Most patients give barely a thought to the oral frena, which are the tiny pieces of tissue that connect the upper and lower lips to the gums (maxillary labial frenulum) and the tongue (lingual frenulum) to the floor of the mouth. However, some people suffer significant cosmetic and functional deficits if either the labial or lingual frenum is too large or if their attachment points are too far extended. In some cases, an overly prominent frenum must be either removed or re-shaped and re-positioned with minor oral surgery procedures, such as a frenectomy or fenuloplasty.
A frenectomy (sometimes also referred to as a freulotomy, frenotomy, frenulectomy) is defined as the removal of a band of tissue, known as a frenulum that holds down a part of the body such as the lip, cheeks, or tongue. A frenuloplasty is defined as the surgical alteration of a frenulum when its presence restricts the range of motion between interconnected tissues. Most patients who undergo a frenectomy are children, to avoid any prolonged issues with aesthetics or function.
Labial / Lip
An overly prominent labial frenum can result in a diastema, or large gap between the front teeth. The tissue may prevent the baby teeth from coming together. A frenectomy may not always be warranted during the deciduous tooth stage. As such, the procedure is not performed until after the permanent teeth have erupted. The eruption of the permanent teeth usually does not eliminate the gap due to the overly abundant and deeply attached tissue. Additionally, the gap cannot effectively be eliminated via orthodontic treatment, and if closed will relapse and drift open again with time.