Lip frenuloplasty: indications, technique, rehabilitation

The frenulum of the lip looks like the sweet lining of the oral cavity. It passes in the middle between the incisors. A fold is identified on both the upper and lower lips.

In most cases, labial frenuloplasty is recommended for young children. Up to 7-8 years of age, disorders may not manifest themselves in any way. Clinical manifestations appear only during the period of teeth change.

If shortening has taken place, then any signs appear even later. Changes begin to occur only in adulthood, although limited lip mobility is present immediately.

Consequences of a short frenulum of the upper lip

Defects in the structure of the frenulum of the upper lip entail a number of negative consequences:

• During the neonatal period or in infancy, the child may have problems with sucking. In such cases, plastic surgery is performed as early as possible to restore breastfeeding.
• A shortened frenulum makes it difficult to pronounce certain words and impairs diction. Many speech therapists recommend frenuloplasty to correct the pronunciation of sounds in children.
• Impaired chewing due to a short frenulum can lead to problems with the digestive system.
• A short frenulum stretches the mucous membrane of the gums, which over time leads to the appearance of an interdental gap - a diastema, which is a cosmetic defect and can lead to malocclusion.
• Due to the retraction of the gums, a gum pocket appears in which plaque and tartar accumulate, which contributes to the development of caries and other inflammatory processes.
• A wide frenulum is a cosmetic defect and also contributes to excessive accumulation of plaque.
• Improper fastening of the bridle in some cases leads to increased sensitivity of the teeth.

Frenum trimming surgery is also an important part of preventing periodontal disease.

Treatment of a short frenulum of the tongue

In children, treatment of a short frenulum is carried out surgically. Excision of the frenulum is a simple operation with virtually no complications. After this procedure, the child feels well and does not experience any pain.

The decision on the need to trim the frenulum (frenotomy) is made immediately as soon as the baby is born, since bloodless plastic surgery cannot affect the general condition of the newborn. The procedure can be performed directly in the maternity hospital or in the dental office. Babies have few blood vessels and nerve endings, so the doctor does not use anesthesia when making a transverse incision. If there is slight bleeding, it can be easily stopped by applying the baby to the chest. After the operation, the newborn adapts to the new conditions for several days, so the mother will immediately feel the difference during feeding.

If the short frenulum is not corrected in time, the child may develop other developmental pathologies a few years later, such as incorrect dentition, speech defects, etc. If you ignore plastic surgery until the child is 5-6 years old, there may be a need for real surgical intervention, in which Sutures are placed and anesthesia is administered. Trimming the frenulum is carried out with special scissors or a radio wave scalpel. The duration of the procedure is no more than a minute.

Children of primary school age are brought to the surgical office by an orthodontist or speech therapist when the consequences of an untreated short frenulum are too obvious. During the operation, the tongue is released. Separately, uneven teeth and incorrect pronunciation have to be corrected.

In the event that it was not possible to perform plastic surgery in childhood, and a short frenulum of the tongue as a person grows older causes severe discomfort and significantly limits the excursion of the tongue, it is necessary to visit a dentist. The doctor will recommend an operation that can relieve the patient of speech defects and periodontal inflammation in the area of ​​the lower incisors. In both adult patients and adolescents, the operation is performed under general anesthesia, using self-absorbing sutures.

Contraindications for surgery

Like any surgical intervention, frenuloplasty has contraindications:

• Bleeding disorder
• Congenital pathologies of the oral mucosa
• Multiple caries (operation is carried out after treatment)
• Osteomyelitis
• Malignant neoplasms
• Mental disorders
• Autoimmune diseases
• Immunodeficiency
• Tendency to form keloid scars
• Severe diabetes mellitus
• Any infectious and somatic diseases during exacerbation

Plasty of the vestibule of the lower vault of the oral cavity

Sometimes in children there is a situation in which the tension and recession of the gums is caused not by a separate frenulum, but by the tension of the entire mucous membrane between the lower lip and gum. The cause of this condition is a low amount of attached gum and crowded position of the teeth in the lower jaw. The consequence of a small vestibule is the exposure of the necks of a large number of frontal teeth of the lower jaw, which is the cause of a large cosmetic defect. To avoid gum recession in this situation, an operation called “plasty of the oral vestibule and orthodontic treatment to straighten the dentition” is required.

How does frenuloplasty occur?

In order for the operation to proceed without complications, it is important to prepare for it correctly. Be sure to perform professional oral hygiene and eliminate foci of infection (caries). This is necessary so that the postoperative wound does not become infected and heals quickly. The list of examinations before surgery is determined individually depending on the patient’s health status and the presence of concomitant diseases. It is not recommended for a child to perform the intervention on an empty stomach.

In modern dentistry, there are several options for frenuloplasty:

Any type of intervention is performed under local anesthesia using self-absorbing suture material. Also popular is laser frenuloplasty, which does not require suturing the wound.

Plastic surgery methods

Depending on the type of pathology and structural features of the frenulum, various surgical techniques can be used.

1. Laser plastic surgery. This method is the most modern. The laser allows you to reduce the time of surgery and subsequent recovery, and also prevents bleeding, as it “seals” the edges of the wound. In addition, the laser has an antiseptic effect, does not cause severe pain and does not leave a scar. The procedure goes as follows:

• The frenulum is treated with an anesthetic gel.
• The laser beam is directed to the problem area.
• Tissues are vaporized under the influence of the beam, blood vessels are sealed and sterilized.

