Frenectomy with CO2 Laser

A frenum is a fold of tissue or muscle that connects the lips, cheek or tongue to the jawbone. A frenectomy is a procedure to remove one of these folds of tissue. Some people have a large frenum under the tongue that prevents the tongue from moving freely and can interfere with speech or breast feeding with young babies. The condition of limited tongue mobility is called tongue tie or ankyloglossia. A lingual frenectomy removes this fold of tissue so the tongue can move more freely.
There are several periods during childhood when you may notice symptoms of tongue tie in your child:

  • In infants, tongue tie can interfere with feeding, though this is rare.
  • When your child begins talking — usually at 12 to 18 months — you may notice that he or she is having problems with speech.
  • Some older children or teenagers may notice that the frenum under their tongue becomes stuck between their front teeth, or that they can’t stick their tongue out as far as their friends can.
  • Your dentist may notice that the frenum is pulling your child’s gum tissue away from the lower front teeth, which can cause periodontal problems.

Sometimes a frenum is attached between the two upper front teeth. The procedure to remove this is called a labial frenectomy. This condition usually is noticed in children after their permanent upper front teeth have come in, but it also can be evident earlier, even before the baby teeth come in. If the tissue is attached too far down on the gum, it can create a space between the two front teeth. Even if an orthodontist closes the gap, the frenum can push the teeth apart again. The frenum also can be attached in such a way that it prevents the baby teeth from coming in. In this case, the condition would be noticed sooner.

Adults receiving dentures may need a frenectomy if the position of a frenum (usually one between the cheek and gum in the back of the mouth, or in the middle of the upper or lower lip) will interfere with the denture’s fit.

Removal of a Frenum

For removal of a frenum, Drs. Murphy, Kosman, Danko, or Warren can use a scalpel or a laser to remove a frenum. A laser minimizes bleeding, reduces the need for sutures and causes less pain. If a scalpel is used, you usually will need sutures.

Typically for younger children, sedation may be required. In older children and adults, the procedure can be done with local anesthesia with or without nitrous oxide. The surgery can be done in as little as 10 to 15 minutes.

A frenectomy can take several weeks to heal completely. An over-the-counter nonsteroidal anti-inflammatory drug can be taken, such as ibuprofen (Advil, Motrin and others), for pain relief. Rinsing with salt water helps keep the area clean. Brush and floss carefully around the area. Depending on the type of stitches we used, they may need to be removed or will dissolve on their own.