When is a Frenectomy Needed?

A frenectomy can greatly improve the quality of a patient’s life at any age. Unfortunately, few people know about this helpful procedure, and even fewer know when a frenectomy is needed.  

The good news is that our dentist in Virginia Beach, Dr. Zaneta Hamlin, can help patients determine when a frenectomy is necessary – and we even perform them in our office! Many babies, children, and even adults can benefit from frenectomy.  

What is a Frenectomy?

A frenectomy is a procedure in which a healthcare professional removes a small amount of tissue, known as a frenum, which connects one surface of the mouth to another surface. There are several frena (plural of frenum) in the mouth, but for now, we’ll focus on two:

• Lingual frenum – a vertical band of thin tissue that connects your child’s tongue to the bottom of their mouth

• Labial frenum – situated above and sometimes between the top two front teeth and below the bottom two front teeth, the labial frenum is connective webbing that attaches the lips to the gum

Tongue-tie

Also known as ankyloglossia, an abnormally short or thick lingual frenum is commonly missed in infants. When the lingual frenum is too short or thick, it holds the tongue too low inside the mouth. It also prevents the child’s tongue from moving freely, which can make it hard for the child to get a full seal on a breast or bottle, eat, or speak clearly. The tongue laying low can affect the palates development as well.

Lip tie

A lip tie is the result of an abnormally short or tight labial frenum on the top jaw. A lip tie makes it hard for an infant open their mouth wide enough to nurse or to latch on while breast or bottle feeding. It can also make it hard for babies and toddlers to eat finger foods or with a spoon – a child who needs a frenectomy may have trouble cleaning food off the spoon with their upper lip. Lip and tongue ties can also lead to picky eating, poor weight gain, swallowing problems and speech issues.  

Your Virginia Beach dentist may recommend a frenectomy to release the tongue or lip.

What are the Signs My Child Needs a Frenectomy?

If your child needs a frenectomy, you may notice one or several symptoms. Infants who need a frenectomy may:

• Have trouble latching on or have other issues with nursing

• Not gain weight at the expected rate

• Show signs of gassiness, colic, or even spit up a lot

• Sleep poorly

You may be able to see if an infant’s lingual frenum is too short, especially when they cry. When an anterior tongue-tied baby cries, their tongue does not lift from the floor of their mouth. A tongue-tied crying baby may not stick their tongue out as far as a baby without ankyloglossia. What’s more, a baby with a normal frenulum will lift their entire tongue when they cry; a tongue-tied baby may only lift the edges up to the restriction, creating a ‘v’ or dish shape with their tongue.  

The tongue is responsible for more than just sticking out (extension). When someone has a mid-tongue restriction, formally known as a posterior tongue tie, elevation (lifting the tongue to the palate), some lateralization (ability to move from side to side), extension (sticking the tongue out) and some peristalsis movement may be present but lacking its full potential. This will lead to some but not all symptoms. These types of ties are typically missed.

Signs a toddler or older child needs a frenectomy

Mouth breathing

Children of all ages who need frenectomies may sleep with their mouths open, also known as mouth breathing. Some kids who need frenectomies engage in mouth breathing during the day. Mouth breathing is essentially having the mouth do a job that the nose is supposed to do. This an irritate and lead to enlarge adenoids and tonsils which may be recommended to be removed by an ENT (especially if they can become an obstruction issue). This prevents a child from experiencing the deepest levels of sleep, which can make them feel groggy, irritable, and sluggish during the day. In the long run, mouth breathing can lead to dry mouth which can in turn increase ones risk for cavities.  

Trouble with speech

It’s normal for small children to have trouble pronouncing certain words – after all, learning to talk is an amazing and complicated feat. Being tongue-tied can make the difficult process of learning to talk even harder. More specifically, the abnormally short or thick frenum makes it hard for the child to make speech sounds that involve touching the tip of their tongue to the roof of their mouth or back of their top front teeth: listen to the way they pronounce the letters t, d, n, l, and z, and the sounds “sh” and “th.” They may also have trouble with the ‘r’ sound.  

Teeth that appear larger than normal

A short labial frenum may pull the child’s gum tissue away from the teeth; the receding gums cause more of the teeth to show. Receding gums can be an issue because they promote tooth decay and other dental problems – and receding gums do not heal on their own (with the exposed root being more porous than the enamel), so your child will need extra dental care sometime down the road. A short labial frenum ca make brushing difficult and can accentuate "buck teeth" coupled with extended pacifier use or finger sucking.

Where can I find a frenectomy dentist near me?

For more information on frenectomies, or to find out if a frenectomy is necessary for you or your child, consult with the Untethered team located in Cusp Dental Boutique. Our Virginia Beach dentist has the experience and tools needed to diagnose and treat the various degrees of tongue and lip tie. Contact Cusp Untethered online or by calling 757-517-0907

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