1. Frenuloplasty. This technique for correcting the position of the frenulum is carried out using surgical instruments. The operation is performed under local infiltration anesthesia. Depending on the shape of the frenulum incision, there are 2 frenuloplasty techniques:

• Y-shaped.
• Z-shaped.

Both techniques allow you to move the frenulum to the desired location. Before the procedure, injection anesthesia is performed, and sutures are applied with a special self-absorbing thread. Frenuloplasty is usually prescribed when the frenulum is too short. The incision is made transversely, as a result of which the organ becomes longer. After this, a suture is placed along the cut edge.

1. Removal of the frenulum or frenectomy. The frenulum is removed if it is too wide. An incision is made along the edge of the mucosa. In this case, the papilla located between the teeth and a small part of the tissue near the roots of the incisors are excised.
2. Plastic surgery of the frenulum of the upper lip with decortication. It is used if the frenulum has grown into the free edge of the gum. During plastic surgery, not only the frenulum itself is affected, but also the strands of connective fibers at the site of fusion are removed. The operation is of great importance, since if the ingrown tissue is not excised, the gums will be destroyed.

Rehabilitation

Frenumplasty is a one-day surgery and has a quick recovery period. Immediately after performing the intervention and receiving recommendations from the attending physician, the patient goes home. Some swelling and soreness may occur after the anesthesia wears off, but this is considered a normal reaction of the body. Discuss with your dentist the possibility of taking safe anti-inflammatory medications in the first 24 hours after surgery.

It is important to follow the basic rules of oral care:

• Brushing your teeth morning and evening using a soft toothbrush
• Avoiding eating hard, too hot or spicy foods during the first few days after frenuloplasty
• Rinsing with an antiseptic several times a day, using a remedy prescribed by the dentist for rapid healing of the postoperative wound
• Performing myogymnastics
• Passing a postoperative examination on the second or third day after the intervention

Complete healing usually occurs within 10-14 days; if you follow all the doctor’s recommendations, the rehabilitation period passes without any complications.

Postoperative period

This procedure cannot be called complicated, and therefore rehabilitation does not involve any complex manipulations. The doctor will recommend to the patient:

• Don't neglect oral hygiene.
• Avoid eating solid or hot food for a couple of days.
• Visit your doctor for check-up 2-3 days after surgery.
• Adult patients should perform myogymnastics to strengthen the muscles of chewing and facial expressions.

During the rehabilitation period, the patient gets used to new tongue movements. Diction changes immediately after surgery. If plastic surgery was performed to eliminate a diastema, it will take longer for the teeth to return to their place.

The recovery period is about 4-5 days.

Dental therapist's opinion

Frenuloplasty is a simple operation that will help the child avoid many unpleasant consequences for health and speech. Many parents do not take this condition seriously and delay visiting a doctor. However, you need to understand that a short frenulum when changing the bite can disrupt the normal growth and relationship of the teeth. Today we use gentle techniques and high-quality anesthesia, so the entire process for young patients is painless and in a comfortable atmosphere.

Activities before labial frenuloplasty

Before proceeding with plastic surgery, it is necessary to sanitize the oral cavity, since infection can cause complications. Some clinics prescribe fluorography and tests, but if lip frenuloplasty is performed with a laser, then such tests are not allowed to be performed, since the procedure is classified as low-traumatic.

If surgery is scheduled for a child, the doctor will recommend feeding him before the procedure. This not only promotes better condition during manipulation, but also prevents poor blood clotting.

Reviews

“We had plastic surgery on our daughter’s short frenulum of her upper lip when she was 6 years old. The procedure was recommended to us by a dentist at the Smile clinic. The whole process took literally a few minutes, they calmed my daughter down, gave her an injection in her gum, so there were no tears. Everything healed within 10 days, there were no problems or complications. Thanks to all the medical staff of the clinic for their professionalism and kind attitude towards children!” Maria, 30 years old

“Before correcting the bite, the dentist recommended cutting the frenulum, due to which there was a gap between my front teeth. Everything went quickly and painlessly. Now I recommend your clinic to my friends.” Olga, 27 years old

“My son had problems with diction due to a short frenulum of the lip. I was very worried about how he would cope with the operation, but the specialists at the Smile clinic quickly found an approach to him and did everything very well. Thank you!" Marina, 33 years old

A short frenulum of the upper lip is a condition that requires proper correction. Lip frenuloplasty is performed without pain and in just one visit to the dentist. The recovery period proceeds easily and without significant restrictions. At the Smile clinic we find an individual approach to patients of any age and in treatment we are guided only by proven, modern methods.

Indications for the procedure

Any surgical intervention is performed only when indicated. Upper lip frenuloplasty is recommended in the following situations:

• Preparation for installation of orthodontic structures. The frenulum puts pressure on a number of teeth and disrupts the bite if it is abnormally large. When it is necessary to install plates, braces or aligners, it is advisable to check the correct attachment of the frenulum and, if necessary, carry out a plastic procedure.
• Diastema. A gap between the front teeth occurs when the frenulum prevents the incisors from meeting in the center. This leads to the growth of the diastema, and in the future it develops periodontitis.
• Periodontitis, periodontal disease. A shortened frenulum has a pulling effect on the mucous membrane of the teeth, as a result the edges of the gums rise and the roots are exposed.
• Preparatory stage before installation of prostheses. This procedure is performed only if there are no problems with the frenulum of the upper lip. Otherwise, there is a high probability of the structure collapsing.
• For speech therapy problems.