My first encounter with dental treatment was when I was a small kid aged 6. Being both of my parent's Dental Doctors, I had regular checks for my teeth eruption pattern. One fine day when I was back from school and playing in the clinic, moving up and down the dental chair, my dad suddenly called for one routine checkup.
To my surprise, my parents, one a periodontist and the other an orthodontist decided on a frenectomy as my two central incisors had just shown up in my mouth. As a kid, I was shell-shocked and excited to have some actual treatment. I was extremely nervous as my mother and one of my uncles, an oral surgeon, planned to do the procedure immediately. My mother lured me into that after the surgery, saying that she'll get me an ice cream which is a compelling argument for a 6-year-old.
Today, I recall my parents telling me that I got stitches which seemed like a pretty cool thing to brag about to my friends, but my upper lip was so swollen that I was afraid to go out. The concept of wearing a mask then would have been so much better.
Now that I am in university and undergoing my training to become a dentist, I look back and recall my first ever dental surgery that intrigued me to learn more about this surgery. Here are a few common questions that came to my mind that I have answered, which might hopefully enlighten you and spark an interest in this field of dentistry.
What is Frenum?
Frenum or Frenal attachments are thin folds of mucous membrane with enclosed muscle fibres that attach a loose part of the oral cavity to a more rigid part. There are two notable frenums in the oral cavity: the lingual frenum and the labial frenum.
E.g., the labial frenum attaches the lips to the alveolar mucosa and underlying bone/ periosteum, and the lingual frenum attaches the tongue to the floor of the oral cavity, which is visible when you raise the tongue upwards.
What is Frenectomy?
It is a surgical procedure performed mainly by a Periodontist or an Oral Surgeon. In a few cases of the maxilla, there is a high frenal attachment in which we can witness papilla invading and sometimes attachment to the palate which are ameliorated by completely removing the frenum. These surgeries are called Labial Frenectomy and Lingual F Tongue Tie Releases for breastfeeding.
Do we have more Frenums in our oral cavity?
Yes, we have numerous frenums in our oral cavity.
Why are labial frenum and lingual frenum important?
The frenum's length and proper attachment play a vital role in the growth and movement of the related areas, such as the lip-tie, as mentioned earlier, and tongue-tie. When the frenum is longer or shorter than its actual size, it restricts the lip movement and the motion of the tongue. In some cases, like mine, it caused a short upper lip leading to a slight gummy smile and a gap between my maxillary deciduous central incisors.
In medical terms, to avoid medical diastema in permanent dentition. It can also lead to other oral problems like gum recession, which might lead to gingivitis or cavities. During oral hygiene, one must be careful and not brush too hard over the labial frenum, which may lead to pain and swelling.
At what age should Frenectomy be recommended?
While the child is young or preferably newborn suffering from feeding issues or phonetics, they are recommended to have frenectomies. However, in some cases, it is recommended for adults as well.
In my case, I had a high frenulum attachment at the palatal papillae due to premature birth. Upon a dental checkup, a labial frenectomy was suggested to avoid fibrous hindrance and medial diastema; therefore, it was meant to be done before my permanent teeth erupted. Back then, scalpels were used, but now lasers are also an option to avoid bleeding. So, this was my story and what I learnt from it. As much as I enjoyed sharing it with you, I hope you guys also enjoyed it.