Poor diction, insufficient quality of chewing food, defects in facial expressions - all these are the consequences of a shortened frenulum of the tongue, a thin leathery membrane running from the bottom of the root of the tongue to the gum on the lower jaw. Signs of a congenital anomaly are noticeable from the first minutes after the birth of a child. The only way to correct the situation is to trim the frenulum of the tongue. According to dentists, the sooner it is done, the fewer negative consequences this birth defect will have. In our clinic, tongue frenuloplasty is performed on patients in infancy, adolescence and even adulthood.
When might a frenulum be trimmed?
Dentists recommend cutting the shortened membrane under the tongue already in the maternity hospital or immediately after discharge from it. In infancy, there are practically no blood vessels, so the operation will be quick, bloodless and without the risk of infection. By the age of three, cutting the frenulum of the tongue is accompanied by bleeding, and recovery is accompanied by discomfort during eating and speaking. Therefore, it is advisable to cut the frenulum in the first months of the baby’s life.
Currently, tongue frenuloplasty is performed at any age. Indications for it are:
- feeding problems - insufficient sucking in infants, poor chewing of solid food in older children;
- inflammation in the mouth at the junction of the frenulum and the gum;
- abnormal position of the tongue in the mouth;
- slurred speech, lisp;
- profuse salivation.
In adult patients, a shortened membrane between the tongue and gum provokes attacks of apnea and snoring. It is mandatory to trim the tongue frenulum for patients who plan to wear orthodontic systems.
Indications for plastic surgery
To carry out surgical intervention, the mere fact of the presence of frenulum defects is not enough. The following indications exist:
- the presence of a diastema, as a result of which the teeth move apart, change their normal location, and trauma to the mucous membrane leads to the development of periodontitis;
- preparatory procedures before installing orthodontic structures to correct the bite;
- diseases of periodontal tissues;
- preparation for installation of a removable denture;
- unclear pronunciation of words.
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Contraindications
There are pathological conditions, the presence of which is a contraindication to surgery:
- brain diseases;
- various mental disorders;
- alcoholism;
- oncology;
- acute or exacerbation stage of a chronic process;
- collagenoses;
- radiation therapy for head and neck tumors.
There are also a number of dental contraindications:
- repeated diseases of the oral mucosa;
- osteomyelitis;
- multiple foci of chronic infections in the oral cavity.
The most optimal age for surgery is from 5 to 8 years, when the permanent front incisors have already appeared. Before 4 years of age, plastic surgery is strictly not recommended for several reasons. Firstly, the upper lip in babies only works 40%, since it is not sufficiently involved in talking and chewing solid food.
And early surgery can provoke the formation of a scar, which will cause even greater problems in the future. Poorly performed surgery can also damage the buds of permanent teeth and cause the need for repeated intervention. It is also impossible to waste time and carry out intervention later than 8 years, because this omission will subsequently result in expensive and not always effective treatment.
Types of procedure
The main condition for plastic surgery of the upper lip frenulum is a quiet stay in the dental chair for at least 15 minutes. Below are the main methods of operation:
- Frenotomy. The fold is cut transversely, sutures are applied longitudinally. The technique is used in the presence of a narrow and transparent frenulum that does not have attachment points.
- Frenectomy. The papilla between the teeth and the tissue between the front incisors are excised. A frenectomy is prescribed if a wide frenulum is present.
- Frenuloplasty. The technique consists of moving the attachment point of the bridle.
In turn, the third method comes in two types:
- Y-shaped frenuloplasty. The technology consists of excision of the frenulum, trimming the edges of the mucous membrane and moving it deeper into the formed vestibule. Next, the mucosa is sutured to the periosteum, and the wound is sutured.
- Z-shaped frenuloplasty is carried out as follows: the frenulum is cut vertically, and two more incisions are made from the incision at appropriate angles and on both sides of it. The resulting flaps are fixed so that the incision becomes horizontal. This approach is very important, since if the bed is not prepared correctly, the operation will not be effective enough. Suturing occurs in the same way as with Y-shaped frenuloplasty.
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The modern method of frenuloplasty using laser radiation is increasingly being used. This bloodless, safe and effective treatment method is gaining increasing popularity.
How does the procedure work?
Tongue frenuloplasty is performed using gentle technology. This operation helps restore the normal length of the frenulum and give the tongue the necessary mobility without loss of stability. The operation is carried out in the office of a dental surgeon and consists of several steps:
- Anesthesia. The doctor applies a local anesthetic to the incision site or injects a sufficient amount of anesthetic solution into the gum.
- Cutting the frenulum. The doctor cuts the membrane under the tongue close to the gum to ease its tension. If necessary, adjust its shape.
- Stitching. The doctor fixes the cut edge of the frenulum to the gum with self-absorbing suture material.
- Seam processing. The mucous membrane is treated with an antiseptic.
The duration of rehabilitation after plastic surgery of the frenulum of the tongue depends on the patient’s age: the lower the number, the faster the mucous membrane will heal. To prevent inflammation, the doctor will prescribe antiseptics for treating sutures and ask you to follow a diet: do not eat hot or cold foods, avoid hot spices.
