Frenulum surgery for the lip and tongue

A frenulum is a thin fold of tissue that connects the lip to the gum or the tongue to the floor of the mouth. If it is too short, thick or attached too close to the teeth, it limits lip or tongue movement, pulls on the gum and affects tooth position. A frenectomy procedure (cutting and repositioning the frenulum) is a short surgical intervention that solves this. At UKRMED it is performed in the surgical dentistry department.

Photo: Klaus-Peter Kuttig, Wikimedia Commons, CC BY 3.0 de

What is a tongue tie

What is a tongue tie? It is a short tongue frenulum. Normally the tongue can touch the palate, stick out and lick the lips freely. With a tongue tie the tongue is hard to lift, its tip looks heart-shaped when stuck out and movement is limited. Tongue tie in adults can affect certain speech sounds and cleaning the teeth.

Upper lip tie

An upper lip tie attaches low, almost at the gum edge between the front teeth. As a result:

• a gap (diastema) remains between the upper front teeth;
• lip movement is limited and the smile looks tense;
• the gum between the front teeth is pulled and recession (the gum moving down and exposing the root) can develop.

Does it need treatment

Not every visible frenulum needs surgery. The dentist decides based on function: whether it affects speech, cleaning, bite or the gums. For example, a review of tongue-tie release in newborns found it reduced mothers' pain during breastfeeding, but no consistent effect on feeding itself. So the decision is made individually.

If an upper lip tie causes a gap between the teeth, the procedure is often planned with the orthodontist, before, during or after braces. If it pulls the gum, surgery helps stop gum recession.

For children, whether and how the procedure is done at a given age is decided at a consultation in paediatric dentistry or by phone.

Tongue tie surgery and lingual frenectomy

A lingual frenectomy releases a short tongue frenulum in adults and children when limited tongue movement affects speech or hygiene. A lower lip frenulum is treated when it pulls the gum by the lower front teeth or interferes with a removable denture.

How it is done

1. Examination. The surgeon assesses where the frenulum attaches, lip or tongue mobility and the gums.
2. Local anaesthesia. The procedure is painless.
3. Surgery. The frenulum is cut and repositioned so it attaches in the right place.
4. Stitches. The wound is sutured; stitches are removed after 1-2 weeks.

The procedure is short and you go home the same day.

Aftercare

• eat soft, not hot food for a few days;
• brush carefully around the area;
• do lip or tongue exercises if the dentist recommends them;
• come back for a check-up and stitch removal.

Prices

Sources

1. O'Shea J. E., Foster J. P., O'Donnell C. P. et al. Frenotomy for tongue-tie in newborn infants. Cochrane Database Syst Rev, 2017. https://doi.org/10.1002/14651858.CD011065.pub2
2. NHS. Tongue-tie. https://www.nhs.uk/conditions/tongue-tie/