8 indications for upper lip frenuloplasty and types of operations

May 31, 2020

Under the upper lip, right in the center of each person, there is a ligament that connects the lip to the alveolar part of the jaw and is called the frenulum. For some, this ligament is short and attached too low, which creates certain difficulties and health problems, which we will definitely talk about below. In this regard, doctors suggest that such patients undergo plastic surgery of the upper frenulum. And UltraSmile.ru journalists will tell you about the operation and its indications in detail.


There are many indications for frenuloplasty

Few people know that the upper frenulum is very important for the correct and full functionality of the dental system. Thanks also to her, we can move our lips, pronounce different sounds, and open our mouths. It also plays an important role in the formation of a beautiful smile aesthetics. If it is shortened or positioned incorrectly, then in some cases this creates conditions for the development of various anomalies and leads to serious problems and consequences, which, in fact, are indications for trimming the frenulum of the upper lip in adults and children.

At what age is it best to have surgery?

Trimming the frenulum of the upper lip is a relatively easy operation, but the optimal age for it, according to most doctors, is 5–7 years, when the permanent incisors begin to emerge. If you carry out the procedure during this period, you can avoid the formation of a diastema and further manipulations to correct the bite by the orthodontist. But according to indications, it is not too late to perform plastic surgery in adolescence, and even in adults.

“I took my child to this operation. My son was 8 years old at the time. He already understood everything that was said to him, and at the same time he was very afraid. Before the operation, we sat and calmed down in the doctor’s office for about 15 minutes. I want to say that the child’s psychological attitude is very important here. About the operation itself: it didn’t hurt, my son didn’t cry. But after the anesthesia began to wear off, he complained that his gums hurt, but this problem was solved with Nurofen syrup. Already on days 4–5, the trace of the wound was almost invisible, although it was done with a scalpel. But in children everything heals quickly.”

Lada, review from the dental portal gidpozubam.ru


The operation is best performed at the age of 5-7 years

Tongue frenulum cutting - what is it?

Plastic surgery of the lingual frenulum can be performed at different ages, but it is mainly performed on newborn children, since disruption of the formation of the mucosal fold under the tongue causes a number of functional disorders.

The procedure for trimming the frenulum of the tongue is a low-traumatic surgical procedure performed by a dentist. The frenulum of the tongue is a fold of the oral mucosa that stretches in the shape of an arc from the central point of the tongue to the middle of the lower dentition at the base of the gums. The main function of the frenulum is to attach the tongue to the lower part of the mouth.

If there are deviations in the location or length of the fold, the movement of the tongue will be impaired, resulting in incomplete functionality. The purpose of the operation is to increase the length or correct the position of the frenulum.

Types and technologies of upper frenuloplasty

Before the procedure, it is important to carry out a complete sanitation of the oral cavity, treat diseased teeth and stop acute inflammatory processes, remove bacterial plaque - all these are sources of infection, which can subsequently provoke postoperative complications. You should also eat before surgery, as hunger can impair blood clotting.

There are several techniques for performing the procedure. The doctor decides which one to use depending on the patient’s age, the location and attachment of the frenulum. Let's list all the technologies that exist today:

  • frenotomy, or frenulotomy: involves transverse dissection of the frenulum if it is very narrow and thin. This is the so-called minor operation, which is considered the least traumatic. The purpose of the manipulation is to relieve the tension of the ligament. The procedure can be performed on newborns, as well as older children,
  • frenectotomy: this is a more complex operation, during which the frenulum of the upper lip is trimmed and part of the tissue located in the space between the central incisors is removed. The procedure is performed if the frenulum is thick, as is often the case in adolescent and adult patients,
  • frenuloplasty: the doctor releases the ligament and moves it to the area where it should be.


The operation is performed under local anesthesia.
Each of the listed operations is performed on an outpatient basis, under local anesthesia. Traditionally - using a scalpel. Afterwards, the doctor applies self-absorbing sutures and sends the patient home. Everything lasts about 10–15 minutes. Next, the patient receives clear recommendations on how to behave during the rehabilitation period. 1 and 3 days after the operation, you need to visit the doctor again for follow-up examinations.

Today, plastic surgery of the upper frenulum can be performed using a laser, which allows the procedure to be carried out quickly, without pain and blood, and to disinfect the operated tissues. This also reduces the likelihood of developing postoperative complications (swelling, pain, inflammation, scars). A big advantage is that when using laser equipment there is no need to apply stitches.


Laser frenulum trimming is the least traumatic

The rehabilitation period takes about 10–14 days. During this time, the patient is not recommended to eat food that can irritate the operated tissues (cold, spicy, hot, hard). It is also necessary to rinse your mouth with an antiseptic and apply wound-healing ointments (for example, Solcoseryl).

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  1. Alimirzoev F.A. Dental anomalies in childhood and their diagnosis // Achievements of university science. – 2014.

How long will it take to heal?

