When Should an Infant Frenectomy Be Done?

An infant frenectomy is a minimally invasive surgical procedure that is done to remove one or both frena from the oral cavity. A frenum is a connective tissue membrane that connects surfaces of the oral cavity. The major frena include lingual (holds the tongue to the bottom of the mouth), labial or maxillary (connects the lips to the gum), and buccal frena (attaches the gums to the cheeks' insides).

When to perform an infant frenectomy

An elongated or short thick lingual frenum limits tongue movement in babies and can make breastfeeding or sucking from a bottle more challenging. The condition is also described as a  tongue-tie or ankyloglossia. If the anomaly is not corrected until the baby grows older, the child may experience difficulty with speech compared to their peers.

The condition may go undetected during routine checkups. Sometimes, it may only be discovered after the child reaches school age. Elongated frena in children may prevent normal extension of the tongue. In extreme situations, the child may find swallowing difficult and painful. Infant frenectomy can be performed quickly and with minimal discomfort within the first few weeks after birth.

If there is an issue like an extended maxillary labial frenum, the worry is often about the risk of orthodontic issues. The elongated labial frenum can inhibit normal growth and spacing of the two front upper teeth. Many parents typically worry about the aesthetic effects of the gap, thinking that it means getting braces. However, it is advisable to delay orthodontic treatment until the adult teeth erupt. Sometimes, the development of adult teeth makes the gap caused by the extended labial frenum close naturally. If the gap remains, then a labial frenectomy can be done to solve the abnormal spacing issue. 

The procedure

If the child is dealing with the side effects of a tongue- or lip-tie, the pediatric dental specialist will recommend a frenectomy as a permanent solution. The dental professional will examine the frenum or frena and decide whether to proceed with the procedure. Unless the frenum is interfering with the child's feeding or speech, they will usually consider natural and non-invasive options first. If surgery is the best solution, it will be completed in the specialist's office.

A lingual frenectomy entails detaching the tissue connecting the tongue and the floor of the mouth. The procedure is done to correct tongue-tie. A maxillary frenectomy involves the removal of the tissue attaching the upper gums to the front teeth. This tissue can make it so that newborns cannot flare or curl out their lips, making it difficult to latch onto the breast or bottle while feeding.

The procedure usually takes about 10 to 15 minutes, and recovery might take around two weeks. The dentist will prescribe pain relief meds to alleviate soreness and pain around the surgery site. The dental professional will also explain the proper aftercare routine, including cleaning the area and preventing unnecessary tongue movement, to the parents before leaving the office.

Aftercare for frenectomy

To avoid reattachment and get the best possible outcome, it is essential to stretch the detached region because the mouth heals extremely fast, and wounds tend to shrink to the center as healing progresses. Babies who have had a frenectomy may feel a bit of pain and have moderate swelling for the first 24 hours following the procedure.

Parents may use acetaminophen as directed in their postoperative care guidelines. Infant frenectomy does not necessitate stopping breastfeeding or bottle-feeding; many babies find it comforting after surgery. Since breast milk has powerful anti-inflammatory and antimicrobial qualities, nursing may also expedite recovery. After surgery, parents should talk to the doctor before giving their child any medicine, including those purchased over the counter.

Before the anesthesia wears off, some infants may have trouble latching on at first, but that problem typically disappears within 30 to 45 minutes. It is normal for a baby to take a few tries before they find their groove with a new feeding method. Regaining nursing proficiency after removing a posterior tongue-tie might take many weeks.

How to help the child

Assessing a child's mouth for a tongue or lip-tie as soon as feasible is crucial, especially for first-time parents. In certain cases, a medical or dental professional's assessment is necessary to identify if the child is experiencing either problem. Both of these disorders can make it difficult for the infant to feed, and one of them may also cause unpleasant reflux. Even if the child can feed effectively despite a mild case of tongue- or lip-tie, delaying treatment for the issue may lead to other problems, including sleep deprivation, irritability, headaches, and an increased risk of cavities. A frenectomy should be performed as soon as possible to protect the child's dental health and prevent future issues.

Final note

The pediatric dental specialist may recommend infant frenectomy following an examination. Contact the dental office to book an appointment to learn more about the procedure.

Request an appointment here: https://www.grandparkwaypediatricdental.com or call Grand Parkway Pediatric Dental at (832) 579-0960 for an appointment in our Richmond office.

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