If you’re curious about tongue tie or lip tie in your child, it’s a good idea to do a little homework to educate yourself. In this post I’ll briefly discuss what is a frenum and should you consider doing a pediatric frenectomy? For example, is there a difference between the conventional vs laser assisted frenectomies? What are the benefits of a laser frenectomy? Can a newborn frenectomy help with breastfeeding issues?
What is a frenum?
The frenum (or frenulum) is typically a small stretch of pinkish tissue (skin) that connects two organs together to prevent excess movement. The most relevant frena (plural for frenum) are the ones in the mouth. One connects the upper lip to your gums right at the midline (check under your lip as if you are trying to pick your nose). And the other is the band of tissue that stretches from the floor of your mouth to the base of your tongue (most visible when you open your mouth wide and try to lick your upper lip by sticking your tongue way up and out).
Like anything else, there can be too much of a good thing. And a restrictive (or super thick) frenum can alter normal mobility and function of the lip, tongue, or both. It can also play a negative role in the esthetics (like creating a gap between the teeth) or health of the gums/teeth (as it can cause recession or cavities).
Do all people who have a tight frenum in their mouth need to have it corrected with a frenectomy?
No. This issue is not one whether you either have or do not have it. It’s the spectrum of severity and other variables that should be considered before making a decision to correct a lip tie or tongue tie.
Some of the considerations (in no particular order) whether you should consider a pediatric, toddler or newborn frenectomy may be:
- Difficulty breastfeeding (painful latch for mom or lots of air being ingested causing your baby to have colic)
- Speech or pronunciation issues
- Orthodontic closure of gaps
- Sensitivity of teeth from recession
- Cavities in area where thick frenum has attached, trapping plaque
- Esthetic concern by the patient where frenum has created space between their front teeth
Dr J Shahangian is a UCSD certified Lactation Educator. Check out his page for a lot more information on breastfeeding support and tethered tissues management.
When should I consider doing a frenectomy for my child?
If you and your provider are concluding that a frenectomy is warranted for either your newborn or toddler, here are some things to consider for timing:
- It's easy and safe to do, even for a newborn (make sure your doctor is experienced with newborns as there are definite differences). Additionally, the procedure in this age group/category is almost always related to breastfeeding issues. Another thing to keep in mind is that a newborn frenectomy alone may not be the answer to challenges in breastfeeding. It’s important to have a good lactation consultant onboard. It is a must in my practice (we connect you with experienced consultants if you don’t have one). In conclusion, many mothers will say they get relief in their breastfeeding. As well as making their breastfeeding more comfortable and they are able to breastfeed for longer periods after having the newborn frenectomy procedure.
- If breastfeeding issues are out of the picture, we won't sedate a young child for the newborn frenectomy. That means we typically will hold off until the child is old enough to sit in the dental chair and cooperate with basic instructions. This typically occurs around age 3 in our office, although every child can be a little different on that timing.
- Children who are comfortable and trusting in the dental chair can have the procedure done in about 30min. The majority of this time is to help get the child comfy. The actual procedure takes typically less than 5 minutes.
- There will be some simple but effective exercises to perform after the frenectomy procedure, ensuring the best outcome for your child.
Dr J Shahangian is a UCSD certified Lactation Educator. Check out this page for more information on what to expect and prepare for a newborn frenectomy and more.
So what’s the difference between a conventional and laser frenectomy?
In the past, this procedure was almost always done with cutting instruments (think scissors or scalpel). But nowadays, fewer and fewer providers are using the conventional technique, due to the advantages when using the laser frenectomy technology.
Here are the advantages of laser frenectomy:
- Nearly no bleeding after the laser frenectomy procedure
- Very new if ever will there be a need for suturing
- Quicker healing
- Minimizes chance of infection with sterilizing effect of the laser light
- Hardly any pain
- Minimal scarring at site after healing
Of course all the above benefits won't apply to all cases. And the more severe the tongue tie or lip tie, the more likely that even with laser assisted technique, some of the above issues can arise.
To get more details about the laser frenectomy procedure visit this very helpful page.
If you would like to schedule a consultation to see if your child needs a frenectomy, please call us: (858) 693-5677. You can also set up a Virtual Consultation with Dr. J
Do you have a question about your child’s oral health that you would like to submit to #AskDrJ? Click here to submit your question.
J. Shahangian
DDS, MS, CLEC, FAAPD
Dr. J is a board certified pediatric dentist and owner of Scripps Pediatric Dentistry & Brush n Brace, pediatric dental offices located in San Diego, CA. He is not only a Diplomat with the board but now also has Fellow status with the AAPD. He is a proud father of 3 beautiful girls, a San Diego native, loves soccer and is passionate about pediatric oral health. His mission is battling the number 1 disease that he has seen take over our beloved children. #AskDrJ provides answers and solutions to parents questions & concerns regarding their children's oral health. Click here for a full list of articles from #AskDrJ
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