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Frenectomy

A normal frenum is a connective band bringing two soft tissue pieces together. In some cases, if that band connects too low or tight it may result in a condition known as a Tongue-Tie or a Lip-Tie, and the tissue can become restrictive in nature which can cause feeding, speech, dental and sleep issues. 

What Is a Tongue-Tie?

Tongue-Tie occurs when the strip of tissue (lingual frenulum) connecting the tongue to the floor of the mouth is shorter than usual. Typically this strip of skin separates before birth, allowing the tongue free range of motion, but with tongue-tie the lingual frenulum remains attached to the bottom of the tongue.

What is a Lip-Tie?

Lip-Tie occurs when the strip of tissue behind the upper lip (labial frenum) connecting the lip to the gum is too thick or too stiff. A lip-tie keeps the upper lip tethered to the gum line, restricting the movement of the upper lip. 

Frenectomy in Infants

Feeding a baby comfortably and efficiently is the most important aspect of a newborn’s life, and a precious experience for a new mom. Tongue and Lip-Ties can jeopardize the beautiful nursing relationship between a mother and her newborn. 

A frenectomy — dividing the lip or tongue-tie — can dramatically improve breastfeeding comfort and efficiency for both mother and baby. Dividing a tie is a quick and simple procedure that allows a baby to freely use their lip and tongue for an efficient, effective, and comfortable feeding experience.

Consequences of an Untreated Lip or Tongue-Tie for Mothers and Babies:

  • Pain or discomfort during feedings that can cause discouragement and lead to a premature end to breastfeeding. 
  • Inability for baby to latch and/or difficulty staying on the breast.
  • Low milk production because of ineffective milk removal. This can also lead to engorgement and/or blocked ducts for the mother. The baby can require more frequent or extended feedings in order to get enough milk. 
  • Sleep deprivation for mother and baby.
  • Poor bonding between mother and baby.
  • Failure of the baby to thrive and gain weight.
  • Increased reflux, colic, gas, and bloating for baby.
  • Improper tongue mobility and improper alignment of teeth/jaw nearest the ties.

How We Can Help

Releasing the frenum is called a frenectomy. Dr. Monajemy performs a procedure called a "laser frenectomy" using a WaterLase laser to gently release the frenum from its attachment. The frenectomy procedure takes between 5 and 30 minutes depending on the severity of the case, and full healing with new skin is evident within 10 days.

Ideally, a frenectomy should be performed 30 minutes to an hour prior to the next scheduled feeding so the baby can nurse immediately after the procedure. The baby is swaddled and placed in our dental chair while being stabilized by an adult to minimize movement during the procedure. Topical numbing gel and/or local anesthesia may be administered on a case by case basis. 

Once the laser procedure is completed, the baby is returned to the parents to review exercises and stretches and for feeding. Moms report significant improvement in personal comfort, baby’s consumption, and efficiency while nursing or bottle feeding. In many cases, moms will be able to experience immediate results, where the baby will successfully latch and feed.

Post-operative discomfort is minimal and usually involves mild soreness for 2-3 days. Unlike a traditional scalpel frenectomy, laser frenectomy allows your baby to eat and function normally immediately following the procedure. 

Frenectomy in Children and Adolescents

In both children and adolescents, consequences of an untreated lip or tongue-tie can include:

  • Poor swallowing and a risk of anterior open bite.
  • A gap between the front teeth.
  • Trapped food, plaque, and bacteria.
  • Dental infections.
  • Loss of tooth structure and tooth loss.
  • Restricted dental arch development and facial development.
  • Clicking jaw or pain in the jaw. 
  • Protrusion of lower jaws.
  • Recurrent orthodontic issues.
  • Gagging, choking or vomiting foods.
  • Persistence of dribbling and drooling.
  • Delayed development of speech.
  • Deterioration in speech.
  • Behavior problems.
  • Sleep disordered breathing.
  • Mouth breathing.
  • Migraines and tension headaches.
  • A propensity to allergies.

How We Can Help

A frenectomy gently releases the membrane connecting the lip or tongue-tie. Dr. Monajemy performs a procedure called a “laser frenectomy" using a WaterLase laser to gently release the frenum from its attachment.  The frenectomy procedure takes between 5 and 30 minutes depending on the severity of the case, and full healing with new skin is evident within 10 days. Topical numbing gel and local anesthesia are typically used. Occasionally, if the child or adolescent is anxious, Dr. Mona may suggest the use of conscious sedation for the frenectomy procedure. 

Post-operative discomfort is minimal and usually involves mild soreness for 2-3 days or up to a week. Unlike a traditional scalpel frenectomy, laser frenectomy allows your child to eat and function normally immediately following the procedure. 

usdiAmerican Dental AssociationAmerican Academy Of Pediatric Dentistry