Lip Tie Frenectomy

Most recognized dental procedures, such as filling cavities, root canals, and crowns, involve the teeth. However, a lesser-known procedure known as a frenectomy is the process of correcting a lip or tongue tie.  

A frenectomy, or frenulectomy, is a surgical procedure that treats a lip and tongue tie. The surgeon cuts or modifies the frenulum — a connective tissue band that joins two areas of the mouth. The two most common scenarios are when a frenulum joins the lips to the gum or the tongue to the mouth floor.

A frenulum that is too short or too tight can impact speech. It can also cause breastfeeding and swallowing issues in babies.

There are two types of frenectomies: labial and lingual. 

Also called a maxillary frenectomy, the labial corrects lip-ties. Labial frenectomies can be performed on both the upper and lower lips; however, they more commonly occur on the upper lips. Lingual frenectomies correct tongue ties and involve the bottom part of the mouth.

There are two types of frenulums (also referred to as a frenum): the labial frenulum and the lingual frenulum. They are each located in a different part of the mouth.

The labial frenulum is located between the upper lip and front teeth. It connects the lip to the gum. A frenulum that is too wide or long can form a space between the two front teeth.

The lingual frenulum occurs between the tongue’s base and the mouth floor. It is visible if you raise your tongue while looking in a mirror. Lingual frenulums vary in size. They can restrict tongue use in some instances.

There is no tongue-tie surgery age limit. A frenectomy is most commonly performed on a baby due to feeding or speech issues. But adults can need frenectomies too. In some cases, the frenulum can be so tight that it pulls the gum away from the teeth. That can lead to gingivitis and cavities. Frenectomies also resolve other mouth issues, including:

• Lip-tie: this limits lip movement
• Tongue-tie: this limits the tongue’s range of motion
• Diastema: this is the gap between teeth
• Pain: brushing and oral care can result in swelling and tenderness

The frenectomy frees the connective tissue, which causes the issues referenced above.

Prior to the procedure, the patient discusses their health history with the provider. This includes sedation options: nitrous oxide (laughing gas), oral sedation, or IV sedation. Sedation isn’t always necessary. Your healthcare provider can make that determination.

The actual procedure involves several steps:

• The patient lays faceup secured. Parents might need to hold their child at this point.
• Sedation application, if necessary
• The doctor snips the frenum using one of the following: a scalpel, surgical scissors, or a cauterizing instrument
• A complicated lip tie or tongue tie procedure could necessitate several stitches to close the incision 

The procedure usually takes 30 minutes or less.

There are both benefits and risks that go along with a frenectomy procedure. The benefits include:

• Allow infants to breastfeed
• Relieve speech issues caused by a tongue-tie
• Reduce tooth decay and gum disease risk
• Improve smile by eliminating tooth gaps

But as is common with any surgical procedure, a frenectomy comes with some risks:

• Bleeding and swelling
• Pain 
• Infections
• Salivary duct injury in the tongue-tie area
• Allergic reaction to anesthesia
• Frenulum reattaches

Infants recover quite fast from a frenectomy. Babies can usually feed right away without any issues. Recovery for children and adults takes three to five days. 

Patients can sip liquids right after the procedure. Hold off on eating food until the numbness from the anesthesia wears off. Adults might need to limit the foods they consume over the first few days. Start with soft foods before moving on to solids.

Post frenectomy, keep the area clean. That is easy to do with infants but can be a bit challenging with kids and adults. Infections can occur in the affected area if food particles get trapped there. Patients could also need some over-the-counter pain relievers to deal with any residual discomfort.

Frenectomies are typically covered by insurance companies so long as the patient has the proper referral. The copay still applies, though.

The cost of a frenectomy without dental insurance can range anywhere from $800 to $8,000.

Consult your dentist to discuss any questions about a lip tie frenectomy (including an adult lip tie or a lip tie for toddlers) or a tongue tie surgery. Or, check out The Smile Generation to find a dentist near you for all your oral health needs. You can read patient reviews, peruse staff bios, and schedule an appointment online with a click of your mouse.