Frenectomy

A frenectomy is a procedure to remove or modify a tight or restrictive band of tissue called a frenum that anchors the lips or tongue to the gums or floor of the mouth. When a frenum is unusually short, thick, or tethered it can limit normal movement and affect feeding, speech, or dental development. The primary goal of a frenectomy is to restore function so a child can eat, speak, and maintain oral hygiene without restriction.

Not every atypical frenum requires treatment, so clinicians focus on how the tissue affects daily function rather than its appearance alone. Early evaluation can prevent secondary problems such as difficulty breastfeeding, persistent speech issues, or a gap between the front teeth. When an exam shows functional limitation, a frenectomy becomes a practical option to support healthy development.

Common signs vary with age but often include trouble latching during infancy, difficulty elevating or protruding the tongue, or a visible gap between the upper front teeth. Older children may have speech articulation concerns, trouble clearing food from the front of the mouth, or persistent plaque buildup because limited movement interferes with cleaning. Parents sometimes notice a tethered appearance when the child tries to stick out the tongue or when the upper lip pulls tightly against the gums while crying or smiling.

Because these signs can have multiple causes, a clinical assessment is important to determine whether the frenum is the primary issue. Providers will consider feeding history, speech milestones, and dental eruption patterns when deciding if a frenectomy is appropriate. Early consultation with a pediatric dental provider or a multidisciplinary team helps families understand whether observation, therapy, or a procedure is the best next step.

The most commonly discussed frena in pediatric care are the maxillary labial frenum (upper lip), the mandibular labial frenum (lower lip), and the lingual frenum (under the tongue). A high or bulky upper labial frenum can contribute to a diastema between the front teeth or tug on the gums, while an unusually short lingual frenum, often called tongue-tie, can restrict tongue elevation and articulation. Each location has distinct functional implications and is evaluated according to how movement and development are affected.

Treatment is reserved for frena that demonstrably impair feeding, speech, oral hygiene, or orthodontic goals rather than for purely cosmetic concerns. Sometimes conservative measures like stretching exercises or therapy are tried first, particularly when function may improve without surgery. When non-surgical approaches do not resolve functional limitations, a targeted frenectomy addresses the specific anatomic restriction.

An evaluation begins with a careful clinical exam that observes how the child uses the lips and tongue during eating, swallowing, smiling, and speaking. Providers measure functional limits by assessing tongue elevation, protrusion, and the effect of the frenum on lip movement and tooth position, and they review feeding history and developmental milestones. Simple functional tests and clear documentation help determine whether the frenum is causing meaningful impairment.

History and collaboration are important parts of the assessment, so clinicians often coordinate with pediatricians, lactation consultants, and speech-language pathologists when appropriate. Many teams trial conservative interventions like stretching or feeding strategies before recommending surgery, especially in infants. When functional deficits persist despite non-surgical care, the clinician will discuss the expected benefits and the recommended next steps.

Frenectomies can be performed using traditional surgical instruments or modern soft-tissue lasers, and both approaches effectively release restrictive tissue when performed correctly. Laser treatment commonly reduces bleeding and swelling, may shorten healing time, and can be more comfortable for some patients, while conventional scalpel techniques are reliable and appropriate in many clinical scenarios. The choice of technique depends on the child’s age, anatomy, clinician training, and the specific goals of the procedure.

Regardless of method, the procedure focuses on releasing tension and, when needed, repositioning remaining tissue to minimize reattachment and support function. Procedures are typically brief and performed with appropriate anesthesia or calming support to ensure patient comfort. After the release, clinicians routinely demonstrate simple exercises to maintain mobility and reduce the risk of scar tissue formation.

When performed by a trained pediatric dental provider, a frenectomy is generally safe and well tolerated, with most patients experiencing only mild and temporary soreness. Possible risks include bleeding, infection, scarring, or incomplete release that could require additional care, but these outcomes are uncommon with careful technique and proper aftercare. Clinicians minimize risk through thorough evaluation, appropriate anesthesia choices, and clear post-operative instructions.

Families receive guidance on signs that warrant follow-up, such as persistent bleeding, fever, or unusual pain, and the practice schedules check-ins to monitor healing. The likelihood of complications is reduced when the decision to treat is based on functional need and when recommended rehabilitation exercises are followed. Open communication with the dental team ensures prompt attention if concerns arise during recovery.

Pain and anxiety are managed according to the child’s age, temperament, and the extent of the procedure; options include local anesthesia, gentle behavior guidance, or mild sedation for younger or particularly anxious patients. For most older children a local anesthetic is sufficient, and the team explains each step in child-friendly terms to reduce fear and build cooperation. The clinical environment is designed to be calming and supportive so children feel safe throughout the visit.

After the procedure, routine pediatric analgesics and simple home care measures are typically effective for soreness, and staff provide clear instructions for comfort and wound care. The care team also demonstrates mobility exercises and uses positive reinforcement to encourage participation in aftercare. If sedation is recommended, families receive a detailed plan and pre- and post-procedure instructions to ensure safety.

Recovery is usually quick, with most children experiencing only mild tenderness for a few days and steady improvement thereafter. Parents are given wound-care instructions, a schedule for gentle stretching or tongue mobility exercises, and guidance on normal signs of healing versus symptoms that require follow-up. Keeping the area clean and following prescribed exercises helps prevent reattachment and supports improved function.

Follow-up visits allow the clinician to confirm appropriate healing and to adjust the aftercare plan if needed, and coordination with speech therapy or orthodontics may be arranged when indicated. Consistent home practice of recommended exercises is often an important part of a successful outcome. Regular communication with the office ensures any questions or concerns are addressed promptly during the recovery period.

A frenectomy can improve the mechanical limitations that interfere with speech or tooth movement, but additional therapies are sometimes needed to achieve optimal results. Speech therapy may be recommended when articulation patterns have developed around restricted movement and require retraining, and orthodontic treatment may be part of a long-term plan if tooth alignment was affected by the frenum. The need for these services is determined on a case-by-case basis after evaluating function and developmental progress.

Many clinicians take a multidisciplinary approach, referring to speech-language pathologists or orthodontists when appropriate to support the child’s overall outcomes. Early coordination and clear goals help families understand what to expect and how different therapies can complement the benefits of a frenectomy. Ongoing monitoring ensures that any necessary referrals are made in a timely manner to support speech development and dental alignment.

At Myers Pediatric Dentistry & Orthodontics the team emphasizes clear communication, thorough evaluation, and coordinated follow-up to support each child’s developmental needs. The office works collaboratively with pediatricians, lactation consultants, speech-language pathologists, and orthodontists when necessary to create a comprehensive plan that addresses feeding, speech, and dental goals. Families receive a plain-language explanation of findings, the recommended plan of care, and specific aftercare instructions to support healing and function.

Scheduled follow-up visits monitor healing and functional improvements, and the team adjusts recommendations based on the child’s progress and any additional needs. If therapy or orthodontic referral is indicated, the practice helps facilitate those connections and communicates with outside providers as needed. This coordinated approach ensures that the frenectomy is integrated into a broader plan for the child’s oral and developmental health.