Frenectomy is a minimally invasive dental procedure that involves the total or partial removal of the frenulum that restricts the mobility of the tongue or lips.

The benefits of frenectomy are extremely important for the healthy growth and development of the child, so it is important to consult a paediatric dentist when certain problems are observed, such as breastfeeding problems, slow weight gain or speech difficulties.

At DENT ESTET and DENT ESTET 4 KIDS clinics, frenectomy is performed with a dental laser due to its advantages over conventional surgery with a scalpel.

In this article, we will discuss the signs that indicate a restrictive frenulum, when frenectomy should be performed, how the procedure is performed, and the recovery period.

The frenulum is a piece of connective tissue (a fold) that is located in different areas of the oral cavity. There is the labial frenulum and the lingual frenulum.

The labial frenulum connects the upper lip to the maxilla and the lower lip to the mandible, while the lingual frenulum connects the tongue to the floor of the mouth.

There are situations in which the tongue cannot perform its important role in chewing food, speaking or breastfeeding babies, and this is caused by a short (restrictive) frenulum.

As for the lingual frenulum, it is visible to the naked eye that the frenulum is too close to the tip of the tongue, restricting its mobility. In babies, restrictive frenulum prevents them from breastfeeding properly.

A restrictive frenulum can be diagnosed by a neonatologist or, later, by a paediatric dentist, but parents can also watch for signs that indicate a short frenulum.

Signs of a restrictive frenulum: 

• inconsolable crying during and after breastfeeding
• feeling hungry even after breastfeeding
• gastroesophageal reflux
• excessive bloating/colic
• slow weight gain.

"If the mother notices any of these issues, it is advisable to seek the support of a paediatrician, but also a paediatric dentist. In older children, there are other signs of a restrictive frenulum: the child cannot open their mouth completely, cannot speak clearly or cannot pronounce certain sounds correctly. In these situations, it is recommended to remove the frenulum," explains Dr. Ana Păvălan, a specialist in paediatric dentistry at DENT ESTET 4 KIDS clinics.

Frenectomy is a procedure in which the frenulum of the lips or tongue is removed or reshaped, which will significantly improve the child's quality of life.

The most common situations in which frenectomy may be useful are:

The existence of a space between the front teeth

An upper lip frenulum that is too thick or too low can prevent the central incisors from closing, maintaining a visible space between them. After orthodontic treatment, frenectomy helps to maintain the beautiful results achieved.

Gum retraction

The tension created by the frenulum can cause the gum to retract from the tooth, causing sensitivity and root exposure. Correcting it protects long-term gum health.

Speech difficulties

In children, a short lingual frenulum can limit tongue movement and make pronunciation more difficult. The intervention can bring about a significant improvement, especially in collaboration with a speech therapist.

Breastfeeding problems

In infants, a restrictive lingual frenulum can make breastfeeding difficult. A small intervention performed in time can make a big difference to the comfort of the baby and mother.

Difficult oral hygiene

An unfavourably positioned frenulum can make brushing uncomfortable, promoting bacterial plaque build-up and gum irritation.

Laser frenectomy can be performed at any stage of life, when indicated:

• in babies, it facilitates breastfeeding;
• in children, it is recommended for speech or as part of orthodontic treatment
• in adolescents and adults, for aesthetic reasons or reasons related to gum health

"Frenectomy helps to feed the baby properly, because children with restrictive frenulum cannot feed properly and may develop various gastrointestinal disorders over time. Frenectomy can also help the child stop mouth breathing (which is a bad habit), improve diction, and minimise the risk of tooth decay. In most cases, children with restrictive frenulum have a higher than normal caries index. The lip is in constant contact with the teeth, and bacterial plaque adheres to them much more easily. In addition, the tongue does not fulfil its role in the self-cleaning process because it lacks the necessary mobility," says Dr. Ana Păvălan.

Types of frenectomy and modern techniques

There are two types of procedures that can be performed to remove the frenulum: classic frenectomy (with a scalpel) and laser frenectomy.

Laser technology has significantly improved the experience in the dental office, and frenulum removal using a laser has become common practice in DENT ESTET and DENT ESTET 4 KIDS clinics.

Instead of a classic scalpel, the laser uses concentrated, extremely precise light, which means a quick and comfortable procedure with minimal bleeding and very little discomfort.

After laser lingual frenectomy, the patient experiences easier and faster healing and a low risk of infection. Basically, everything is much simpler, and the patient can resume their normal activities immediately after the procedure.

The procedure and recovery after frenectomy

Laser frenectomy is a simple procedure, suitable even for anxious patients. The entire process takes only a few minutes, and the sensation of pain is minimal to non-existent, depending on each patient's individual perception.

Stages of laser frenectomy:

• The dentist assesses the clinical situation
• If necessary, a light local anaesthetic is applied
• The laser reshapes the frenulum with great precision
• The area is sealed instantly, without bleeding
• The patient receives simple recommendations for the following period

As for recovery after laser frenectomy, healing is usually quick and uneventful.
There may be slight discomfort in the first 24–48 hours, but this passes quickly.

"For an easy recovery, it is recommended to avoid very hot or irritating foods (e.g. those with an intense sour taste), oral hygiene should be performed gently but thoroughly, and if necessary, an antiseptic mouthwash can also be used. If the lingual frenulum has been removed, small tongue mobility exercises are also recommended," explains Dr. Ana Păvălan, a specialist in paediatric dentistry at DENT ESTET 4 KIDS clinics.
 
 

Questions about frenectomy

Is laser frenectomy painful?

No. Laser frenectomy is a minimally invasive procedure and, in most cases, painless. Local anaesthesia ensures comfort, and the laser significantly reduces bleeding and post-procedure discomfort.

How long does healing take?

Healing after laser frenectomy is rapid and usually takes a few days. Due to the biostimulating effect of the laser, tissues heal faster.

What are the differences between classic frenectomy and laser frenectomy?

Classic frenectomy is performed with a scalpel, while laser frenectomy involves less bleeding, a reduced risk of infection and faster healing.