When is a Frenectomy Needed?

In infants, an elongated lingual frenum may make it difficult to nurse or to feed sufficiently from a bottle. A child with this condition is commonly referred to as being “tongue-tied".  If the abnormality is left uncorrected until the patient has reached the toddler years, parents and caregivers may notice that the child affected experiences a more difficult time of speaking than their peers. The condition is not always detected by a pediatrician or general dentist during routine checkups. In fact, it may be first noticed when the child enters pre-kindergarten or elementary school.  A child with an elongated frenum may not be able to extend the tongue as would be considered normal.  In extreme cases, the child may even experience difficulty and discomfort while swallowing. Fortunately, a typical frenectomy can usually be performed quickly and with minimal pain during the first few weeks of birth. 

In the case of an extended maxillary labial frenum, the issue of concern is the potential for orthodontic problems.  If the frenum extends too far down near the gum line, it can interfere with proper growth and spacing of the upper two front teeth. This results in the development of a large gap between these two teeth. Though many parents may worry about this gap from an aesthetic perspective, believing it to signal the need for braces, it is generally recommended that orthodontic procedures be delayed until the child’s permanent teeth have emerged.  If, after braces have been placed, the gap remains between two permanent teeth, the labial frenectomy should be considered as a solution to the abnormal spacing.  In many cases, the emergence and growth of adult teeth result in a natural closure of the gap caused by the labial frenum’s length.