A lingual frenectomy is the surgical removal of a band of tissue called the lingual frenum or frenulum, which connects the underside of the tongue with the floor of the mouth. The procedure is used to correct ankyloglossia, also known as tongue-tie, where the frenum of the tongue restricts the range of motion. The cause of tongue tie is not known, but some research indicates the condition might be hereditary.
Ankyloglossia is defined by an unusually short and thick lingual frenum, the membrane connecting the underside of the tongue to the floor of the mouth. Ankyloglossia varies in degree of severity from mild cases characterized by mucous membrane bands to complete ankyloglossia, where the tongue is entirely joined to the floor of the mouth.
What Problems are Caused by Ankyloglossia?
Ankyloglossia can affect eating, especially in breastfeeding infants. Speech and oral hygiene can also be affected. Ankyloglossia can also prevent the tongue from contacting the anterior palate, the rigid front part of the roof of the mouth that separates the oral and nasal cavities, creating misalignment between the teeth of the upper and lower dental arches when the jaws close. This can then promote an infantile swallow and hamper the progression to an adult-like swallow, which can result in an open bite deformity.
How is Frenectomy Surgery Performed?
Frenectomy can be performed on infants, children, and adults. The resulting difference in tongue length is generally a few millimeters. Depending on the procedure and aftercare, the tongue may end up being slightly shortened.
Your dental surgeon or general surgeon will perform lingual frenectomy in one of the following ways:
- Traditional surgery involves the use of a knife or scalpel. The abnormal tissue is removed, and dissolvable or removable sutures are placed on the incision. Bleeding is usually minimal.
- Soft tissue laser surgery is a procedure where the surgeon uses a laser tool. The excess tissue is cut, and the site is sealed (coagulated). The patient does not experience bleeding.
- Electrocautery (thermal cautery) is a form of surgery where a heated electrode is used to burn the excess or abnormal tissue. The patient does not experience bleeding.
The lingual frenectomy procedure typically requires 30 to 60 minutes, depending on the technique used. The actual surgical incision requires only a few minutes. Local anesthesia is administered by injection prior to the traditional method. Anesthesia most likely will not be necessary for the laser or electrocautery procedures, but your surgeon will still provide anesthesia if that is your preference.
What are Possible Risks and Complications for Lingual Frenectomy?
Before lingual frenectomy surgery, discuss any health risks with your surgeon, including age, obesity, diabetes, history of smoking, kidney and liver issues, high blood pressure, history of bleeding disorders, and long-term illnesses such as autoimmune disorders and chronic infections.
Recovery usually occurs within a few days to a week. Complications after surgery can include excessive bleeding, pain and bruising, swollen lips and gums, or infection in the surgical site. Use of ice packs to reduce pain and swelling, over-the-counter pain relievers, and gently gargling with salt water two to three times per day will usually resolve any complications.
Contact your surgeon right away if you experience signs of infection, nausea or vomiting, severe headache, fever, or dizziness.
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