway. Although a frenectomy isn’t usually a standalone cure for OSA, it can be a valuable component of a comprehensive treatment plan, especially for those with anatomical issues related to tongue movement.

In some cases, the frenum, particularly the lingual frenum, can contribute to airway obstruction by preventing the tongue from maintaining its proper position during sleep, potentially contributing to airway blockage.

A more mobile tongue can also contribute to better overall muscle tone in the throat, reducing the likelihood of airway collapse.