Minor oral surgery in children – undercutting of the frenulum

The frenulum is a mucous membrane that connects two surfaces together, limiting their mobility. The frenulum enables the movement of the lips and tongue, is responsible for maintaining proper muscle tone and maintaining proper chewing function. There are several types of frenulum – sublingual, labial, buccal.

A short frenulum of the tongue is a defect that should not be ignored. It can restrict tongue movements, hinder sucking, and in further development, chewing and proper oral hygiene. It perpetuates incorrect habits that later result in speech or bite defects. A sublingual frenulum that is too short in an infant causes the child to tire quickly and has problems with excessive salivation. Disturbed outflow of saliva from under the tongue causes frequent choking on infantile saliva and coughing. A frenulum that is too short makes it difficult to articulate certain sounds, such as: d, l, n, r, s, t, th, or z .

In a certain type of frenulum attachment of the upper lip, complications may occur – including incorrect positioning of the incisors, i.e. diastema. Indications for frenectomy include, m.in: diastema remaining above 2 mm despite the protrusion of incisors and canines in the jaw, persistent inflammation of this area, accumulation of food debris in the gingival fissure, large dental deposits, caries of the central incisors, speech therapy indication, as well as indication by the dentist before orthodontic treatment.

A frenotomy involves cutting the membrane horizontally to allow the tissues connected by the frenulum to be more mobile. The procedure can be performed using the classic method with the use of a scalpel (requires stitches) or with the use of a laser. After laser cutting of the frenulum, there is much less bleeding and the wound heals faster. The procedure itself is performed under local anesthesia and takes only several minutes.

Cutting the frenulum of the tongue is recommended as soon as possible after diagnosing its defect, as its position does not change physiologically. It is a safe procedure and can be performed as early as infancy. It is worth noting that the older the child, the more stressful the frenulum cutting procedure may be.

Contraindications to frenotomy include allergy to anesthetics, Pierre Robin syndrome, the use of blood thinners – reducing blood clotting, severe hemorrhagic conditions, blood clotting problems and active respiratory tract infection.