The thin bands of tissue in the mouth that connect the underside of the tongue to the floor of the mouth and the inner surface of the lips to the gum are called frenula, popularly known as the tongue tie or lip tie. Everyone has these bands, and they are normal structures. However, in some people, the band being unusually short, thick or attached very close to the gum can lead to problems in areas such as breastfeeding, speech, tooth alignment or gum health. In these situations, the procedure of surgically releasing or removing the band is called a frenectomy. Answering the questions of what a frenectomy is and when it is needed helps you notice the situations where it is truly needed while avoiding unnecessary interventions. As DijiDent Oral and Dental Health Polyclinic, we evaluate the frenula of our patients in Türkiye from a functional perspective.
Tongue Tie (Ankyloglossia)
A short or thick band under the tongue can restrict the movements of the tongue. This condition is medically called ankyloglossia. Being unable to stick the tip of the tongue out past the lips or raise it to the palate, or the tip of the tongue looking heart-shaped, are among the possible signs. However, the appearance of the tongue tie alone does not determine the need for treatment; what is decisive is whether it causes a problem with function.
In Babies
In some babies, a tongue tie can lead to breastfeeding problems by making it difficult to latch onto the breast correctly. The baby not gaining enough weight, frequently letting go of the breast during feeding, or nipple pain and sores in the mother may be seen. Since breastfeeding problems can have many different causes, it is recommended that the evaluation be done together with a pediatrician and a lactation consultant. In suitable cases, a simple procedure can make breastfeeding easier.
In Children and Adults
In some children, a tongue tie can affect the production of sounds such as “l”, “r”, “t” and “d” that require movement of the tip of the tongue. Since speech problems can have many causes, evaluation by a speech and language therapist is important. In adults, restricted tongue movement can affect cleaning the teeth, eating or denture use.
For this reason, in babies and children, the decision should be based not only on the appearance of the band, but on functional findings.
Upper Lip Tie
The band connecting the inner surface of the upper lip to the gum between the front teeth may, in some people, be thick and attached very close to the gum. This can contribute to the formation of a gap (diastema) between the upper front teeth. However, in children, a gap between the front teeth during the transition from baby teeth to permanent teeth is normal and often closes on its own with the eruption of the canines. For this reason, rather than early intervention during childhood, waiting is generally preferred and the eruption of the permanent teeth is monitored.
If a thick lip tie is thought to play a role in the reopening of gaps closed with orthodontic treatment, the frenectomy is generally planned in coordination with the orthodontic treatment.
Lower Lip Tie
The lower lip tie attaching very close to the gum margin can pull on the gum with lip movements, contributing to gum recession on the lower front teeth and making the area difficult to clean. In this case, a frenectomy can be considered, together with gum grafts if necessary.
In Denture Wearers
In patients using removable dentures, ties coinciding with the edge of the denture can reduce the denture’s retention and lead to sores. In this case, a frenectomy can be done before the denture is made or when it is renewed.
How Is a Frenectomy Performed?
The procedure is usually done under local anesthesia and takes a short time. The band is released or removed with surgical instruments or, in suitable situations, with a laser. A few stitches are placed if necessary. Procedures done in babies usually take a very short time, and the baby can feed immediately after the procedure.
After the Procedure
Mild discomfort: Mild pain and sensitivity may be seen for a few days.
Nutrition: Lukewarm and soft foods are preferred in the first days.
Exercises: Especially after tongue tie procedures, the exercises recommended by the dentist or therapist are important to prevent the band from reattaching and to improve tongue movements.
Speech therapy: In children with speech problems, the therapy process may need to continue after the procedure.
Frenectomy with a Laser
In some cases, a frenectomy can be done with a laser. In suitable situations, a laser can provide less bleeding and healing that does not require stitches. However, conventional surgical methods are also effective and safe. The method is chosen according to the structure of the band, the patient’s age and the clinical conditions.
Correct Evaluation, Avoiding Unnecessary Intervention
Not every band that looks short requires treatment. The frenectomy decision should be made based on functional problems and the exclusion of other possible causes rather than the appearance of the band. At DijiDent, when necessary, we carry out this evaluation in collaboration with a pediatrician, lactation consultant, orthodontist or speech therapist.
Frequently Asked Questions
No. It is only evaluated when it causes problems with breastfeeding, speech or oral functions.
It can affect the production of some sounds; however, since speech problems can also have other causes, a therapist’s evaluation is important.
It can contribute; however, in children this gap is generally normal and may close on its own.
It is done under local anesthesia; afterwards, mild discomfort may be seen for a few days.
In suitable cases causing breastfeeding problems, it can be done after evaluation together with a pediatrician and a lactation consultant.
The right evaluation for ties that affect function.
Contact us to book an appointment to learn whether a tongue or lip tie is causing a problem for you or your child. Let us carry out your functional evaluation at DijiDent Oral and Dental Health Polyclinic.
This content is for general information purposes and does not replace an examination by a dentist. Breastfeeding problems in babies should be evaluated together with a pediatrician and a lactation consultant.
