Frenectomy
A frenum is the small band of tissue connecting the lip or tongue to the gum. When it attaches too close to the teeth or is too tight, it can pull the gum away, keep a gap open between the front teeth, or limit the tongue. A frenectomy releases it in a short procedure.
When a Frenectomy Helps
- A high upper-lip frenum that pulls the gum between the front teeth, or keeps a gap open.
- A lower-lip frenum that tugs the gum on the lower front teeth, where the tissue is often thin to begin with.
- A tongue tie that limits tongue movement, affects speech or swallowing, or makes cleaning the lower front teeth difficult.
- Before or during gum grafting on the lower front teeth, where a pulling frenum would undo the graft.
Timing matters most for the gap between the upper front teeth. A 2022 systematic review by Tadros and colleagues found that only certain frenum types, papillary and papillary penetrating, are associated with a maxillary midline gap, and that the literature recommends against releasing the frenum before the gap has been addressed orthodontically, because closing it first helps prevent the gap from reopening.
What Happens
Local anesthetic. The frenum is released and the attachment repositioned so it no longer pulls; a few small dissolvable sutures close the site. Ten to twenty minutes. If the gum is also thin, a small graft may be placed at the same visit. In the AAP Regeneration Workshop review by Kim and Neiva, widening the band of keratinized tissue is reported as something that may prevent gingival recession from developing and progressing, on a body of evidence the authors describe as too thin to answer the question strongly.
Recovery
Soreness for two to three days, soft food for a few days, and gentle stretching exercises for tongue-tie release to prevent reattachment. We give written instructions and see you at two weeks.
Cost and Insurance
A frenectomy is a single-fee procedure on your written estimate and is often partially covered by dental insurance. Insurance and financing.
Frequently Asked Questions
Why is a periodontist doing this?
Because the frenum's effect is on the gum: a high lip frenum pulls on the gum between the front teeth, and a tight one can hold a gap open after braces close it. Whether a frenum on its own causes recession is not well established; the reason to release one is usually the pull it puts on tissue that is already thin. Periodontists treat the frenum and, when needed, graft the thin gum it has been pulling on in the same visit.
Does it hurt?
Local anesthetic during; a few days of soreness after, like a small cut in the mouth. Children do well with it. Most people are eating normally within a day or two.
When should it be done relative to braces?
For a gap between the front teeth, usually after the orthodontist has closed the space, so the healing tissue holds the teeth together rather than the frenum holding them apart. Your orthodontist and Dr. Verrett coordinate the timing.
Do you treat infants?
We treat children old enough to sit for a short procedure with local anesthetic, typically school age and up, and adults. For infant tongue tie, a pediatric dentist or ENT is the right first call.