Surgical repair of the membrane under the tongue is the only effective method to avoid speech problems in the future. Trust the professionals at our clinic, make an appointment by phone.
Frenules in the oral cavity
There are three frenulums in the child's mouth. A frenulum in the oral cavity is nothing more than a small strand of mucous membrane. But, despite this, the frenulum in the oral cavity is of great importance in the life of a child; the child’s nutrition, correct pronunciation of sounds, the condition of the mucous membranes, not to mention the child’s bite and facial aesthetics depend on their condition.
Dentists distinguish between the frenulum of the upper and lower lips and the frenulum of the tongue. Each of them has its own location and performs a number of functions. The frenulum of the lower lip connects the body of the lower jaw and the lower lip; normally, the frenulum is woven into the gum of the lower jaw below the level of the central incisors.
The frenulum of the upper jaw is located according to the same principle as the frenulum on the lower lip. This mucous cord also raises many questions and complaints from parents, since it is primarily associated with the formation of an aesthetic defect in the oral cavity - a gap between the teeth. And the last frenulum in the baby’s mouth is the lingual frenulum, which is woven into the tongue and sublingual space.
They will work with you
Balinda Vadim Stepanovich Specialist in the field of orthopedic dentistry. Proficient in all methods of removable and fixed prosthetics, including metal-ceramic structures and the use of supports on dental implants; aesthetic restoration of teeth using metal-free structures.
Shakun Anton Yurievich Specialist in the field of orthopedic and surgical dentistry. Proficient in all modern types of dental prosthetics and surgical treatment, including: • aesthetic restoration of teeth with metal-free structures; • prosthetics with metal-ceramic structures; • prosthetics on dental implants; • dental implantation.
Chelnokov Sergey Fedorovich Implantologist, work experience in private practice for more than 26 years. Able to successfully perform implantation regardless of the amount of bone tissue available to the patient and the condition of the bone. Participant of many congresses and seminars on implantation in Belarus and abroad. He is a lecturer at the Intrnatinal Implant Foundation (International Implant Society).
Methods for trimming the short frenulum of the upper lip
Correction of the frenulum of the upper lip is carried out in two ways - by partial removal or by incision and subsequent stitching for fusion in an anatomically correct position.
A pathologically formed frenulum is prone to spontaneous rupture when falling and chewing solid food. Therefore, if you suspect its abnormal development, you should consult a doctor for diagnosis and surgical treatment.
The choice of method for eliminating pathology depends on its severity and type. Correction is carried out through surgery or laser surgery. Each method has its own advantages and indications for use.
Surgery
Surgical correction of the frenulum is performed using a scalpel under local infiltration anesthesia. Typically, dentists use Ultracaine D-S-Forte, which contains epinephrine, for pain relief, thanks to which the procedure is not painful at all - only light pressure is felt on the surgical area. Before the procedure, it is necessary to undergo a general urine and blood test, coagulation and fluorography.
To change the width, length or position of the bridge between the upper lip and jaw, the doctor excises it. Normally, minor bleeding may occur during surgery. The manipulation takes less than 30 minutes.
For several days after the procedure, there may be slight swelling of the soft tissue in the upper lip area, and bleeding and pain may persist. Normally, complete wound healing takes 10–11 days. During this period, you need to stick to a diet, eat liquid food at a neutral temperature, perform antiseptic rinses and apply applications for speedy healing.
Depending on the type of frenulum defect, various types of surgical plastic surgery are used:
- Frenuloplasty. It is performed when there is a narrow fold of the oral mucosa, if correction of its position and method of attachment is necessary.
- Frenectomy. It is performed when there is a pathologically wide bridge, which is fraught with the accumulation of a large amount of plaque, which provokes the development of inflammatory dental diseases. In addition, the method of complete excision of the fold of the oral mucosa is used when it is damaged as a result of a fall.
- Frenotomy. It is carried out if the fold is too narrow and is not attached to the edge of the alveolar process.
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Question answer
- Is it really necessary to quit smoking before implantation surgery and then not smoke for another six months? Smoking is a relative contraindication. Smoking is very harmful. If initially there are many risk factors, then we warn about this and the patient himself weighs the risk of smoking.
- Will implants interfere with general X-ray diagnostics of the body (and in particular the neck and head)?
The implants will not interfere with an X-ray examination.
Frenum of the lower lip
Dentists say that not all babies have a frenulum on the lower lip; it may be completely absent or forked. To study the length of the frenulum, the same technique is used as for studying the frenulum of the upper lip. Normally, the frenulum should be thin and attached in the middle of the body of the jaw. An important condition is that the frenulum of the lower lip must coincide with the center line between the incisors. If these conditions are not met, the bridle is short.
A short oral frenulum interferes with breastfeeding, as the baby cannot properly latch onto the mother's nipple. Fortunately, this situation is quite rare; the most typical manifestation of a short frenulum in the oral cavity is the presence of inflammatory gum diseases in the area of the lower incisors and malocclusion according to the same principle as in the upper jaw.
There are no age restrictions when excision of the mandibular frenulum; usually the mandibular frenulum is diagnosed and corrected at approximately the same time. The principle of the operation is similar to correction on the upper jaw.
