Frenums and Frenectomy

In the oral cavity, most people have two bands of tissue called frenums that are located in and around the teeth and gums. What happens if the tissue impairs oral function? A procedure called a frenectomy may be the answer.

What Is a Frenum?

They are two basic types of frenums: a lingual and a labial frenum.

The lingual frenum is located between the base of the tongue and the floor of the mouth. It comes in all different sizes, and if the frenum restricts the movement of the tongue (a condition called "tongue tied"), a surgical procedure called a frenectomy may be performed. A frenectomy can be performed by a general dentist, an oral surgeon or another specialist. The goal is to free the tongue and allow proper speech, swallowing and movement.

In the upper arch, the tissue that connects the gum to the lip is called the labial frenum. If it is abnormally wide or long, it may connect through to the gum tissue between the teeth and extend to the front portion of the roof of the mouth. When the upper frenum is too wide or long, it can create a space between the two front teeth, and that may require a surgical procedure performed by a general dentist, oral surgeon or other specialist. If the patient is seeing an orthodontist and the goal is to close the space between the two front teeth, then a consultation with the orthodontist as to when the surgery should take place is a good idea.

What Is a Frenectomy?

Depending on the preference of the doctor and the limitations of the procedure itself, the frenum is reduced in size with a scalpel (blade) or a laser made specifically to cut soft tissue, according to the Journal of Clinical & Diagnostic Research. In some instances, the surgeon doing the procedure may use a combination of the two instruments to shape and precisely cut the tissue to get an ideal result.

What Happens After a Frenectomy?

In many instances, there is very little post-operative pain and swelling, and the patient can have normal function of the lips and tongue. Many patients hardly notice the effects of the surgery.

Some patients liken the procedure to having a "pizza burn" in and around the mouth. Swishing with a mouthwash such as Colgate Total Advanced Pro-Shield, which kills 99% of germs on contact, may protect the uncovered surgical area and hasten the healing process.

After a few post-surgery checks, patients can then continue to see their dentist and dental hygienist regularly as part of their preventive maintenance program.

Having a frenum reduced in size or length is a simple procedure, and it can be performed at any age to improve oral health and promote a lifetime of smiles.

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Each tooth has several distinct parts; here is an overview of each part:

  • Enamel – this is the outer and hardest part of the tooth that has the most mineralized tissue in the body. It can be damaged by decay if teeth are not cared for properly.

  • Dentin – this is the layer of the tooth under the enamel. If decay makes it through the enamel, it next attacks the dentin — where millions of tiny tubes lead directly to the dental pulp.

  • Pulp – this is the soft tissue found in the center of all teeth, where the nerve tissue and blood vessels are located. If tooth decay reaches the pulp, you usually feel pain and may require a root canal procedure.