Tongue Tie: Do You or Your Child Need a Frenectomy?

What is a tongue tie?

A tongue tie, known medically as ankyloglossia, is when the lingual frenulum (the small tissue connecting the tongue’s underside to the mouth floor) is unusually short, thick, or tight. This can restrict the tongue's range of motion and lead to various problems.

What is a frenectomy?

A frenectomy involves removing or modifying a frenulum (a small fold of tissue restricting organ movement). In the context of oral health, a frenectomy is a relatively straightforward procedure that usually refers to treating ankyloglossia (tongue-tie) or a restrictive labial frenulum (lip-tie).

Types of frenectomy

1. Lingual frenectomy

Lingual frenectomy releases a tongue-tie, where the lingual frenulum is too tight, affecting tongue movement, breastfeeding in infants, speech problems in children or adults and oral hygiene issues.

2. Labial frenectomy

Labial frenectomy addresses the lip-tie, where the labial frenulum (connecting the upper lip to the gum) is tight and restricts lip movement, causing breastfeeding difficulties, gaps between the front teeth and irritation or pain.

Frenectomy surgical procedure

1. Consultation

Evaluation by a dentist, paediatrician, or specialist determines you or your child’s need for a frenectomy, followed by a discussion of medical history & symptoms.

2. Preparation

Local anaesthesia is typically used to numb the area, especially in older children and adults, though for infants, topical anaesthetics may be sufficient.

3. Surgical techniques

Traditional methods would use a scalpel to cut the frenulum.

Laser frenectomy utilises a laser to cut and cauterise the tissue, which can reduce bleeding and speed up healing.

Electrosurgery uses an electric current to cut tissue & control bleeding.

4. Post-procedure care

Post-care may include prescribed pain relievers, oral hygiene guidance, surgical site care and gentle stretching exercises to prevent the frenulum from reattaching too tightly during healing.

Frenectomy recovery and aftercare

1. Healing time

Initial healing usually takes about 1-2 weeks, while complete healing may take a few weeks longer, depending on the individual's age and overall health.

2. Diet

Soft foods and cold liquids minimise discomfort and irritation. Avoid spicy, acidic, or hard foods that might irritate the surgical site.

3. Oral hygiene

Gently brush and rinse with prescribed mouthwash or mild saltwater to keep the area clean. Avoid vigorous mouth rinsing to prevent disrupting the healing tissue.

4. Follow-up

Regular check-ups will help to ensure proper healing, while speech therapy may be recommended if the procedure was done to address speech issues.

FAQs

What are the potential risks and complications of a frenectomy?

• Infection — Rare but possible; antibiotics can be prescribed if needed.

• Bleeding — Minimal, especially with laser procedures.

• Pain and swelling — Manageable with pain relievers and cold compresses.

• Reattachment — Rare but can occur if post-operative care is not followed.

How is a frenectomy beneficial?

• Improved oral function — Enhanced ability to move the tongue and/or lips properly, improving speech, eating, and oral hygiene.

• Better breastfeeding — Improved latch and feeding efficiency for infants.

• Aesthetic improvement — Closing of gaps between teeth and more natural lip movement.

A frenectomy can greatly enhance quality of life by alleviating the restrictions caused by a tight frenulum. Consulting with a healthcare provider can determine if this procedure is appropriate and what specific benefits it may offer in individual cases.