A frenum is a naturally occurring band-like soft tissue attachment, which attaches the muscles of the lips and tongue to the gum ridge. These structures are quite normal and an standard anatomic finding in all of our mouths. However, some individuals can have very strong and tightly attached forms of these bands, which can actually be quite problematic. The most commonly prominent and problematic frena (plural for frenum) include:
The Upper Midline Labial Frenum: This band attaches the middle of the upper lip to the gum ridge between the two upper front teeth. When tightly attached high on the gum ridge, this band of tissue can actually prevent the two front teeth from growing together, resulting in a diastemma (or gap), which can lead to a long-term orthodontic and cosmetic problem. Also, it can lead to chronic gum recession adjacent to the two front teeth.
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The Lingual Frenum: This band attaches the underside and tip of the middle of the tongue to the gum ridge on the backside of the lower front teeth. When this frenum is overgrown and/or tight, some pediatric and adult patients can actually experience significant problems with speech, swallowing, chewing, and chronic irritation from limited mobility of the tongue. This is a condition know as “tongue tied” or more scientifically “ankyloglossia.”
The Lower Midline Labial Frenum: This band attaches the middle of the lower lip to the gum ridge between the two lower front teeth. When tightly attached high on the gum ridge, this band of tissue can actually cause significant recession of the gum tissues on the lower front teeth, which can lead to long term compromise of the health of these teeth.
If any of these problems are noted, treatment with a procedure called a “frenectomy” is indicated in order to prevent ongoing or worsening issues. A frenectomy essentially involves surgical removal of the problematic tight band of tissue in order to release the tension on the affected attached structures. Depending on which problem is being treated, a frenectomy provides excellent results with facilitation of gap closure between the front teeth, significantly improved tongue mobility and function, and/or better long-term gum health around affected teeth.