Ever wonder where the expression ‘tongue-tied’ comes from?

As always, KidZdent is shining the spotlight on the latest research and evidence surrounding what is commonly referred to as tongue or lip ties. In a perfect world, tongue or lip ties would be classified and assessed in the earliest stages of infancy. However, it is only now surfacing that certain factors regarding the full range of motion, tension, and pressure between tongue and lip ties are being linked to behavioral conditions, developmental issues, speech impediments, sleeping disorders, and disrupting overall health and wellness. All of this can be avoided with the right information and preventative dental care coming from the team at KidZdent.

More and more children and young adults who were not diagnosed at an earlier age are now seeking corrective treatment as we emphasize the importance of frenectomies. KidZdent is always here to provide family-focused pediatric dentistry to children of all ages, including special needs experience and expertise. 

At KidZdent, we try not to use the medical terms to scare off our patients, but we also want to educate our parents so they have a comprehensive understanding. Our hygienists and doctors are always willing to answer questions and explain all of the options with details.

With that being said, a frenum is a technical term used to identify the natural piece of tissue located directly underneath the base of the tongue muscle or the midpoint of the upper lip connecting the inner region of the mouth with the gum line acting as a tether to limit movement.

Many infants are born with a short (an additional) muscle attachment between either the upper or lower front teeth preventing the jaw from normal growth and teeth from aligning properly. This creates potential spacing between the teeth. A lack of length in this tissue may lead to pulling on the gum tissue near the front teeth, resulting in a recession of the gum tissue. Whether too short, tight or tough, the inhibited activity can make regular tasks like eating or talking more difficult. Proper length and attachment of the frenum is an important aspect of oral posture, balance, and breathing during infancy and as a child develops.

KidZdent Presents the Signs of a Problematic Frenum which include:

  • Breastfeeding difficulty like gumming rather than sucking sensations, failure to latch, or a tendency to fall asleep during feeding
  • Reflux, gagging, gasping, choking, aerophagia (swallowing air), & distended abdominal issues
  • Inability to blean anterior teeth (decalcified or decayed enamel)
  • Trouble gaining weight which is an overall concern for overall health and development
  • Aesthetic effects become more apparent like spacing issues or a pronounced gap in the front teeth (You may not notice the physical appearance until the child is older)

Since corrective action is often necessary to resolve restricted movement, KidZdent may recommend a frenectomy. A frenectomy is a mildly invasive surgical procedure which releases the frenum to allow proper function and maneuvering. By providing this treatment, patients will experience an increase in oral stability, multiple health benefits and improved success of the final orthodontic result at KidZdent.

A frenectomy can be described as a simple and common treatment which addresses a few distinct oral problems, usually involving the tongue and upper lip.  It’s an extremely low-risk, in-office procedure. The ultimate objective is to restore normal utility and mobility in the mouth. 

When a frenectomy is carried out in the earlier stages of infancy or childhood, it can spare and prevent negative effects of shorter frenums like:

  • Tongue thrusting
  • Snoring or other sleep disorders
  • Breathing issues
  • Speech impediments
  • Swallowing ailments
  • Stomach & digestive conditions
  • Behavioral anxieties
  • Difficulty maintaining oral hygiene
  • Improper brushing techniques

Patients who undergo a frenectomy are instructed to complete stretching exercises to ensure a wide range of flexibility by our KidZdent practitioners.

Although there are multiple frenums in the human body, frenectomies use similar techniques on the below-targeted areas.

Labial Frenectomy (upper lip): A labial frenectomy primarily involves the reduction of the frenum attaching the upper lip to the upper jaw. The ligament tissue can extend toward the two upper front teeth and cause a diastema, or gap in the teeth. It may also actualize an “open mouth posture,” by restricting the movement of the lip and impeding the mouth from closing properly. This leads to open mouth breathing, which is maturing children impairs the advancement of nose breathing and by extension proper airway and jaw development. It may also cause gum recession. 

Labial Frenectomy (lower lip): The lower lip frenectomy is done for similar reasons as the upper lip, generally to stop periodontal problems and gum recession. But it is also performed in older adults who are being fitted for dentures. When the lips move, the frenum can pull the dentures loose, leading to improper fit. 

Lingual Frenectomy: The lingual frenum is the band of tissue underneath the tongue that binds the tongue to a resting position. In most people, there’s sufficient elasticity so that the tongue has proper range of motion to perform everyday functions like speaking and eating. If it’s too tight or short it holds the tongue too close to the floor of the mouth. Ever wonder where the expression ‘tongue-tied’ comes from?

If the tongue is attached too low, the movement is restricted and development problems such as orthodontic issues, sleep apnea, swallowing and speech issues can occur. It can stop the tongue from pressing properly against the upper palate during routine swallowing, directing it instead between the teeth and preventing the bite from closing all the way over time. Finally, being tongue-tied is an underlying cause for many dental and health problems.

There are many accepted and familiar ways to perform frenectomies, especially since they occur so frequently. All of which have minimal impact and rapid heal time.

The most effective and commonly recommended type of frenectomy procedure by KidZdent involves a small incision to reduce and release the frenum and possible suturing. The area will be anesthetized using a topical and local anesthetic. Laughing gas can also be used to relax the patient.

A frenectomy using a laser is effective in some cases, but not all. Factors like structural development, age, width and/or thickness of the frenum will be assessed by the KidZdent team.

A laser frenectomy may not be advised because depending on these factors the laser may not be able to reduce the tissue enough to deliver the full range of movement. These factors will allow us to determine the proper procedure to produce the best possible outcome and deliver a full range of movement.

  • Optimal results may be achieved with a scalpel or a laser in under 15 minutes
  • Little to no postoperative discomfort or bleeding
  • May not even require stitches
  • Quick healing/recovery time

  • Avoid eating hard food that requires using the front teeth
  • Do eat softer food using the back teeth for chewing
  • Drink cool liquids such as a ginger ale and water
  • Ice pops and ice cream can be very soothing (and makes everything feel better!)
  • Rinse with warm water and salt to soothe the area and promote healing
  • Swelling is sometimes expected. Use an ice pack to help reduce lip swelling
  • Use Tylenol or Motrin to relieve discomfort. Follow the instructions on the bottle
  • Brush regularly taking care to avoid hitting into the surgical site
  • Avoid strenuous activities or high-contact sports

Patients will need to monitor the surface for about a week. Notify the office if any questions or complications.

Have questions or need any help from our team? Reach out to us below and one of our team members will get in touch with you as soon as we see your request.