Frenotomy vs. Frenectomy: What’s the Difference?

If your child has been diagnosed with a tongue tie or lip tie, you may have heard about two possible treatment options: frenotomy and frenectomy. Both procedures are designed to help improve your child’s oral function, but they differ in approach and when they are used. In this blog post, we’ll break down the differences between a frenotomy and a frenectomy, helping you better understand each surgical procedure and what to expect so you can make the best decision for your child’s oral health.

What Is a Frenum?

A frenum (or frenulum) is a small band of tissue in the mouth that helps connect and support different parts of the oral anatomy. There are two main types of frenum in the mouth: the labial frenum and the lingual frenum. The labial frenum is found in the front of the mouth, connecting the upper lip to the upper gums and the lower lip to the lower gums. The lingual frenum connects the base of the tongue to the floor of the mouth.

While these connective tissues play a role in normal oral movement, they can sometimes be too tight or thick, restricting movement and causing problems with breastfeeding, eating, or even dental development. In such cases, procedures like a frenotomy or frenectomy may be recommended to release or remove the tight soft tissue and restore proper oral function.

What Is a Frenotomy?

A frenotomy is a simple, minimally invasive procedure that involves releasing a tight frenulum. In this procedure, a small incision is made in the frenum to loosen it, allowing for greater movement of the tongue or lip. This simple procedure is often recommended for mild cases of tongue ties or lip ties and can be performed quickly. Frenotomy procedures help improve oral function, making it easier for babies to breastfeed and for children to eat and maintain proper oral hygiene.

What Is a Frenectomy?

A frenectomy is a more complex procedure than a frenotomy and involves the complete removal of the lingual frenum or the labial frenum. This procedure is typically recommended when the frenum is causing more significant problems, such as severely restricting tongue or lip movement, leading to issues with feeding or dental alignment. A frenectomy can be performed using traditional surgical methods or with advanced laser technology, which reduces discomfort and speeds up healing. The goal of a frenectomy is to improve oral function and prevent future complications, giving your child a more comfortable experience when eating or smiling.

Benefits of Frenectomy and Frenotomy

Both frenectomy and frenotomy offer significant benefits for children experiencing issues due to a tight or restrictive frenum. These procedures can improve their oral function and overall comfort in various ways. Here are the key benefits:

• Improved Breastfeeding: For infants, a tight frenum can hinder breastfeeding by preventing a proper latch. A frenectomy or frenotomy can enhance the latch, making breastfeeding easier for both the baby and the mother. This can lead to better feeding, proper weight gain, and a more comfortable experience for both.
• Better Oral Function: Releasing a restrictive frenum improves mobility in the tongue or lips, enhancing essential functions such as eating and swallowing. Your child will be able to perform these activities more comfortably and effectively.
• Enhanced Speech Development: If a tongue tie is causing speech delays or articulation issues, releasing the frenum may allow for better tongue movement, making it easier for your child to pronounce certain sounds clearly. However, before surgery, a speech-language pathologist (SLP) should assess whether the tongue tie is affecting speech and whether a frenectomy is necessary. This ensures that the procedure is truly beneficial for your child’s speech development.
• Improved Oral Hygiene: A tight frenum can make it difficult for children to properly brush and floss, increasing the risk of cavities and gum disease. By improving lip or tongue movement, these procedures make oral hygiene easier and promote better dental health.
• Supports Orthodontic Treatment: A restrictive frenum can cause alignment problems or gaps between teeth. Addressing this early through a frenectomy or frenotomy can help prevent future misalignment and support more effective orthodontic treatments.
• Better Sleep Quality: Restricted oral structures can lead to mouth breathing, snoring, or even sleep apnea. By improving airflow, a frenectomy can help your child sleep more deeply and restfully, which in turn supports their overall health, mood, and focus during the day.
• Prevents Gum Recession: A frenectomy or frenotomy helps prevent gum recession by reducing the tension on the gum tissue. This protects the gums from long-term damage, reducing the risk of conditions like periodontitis and helping maintain a healthy and attractive gum line.

Each child’s situation is unique, and the benefits will depend on their specific needs. By addressing a tight frenum early, you’re giving your child the opportunity for healthier development and preventing future complications.

Is Frenotomy and Frenectomy a Cosmetic Procedure?

While both frenotomy and frenectomy can have cosmetic benefits, they are primarily performed for functional reasons rather than cosmetic ones. These common procedures are typically recommended to address specific medical concerns related to the frenulum that can interfere with essential functions.

The primary goal of these procedures is to improve oral function, whether that’s helping an infant latch properly during breastfeeding or ensuring better oral care and dental health. These functional improvements are the main reason pediatric dentists recommend these procedures.

However, in some cases, there are secondary cosmetic benefits as well:

• Improved Aesthetics: For some children, releasing a tight labial frenulum can close gaps between the front teeth, improving the alignment of their smile. This is particularly beneficial when a tight frenulum has caused a visible gap or dental misalignment.
• Enhanced Oral Comfort and Confidence: These quick procedures can improve tongue or lip mobility and make smiling more comfortable. This increased comfort can positively affect a child’s confidence and self-esteem, as they may feel more at ease with their appearance and overall oral function.

While these procedures can enhance aesthetics in some cases, they are not classified as cosmetic surgeries. Instead, frenotomy and frenectomy are functional treatments aimed at improving oral health, with the added bonus of cosmetic benefits for some patients.

Which Procedure Is Right for My Child?

Several important factors influence whether a frenotomy or frenectomy is the right procedure for your child. These considerations help our pediatric dentist or orthodontist determine the best approach to resolve issues related to the frenum. Here are the key factors:

• Severity of Restriction: The degree to which the frenum limits movement plays a crucial role in deciding the appropriate procedure. If the restriction is mild, a frenotomy may be sufficient. However, if the frenum is too tight or thick or causes significant oral dysfunction, a frenectomy, which involves completely removing the frenum, might be necessary to address the problem fully.
• Impact on Oral Function: The extent to which the frenum affects your child’s ability to perform essential functions like breastfeeding or eating helps guide the decision. A frenotomy may be the first option for mild cases. In contrast, a frenectomy is more appropriate for severe cases that cause long-term issues with oral hygiene or dental development.
• Age of the Child: A frenotomy procedure is generally preferred for younger patients due to its less invasive nature and quicker recovery process. Infants tend to heal faster from minor procedures, making frenotomy an attractive first-line option. In cases where the frenum causes significant functional limitations, a frenectomy procedure may be more appropriate regardless of age, as it addresses more complex issues.
• Recovery Considerations: Recovery from a frenotomy is generally quick, typically taking about one to two weeks, with minimal post-procedure care needed. For laser frenectomies, the recovery time is also around one to two weeks, though complete healing may take up to four weeks for some children, depending on factors like age and overall health. While laser frenectomies are a less invasive option and involve less bleeding and a lower risk of infection, it’s important to follow proper aftercare to avoid complications and ensure smooth healing. Adhering to our aftercare instructions will help make your child’s recovery process as comfortable and effective as possible.

At Camp Smile Pediatric Dentistry & Orthodontics, we take a holistic approach to your child’s dental care. We collaborate with specialists like lactation consultants, speech and occupational therapists, primary care providers, and other healthcare professionals to assess your child’s unique needs. Together, we recommend the most suitable procedure to ensure the best possible outcome, addressing both immediate concerns and long-term oral health. With four convenient neighborhood offices in Minnesota and one in Omaha, Nebraska, our friendly team is ready to provide your child with expert care in a comfortable environment. Contact us today to schedule an appointment and see how we can help your child achieve a healthy, beautiful smile!