A tissue attachment which holds the lips or tongue from moving too far is called a Fenum or Frenulum.
In some instances, the frenulum attaches high on the jaw near the teeth. Most of the time, this causes no problems. If inflammation and gingival recession is present near the high attachment, then we often recommend removing that portion of the high attachment to prevent or stop recession and bone loss.
Sometimes, if it is a very thick and fibrous high attachment, it will create a space between the teeth. This is often seen between the front 2 big teeth. When orthodontics closes the space, we need to remove the frenulum so it will not push the teeth open again.
Another instance for a frenulectomy is for a patient receiving a full denture. These tissue attachments, if high, can negatively impact the denture as the denture will need to be fabricated to go around the attachment. This can make the denture less stable and the movable frenulum tissue can become sore if it rubs on the denture.
One last reason for a frenectomy is for a ‘tongue tied’ patient. Being tongue tied is really just that frenulum on the floor of the mouth which holds the bottom of the tongue extending too far up the tip of the tongue. This prevents the tongue from extending. Speech can be affected. Also, new born babies may have severe latching problems as the tongue cannot extend out.
Now that we have reviewed what a frenectomy is and the typical cases we see needing treatment, how is the procedure done? Back in dental school, I was taught and provided this treatment in multiple situations. I hated doing it because it felt very barbaric. Scalpel dissecting and opening hemostats inside the incisions to blunt dissect the sides and remove tissue attachments and multiple sutures to hold it closed as it heals. Yikes. But today, our Federal Way dental office uses a laser. No barbary.
Example case of a frenectomy with a laser:
Dr. Shoop had been noticing slight inflammation on and off by the frenulum holding his lower lip to the jaw. He has a high attachment here and knew what had to be done. After getting himself numbed up, he took our Gemini Diode dual wavelength laser and removed the attachment. It was quick, painless, no blood, no sutures and healed easily. Lasers are such a blessing to dentistry and can be used for our benefit in many ways. Maybe we will explore more benefits of our laser in future blog posts. Until then, enjoy these pictures and video of Dr. Shoop’s Frenulectomy and our other blog posts!