A lip or tongue frenectomy is a medical procedure which involves changing the shape of a "frenum" in the mouth. These frena are little pieces of muscle which anchor parts of the mouth together, and they can be found both at the centre of the upper lip, and underneath the tongue. When they are too tight, they can cause cosmetic abnormalities, dental problems and speech impediments. So, altering them can often be a sensible move.
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Everybody has a couple of pieces of tissue (called frena) in their mouth which anchor the tongue and upper lip. Normally, these connectors are not a problem. However, when they are too large, they can result in speech impediments and aesthetic problems, such as front teeth being too far apart. A labial frenectomy refers to the removal of the tissue connecting their upper lip to the top of the mouth. A tongue frenectomy deals with the tissue underneath the tongue. In both cases, surgery is required, and success rates are very high for both procedures.
The surgical process is similar in both a labial frenectomy and a tongue frenectomy. Both involve cutting the frenum and releasing the tissues it's attached to. A typical procedure might go as follows:
Consultation with an oral or dental specialist
The first step is to assess whether a frenectomy is the best course of action. It may be that a frenotomy (a resizing of the frenum) is preferable. Your dental surgeon will look at the frenum involved, assess your aesthetic and speech situation, and recommend a suitable way forward. If surgery is elected, it will be necessary to make an outpatient appointment for the procedure.
Preparation and admission
The surgery can be carried out in one appointment, with no need for an overnight stay. Before attending the clinic, patients will be asked to avoid eating for a period of time, and they will also need to avoid alcohol and smoking, as a local anaesthetic will almost always be required. When the time for surgery arrives, the anaesthetic will be administered, numbing the area around the frenum.
This is the core of the operation, and there are three major forms of excision. The most common method involves cutting the frenum using a scalpel. When the tongue or upper lip has been properly separated from the gums or base of the mouth, the incision site will be sutured and disinfected. The second option is to use "electrosurgery". In this technique, heated electrodes are applied to the frenum, effectively burning the tissue away. This cauterises the wound site, reducing the scope for bleeding and potentially resulting in faster healing times. But it raises the risk of burns. Finally, in laser-based techniques, excision is achieved via diode lasers. These techniques are the most precise and require a lower dose of anaesthetic. Lasers are also preferable in cases where metal crowns are present. In any case, the procedure lasts for a matter of minutes in most cases (at most 1 hour). After that, you will be free to return home.
As noted above, the actual excision process can be carried out mechanically (via a scalpel), using electro surgery or by using diode lasers. The latter is the most advanced and generally the least invasive. When carried out well, it ensures a precise excision of frenum tissue and keeps recovery times low. More broadly speaking, there are two types of frenectomy that are relevant here. Lip frenectomies deal with the upper lip and tend to be recommended for dental reasons. By removing excessively large frena, dental surgeons can make it easier to apply braces to reposition aesthetically unappealing teeth. Tongue frenectomies are mainly prescribed for cases of ankyloglossia and are commonly performed on young patients before their speech impediment develops into a major problem.
Both forms of frenectomy have an excellent track record and high success rates. The procedure is not complex and won't take long. Patients tend to be in and out of dental clinics in a couple of hours. When you emerge from the clinic, you will notice immediately how either your upper lip or tongue is less closely connected to your mouth. If you are undergoing a tongue frenectomy, your surgeon may refer you to a speech therapist. They will be able to provide detailed recommendations about tongue exercises and strategies to improve your vocalisation. If you have suffered from a speech impediment in the past, you will see rapid improvements within a few sessions. If you are undergoing a lip frenectomy, you may find it easier to speak and eat, and your lips may appear aesthetically more attractive. However, the real benefits of the procedure will come after further dental work that's intended to alter the position of your teeth. In the long-term, a lip frenectomy will allow you to improve the appearance of your smile, but the results are not instantaneous.