After plastic surgery of the frenulum of the lower lip, the rehabilitation period takes up to two weeks, and the wound on the upper lip heals in just a few days. In the first case, anti-inflammatory treatment is often prescribed to ease the postoperative period and eliminate the risks of complications.

To avoid injury and the risk of infection, thorough but gentle oral hygiene twice a day is necessary. You should avoid hard and hot foods in your diet, and rinse your mouth after eating. Parents are advised to pay closer attention to the cleanliness of their child’s hands.

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Comments

Which doctor can give a referral for this operation?

Marina (06/14/2020 at 07:28 pm) Reply to comment

    You can get a referral after an examination by a dentist or periodontist, orthodontist, speech therapist, or neonatologist (for newborns). The operation itself is performed by a dental surgeon.

    Editorial staff of the portal UltraSmile.ru (06/17/2020 at 09:07) Reply to comment

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Indications for the procedure

For newborn children, cutting the frenulum of the tongue is recommended quite often. A pediatrician or dentist can identify the pathology. In most cases, disorders are detected already in the first months of a child’s life. At the same time, the doctor always takes into account the individual characteristics of the structure and position of the mucous fold.

If we are talking about a newborn baby, then plastic surgery is prescribed in the case of obvious pathology in the formation of the frenulum, or difficulties with breastfeeding. The baby may have difficulty latching on to the nipple or pacifier and difficulty sucking on the breast or bottle.

Untimely plastic surgery may subsequently lead to difficulties with chewing food, bite formation, and diction problems. In older age, recommendations for surgical treatment can be given by a speech therapist or orthodontist.

When to see a doctor?

Most people can treat a frenulum tear at home. However, in some situations a doctor may be required.

A person should see a doctor within 24 hours if the injury appears infected but there is no fever.

You should consult a doctor immediately if the following symptoms appear:

  • a deep tear that may require stitches;
  • severe pain that lasts for several hours;
  • difficulty swallowing liquids, including saliva;
  • problems with fully opening or closing the mouth;
  • increased pain or swelling after 48 hours;
  • heat.

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Stages of the procedure

Trimming a short frenulum, despite the lack of complexity of the procedure, should be performed by a qualified specialist and in a medical facility. Patients do not require hospitalization. The operation takes no more than 10 minutes. Immediately after completion of the plastic surgery, the child is sent home. It is not recommended to feed the baby in the first two hours. Young children are allowed to drink water.

Stages of plastic surgery of the frenulum of the tongue.

  1. Preparation. The doctor asks parents for complaints, performs an examination and, if necessary, gives recommendations on preparation for the procedure.
  2. Operation. Administration of anesthesia, antiseptic treatment of the oral cavity, trimming of the frenulum.

In newborns, the integrity of the mucous membrane is restored in 1–3 days. The child may be restless on the first day. Difficulties with feeding cannot be ruled out, but already on the second day, babies begin to correctly take the breast or bottle nipple, which caused difficulties previously. Parents are advised to give the baby water after each feeding to avoid the accumulation of formula or milk in the mouth and the subsequent development of infection. Also, the mother must maintain breast hygiene and sterilize bottles.

Contraindications

Tongue frenuloplasty in newborns does not involve major surgical intervention, so the operation is considered safe. In addition, the procedure is painless and does not require anesthesia. However, given that after cutting a short fold of mucosa, a small wound still forms, there are temporary restrictions on manipulation related to the child’s health condition.

Temporary contraindications:

  • inflammatory diseases;
  • infectious diseases;
  • immunodeficiency pathologies;
  • acute respiratory viral or bacterial infections.

If there are contraindications for health reasons, it is advisable to postpone the operation until complete recovery.

Can it heal on its own?

Most frenulum tears heal on their own in 3-4 days. Infections or other complications are rare.

While the injury is healing, you can apply a cold compress to it for 20 minutes to relieve pain.

Over-the-counter pain relievers such as Tylenol or ibuprofen are also helpful.

After a frenulum rupture, it is important to stay hydrated. A person should stick to soft foods to avoid chewing and avoid salty, sour or spicy foods. This may irritate the wound.

How to check a child's frenulum?

A shortened frenulum between the lip and gum is diagnosed quite simply even in infants. To do this, you need to carefully pull back the child’s lips and see how pronounced the fold of the mucous membrane is and where it is attached. If it is short, then it will have a thick appearance and its attachment point will be at the very base of the incisors.

The hyoid frenulum normally has a length of at least 8 mm and is attached approximately halfway between the root and tip of the tongue. A small frenulum usually looks like a fold on the mucous membrane, attached along its entire length to the tongue or sublingual space.

Complications

If the labial frenulum is torn, there is a risk of infection. However, a doctor can easily treat these infections.

A labial frenulum tear is unlikely to cause serious complications. However, people with abnormal labial frenulum structure may experience:

  • receding gums around teeth;
  • large gap between the upper front teeth;
  • Difficulty moving lips.

The surgeon can correct these problems through medical procedures, including frenulum removal.

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