Everything you wanted to know about frenulum removal and frenectomy
What is a frenulum?
Frenulums are small tissue folds in the oral cavity, commonly known as “bands.” Their function is to limit excessive movement, and they are a completely normal anatomical feature that everyone has. However, in some cases, they may be more pronounced, leading to certain complications.
You have likely encountered individuals with a visible gap between their upper front teeth or minor speech difficulties. One possible cause of these issues is an overly prominent frenulum. While these features may sometimes appear charming—especially in children—it is important to take them seriously. Although an enlarged frenulum does not necessarily lead to severe health problems, it can have undesirable effects on both aesthetics and oral function.
Frenulums are located in several places within the mouth. Depending on their position, the oral cavity contains two labial frenulums (found under both lips), four buccal frenulums (located on the sides of the mouth), and one lingual frenulum (found under the tongue).
In some cases, the attachment of a frenulum can be positioned very close to the gum ridge, causing both functional and aesthetic difficulties. A common issue is a prominent labial frenulum between the central incisors in the upper jaw, which often leads to a gap between the front teeth (diastema). Beyond aesthetics, this condition may also contribute to gum recession, which, if left untreated, can eventually lead to periodontitis.
A tight lingual frenulum can restrict tongue movement (a condition known as tongue-tie or ankyloglossia), which can make breastfeeding, speech articulation, and even tooth positioning more challenging. In later years, it may also contribute to gum recession on the inner (lingual) side of the teeth, increasing the risk of periodontitis. Other frenulums, particularly buccal and lingual ones, may also contribute to gum recession in their respective areas.
In older individuals, pronounced frenulums frequently interfere with the fit and comfort of removable dentures. For this reason, pre-prosthetic procedures often include a frenectomy to ensure a better fit for dentures and improve oral function.
What is a frenectomy and how is it performed?
A frenectomy is a surgical procedure used to remove the frenulum. There are two main methods for performing a frenectomy: the traditional surgical method and laser frenectomy.
Surgical frenectomy
The surgical method involves removing the frenulum using a scalpel, after which stitches are required. Due to the need for suturing, this procedure is more invasive and traumatic compared to the laser method, but it is still commonly performed. Stitches are typically removed after seven days. During this time, the patient may experience discomfort due to the tension caused by the sutures. Additionally, because of the presence of stitches, patients often avoid brushing the treated area, which can lead to plaque accumulation and slow down the healing process.
These drawbacks make the surgical method less desirable. However, with the increasing use of laser technology in dentistry, an alternative method has emerged that addresses most of the issues associated with traditional surgical frenectomy.
Laser frenectomy
Laser frenectomy is a safe and advanced method for removing the frenulum, and it is the preferred technique due to its numerous benefits. One of the main advantages is that healing is significantly improved because no sutures are required. The procedure is performed under local anesthesia, making it completely painless for the patient.
The laser provides precise cutting while simultaneously coagulating the blood vessels (hemostasis), resulting in minimal bleeding. Additionally, the risk of fibrous tissue formation after healing is significantly reduced. Since lasers have the ability to stimulate the healing process, further laser treatments in the days following the procedure can accelerate tissue recovery and ensure optimal healing.
