Frenectomy Explained: Reasons, Recovery, and What to Expect

Medically Reviewed By Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
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A frenectomy is oral surgery to remove a frenulum, a small band of connecting tissue in the mouth. Frenectomy is a common procedure to treat a tongue-tie or lip-tie. A frenum, also called a frenulum, is a band of connecting tissue within the mouth. One prominent frenulum is under the tongue, and the other frenula are inside the lower and upper lips.

A frenectomy, also called a frenulectomy, is the complete removal of a frenulum. A similar procedure called frenotomy involves cutting the frenulum without removing it.

Another procedure called a frenuloplasty involves cutting and repositioning the frenulum rather removing it.

This article will explain a frenectomy procedure, including reasons, risks and benefits, recovery, and what to expect during a frenectomy.

What is a frenectomy?

Medical illustration of frenulum

The American Association of Oral and Maxillofacial Surgeons (AAOMS) describes frenectomy as a simple surgical procedure to release a band of tissue in the mouth.

Frenectomy can help address health concerns that result from a tighter or shorter frenulum than usual. These health concerns may include a newborn having difficulty breastfeeding due to a tongue-tie, ankyloglossia. In older children, a lip-tie can cause a gap to form between the top front teeth.

However, if a frenulum does not cause problems, a frenectomy is often unnecessary.

In a 2020 clinical consensus statement, a panel of pediatric ear, nose, and throat (ENT) doctors expressed concern about an increase in unnecessary frenectomies due to overdiagnosis of tongue-tie. Talk with your child’s doctor about the benefits and risks of frenectomy to determine if it is the right choice for your child.

There are two primary types of frenectomies. A lingual frenectomy removes the frenulum from under the tongue, and a labial frenectomy removes a frenulum from inside the upper or lower lip.

What are reasons for a frenectomy?

Young infant lying on back sticking tongue out at smiling father
George Zoumas/EyeEm/Getty Images

Doctors perform frenectomy on people of all ages, ranging from infants to adults. Reasons for frenectomy include the following.

Improving breastfeeding for infants

The movement restriction from tongue-tie can cause difficulty with behaviors in infants, particularly breastfeeding. Research from 2019 states that around 5% of infants have tongue-tie.

When an infant has tongue-tie, they may be unable to latch onto the breast properly for feeding. This can lead to the baby getting improper nutrition or swallowing air, which can cause gassiness and discomfort. An incomplete latch can also cause nipple soreness and cracking, which makes feeding more difficult for parents as well.

A frenectomy can improve the baby’s tongue mobility and allow for a proper latch during feeding.

Learn more about tongue-tie, including pictures, types, and causes.

Addressing a tooth gap

The AAOMS explains that on the top lip, a frenulum can interfere with tooth spacing and create a gap between the front teeth. For some people, this is a cosmetic concern. However, this type of gap can also be prone to bacteria, making it vulnerable to infection, such as gingivitis.

If a person plans to have braces to correct a tooth gap, the presence of a lingual frenulum could cause potential issues.

In a 2018 letter to an editor, the authors note that dentists should only perform labial frenectomy on children after their permanent teeth come in. They also advise that dentists work with orthodontists to determine the appropriate timing for labial frenectomy, particularly if the person plans to have orthodontic work.

Improving speech

Both a tongue-tie and lip-tie can cause difficulties with speech during childhood. Research from 2019 found that tongue-tie can particularly affect pronunciation of consonants including “t,” “d,” “l,” and “n.”

In a 2020 study involving children with tongue-tie, researchers found that lingual frenectomy improved speech by 89%. Among children who had experienced speech delay, 50% said new words following their procedure.

Your doctor or your child’s clinician will discuss the benefits and risks of frenectomy to help determine if it is the right treatment for you.

What should you expect during a frenectomy?

A frenectomy is typically a simple, quick procedure. For babies under 3 months old, doctors or dentists can perform a frenectomy in their office. For older children and adults, a frenectomy takes place in an operating room.

Methods for frenectomy

A 2012 research review outlines three methods for frenectomy:

  • Scalpel: A doctor uses a sharp blade to cut the frenulum out. This is the most common technique, though it can carry a risk of bleeding.
  • Electrosurgery: A doctor uses an electric current to remove the frenulum and cauterize the area. This method is less likely to cause bleeding but has a risk of burns.
  • Laser: A doctor uses heat from infrared rays to remove tissue. This method tends to be shorter with fewer complications, but healing can take longer.

Before the procedure

Before the procedure, your healthcare professional will gather all necessary past medical information. They will also discuss the procedure steps and have you sign paperwork to obtain consent.

Your care team will also discuss pain management options and expectations during and after the procedure. In most cases, doctors use a local anesthetic to numb the treated areas. In young babies, doctors may use no anesthetic, since this area has very few nerve endings at this age.

If you have concerns or questions about the procedure, talk with your doctor to ensure you have a clear understanding of what to expect.

Q:

What happens during a frenectomy procedure? Is it painful for babies?

Anonymous

A:

Babies will typically be awake for a frenotomy procedure. Children older than 3 or 4 months will likely be asleep or receive some sedation.

The frenotomy, which is a simple cut, will take 15–30 seconds. Sugar water is usually given to relieve pain. Pain is usually minimal and crying stops once the baby feeds. Some small amount of bleeding or bloody saliva is typical and also stops with feeding.

Older children may or may not receive a local anesthetic and may have frenotomy, frenectomy, or frenuloplasty performed. Doctors may or may not use sutures to close the wound.

Dentists may have differences in how they perform frenectomy.

Reports of pain are usually minimal, and children are back to normal activities by the next day.

Nicole Aaronson, MD, MBA, CPE, FACS, FAA Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

After the procedure

Babies can typically resume feeding immediately after a frenectomy with no aftercare necessary.

You may feel numb around the areas treated with a local anesthetic for labial frenectomies. You also may experience light bleeding, swelling, and mild pain as the anesthetic wears off.

Before you leave, your clinician will provide detailed recovery and home care instructions. They may suggest pain relief medications for comfort.

How long is recovery after a frenectomy?

Talk with your care professional about the time it should typically take to recover from your procedure. Recovery time depends on many factors, such as the procedure type and your overall health. 

However, in many cases, the area will start healing after about 1–2 days. Over the first week, a white patch may continue to form over the treated area. During the week, pain, bleeding, and soreness should usually lessen.

Other frequently asked questions 

These are some other questions people often ask about frenectomy.

How much does a frenectomy cost?

A 2014 analysis of frenectomies performed at The Children’s Hospital of Philadelphia estimated the surgical fee at $850, not including additional anesthetic or hospital fees.

Insurance often covers lingual frenectomy. However, always confirm your coverage with your insurer before any procedure for an accurate estimate of expected costs.

Does a dentist do a frenectomy?

Dentists can perform frenectomy. Other specialists who perform frenectomy include ENT doctors and oral and maxillofacial surgeons.

Summary

A frenectomy is an oral surgery that removes a frenulum. Doctors often perform frenectomy to treat a tongue-tie or lip-tie.

A frenulum, or frenum, is a band of connecting tissue in the mouth. Frenula are located under the tongue and inside the lower and upper lips.

Frenectomy often can help improve breastfeeding for infants with tongue-tie. Talk with your doctor or your child’s pediatrician about frenectomy, including benefits and risks, to determine if the procedure is right for you.

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Medical Reviewer: Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
Last Review Date: 2022 Aug 22
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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