Tucked inside the gummy, toothless smile of an infant is a small piece of tissue under their upper lip called the labial frenulum.
"Frenulum" is the term used to describe a band of tissue that attaches two structures, and the labial frenulum is the specific attachment on the inside of the upper lip that connects to the upper part of the gums, just above the front teeth, according to a study in Global Pediatric Health. If you pull up your upper lip, you will be able to see this thin band. All babies are born with this, but the level of the attachment to the gums varies between individuals. In general, according to the Global Pediatric Health study, younger children have a more prominent frenulum than older children.
Lip Ties in Infants
If the frenulum attachment is very tight in an infant, they may have what is known as an upper lip tie. While this condition is uncommon, babies who are diagnosed with a lip tie can have difficulty when breastfeeding, according to a case report in the Archives of Craniofacial Surgery. In the majority of cases, the issue corrects itself over time as the child grows. However, in severe cases, the tie can create a gap between the two front teeth, known clinically as a diastema.
In the majority of cases, a mild lip tie can be corrected through a surgical procedure known as a frenulotomy, as the Archives of Craniofacial Surgery report notes. The procedure involves a trained medical professional making an incision — often with the use of a dental laser — in the labial frenulum to release the attachment, according to a study in The Laryngoscope. Typically, the baby will be able to feed immediately, and the release of the lip tie will allow them to open their mouth wider and attach more easily. Few babies need medication after the procedure. To ensure the area heals properly, parents should stretch and massage the area several times a day for several weeks to ensure the tissue doesn't reattach.
As stated in the Textbook and Color Atlas of Traumatic Injuries to the Teeth, labial frenulum injuries are relatively common in toddlers who are learning to walk. Toddlers often fall with their mouths open, and they may fall against a hard object that can result in bruising and even tearing of the frenulum. Importantly, injury to the labial frenulum can also be a sign of forcible bottle-feeding, so if you notice a child with a frenulum tear who hasn't had a recent fall, you may want to seek support.
In most cases, a torn frenulum is no cause for concern and will repair on its own, according to the University of Michigan. If the wound is deep, it may require stitches from a doctor.
Although rare, issues with the labial frenulum can affect a baby's feeding ability. Lip ties need to be identified as soon as possible by either a pediatrician or a dentist. Parents should take their child to the dentist by their first birthday, not only to acclimate the child, but to identify any abnormalities such as lip or tongue ties as early as possible. If your dental or medical professional confirms that your baby has an abnormal frenulum, rest assured that they will assess any feeding difficulties and recommend the best approach to keep your baby's mouth healthy.