Frenectomies

By: Kenva Smith

& Shaina
Matthews

This Photo by Unknown Author is licensed under CC BY

Ankyloglossia
• Condition that restricts the tongues range of motion
• Limitation in lingual mobility that impedes
protrusion/elevation of the tip of the tongue due to
shortness of genioglossus muscle
• It is present at birth
• It can an affect how a child eats and speaks, and can
interfere with breastfeeding 
• 3% of babies are born with this condition
• Can be hereditary
• Occurs mainly in male infants
 How does it work?
• It is a simple surgical procedure that removes
the frenulum to increase range of
motion(lingual) or close a gap(labial)
• The doctor makes an incision(cuts the
frenulum) and relocates the frenal
attachment 

Frenectomies
Removal of frenulum(small fold of tissue)  helps:

• Babies eat/breastfeed

• Speech
 Breastfeeding

• Insufficient latching/suckling can pose potential

problems with the infants. These problems include:

• Weight gain (unable to get nutrients needed to grow)

• Increased feeding time (unable to latch makes it take

longer for baby to get full amount) 

• Pain in the mother's nipples( with the abnormality of

the frenum, it makes it painful for the mother to
breastfeed)

This Photo by Unknown Author is licensed under CC BY-NC-ND

Maxillary Labial Frenum
• Where is it and when is it formed?

• It is connected to the incisive papilla during

the early stages of embryonic period

• What can it do?

• High adhesion to alveolar bone can result in a

diastema (or gap) between the teeth as well
as eruption site abnormalities in the
central/deciduous incisors
• Recession can occur on the maxillary incisors
leading to possible tooth mobility, sensitivity
and root caries
• If left untreated ,by age 10, the gap can
naturally close on its own due to eruption of
permanent maxillary teeth
• If the permanent teeth do not close the gap
naturally, this can cause many problems
(dental and non dental related)  
• *Cosmetic problems being the most
common complaint *
Before & after
photos of
maxillary and
mandibular
frenectomies
 Speech
• A child’s speech should be understood by
age 3
• Limited tongue mobility and position of
frenum 
• Difficulty pronouncing specific sounds ( D,
L, N, S, Z, T, TH ) 
• Frenectomies in children with
ankyloglossia resulted in intelligible,
improved speech
What is the best age for
frenum dissection?

• Simple answer?
• Research is still unclear. Get it done early to avoid long & painful breastfeeding
sessions as well as nutritional, dental, and speech complications.
OR
WAIT?? 
• Problems may improve with growth
• Child may develop scars from the procedure 
• Invest in speech therapy as an alternative
 Laser vs. Surgical
• Laser: 
• Er:YAG laser or CO2 laser
• Topical anesthetic or local
anesthesia
• Simpler
• Increased patient compliance 
• Shorter treatment time 
• Significantly less postoperative pain
than with surgical technique
• May damage alveolar bone if too
much power is used 
• Be cautious not to damage patient’s
eyes
Frenectomy
Laser
Procedure
Surgical

• Surgical involves:
• Blunt scissors or scalpel 
• General anesthesia or topical anesthetic
• Sutures  for hemostasis
Frenectomy
Surgical
Procedure
Post procedural care

• Tongue extension exercises 

• Antibiotic regimen 
• Analgesics 
• Sucking stimulation for infants done before
and after procedure
Dental Hygiene Considerations
• Be able to  clinically recognize ankyloglossia and other frenum
abnormalities 
• Take care when manipulating tongue or lips
• Educate patient or parent on implications of the frenum
abnormalities 
• Give anticipatory guidance