A frenum (also called a frenulum) is a band of tissue that connects or holds down a part of the body such a the tongue, lip, or cheeks. The band of tissue connecting the tongue to the floor of the mouth is called the lingual frenum, while the band connecting the lip to the gum in front the the teeth is called the labial frenum.
Occasionally a frenum might be exceptionally short, thick, or tight, or may extend too far down along the tongue or the gum. When a frenum is positioned in such a way as to interfere with the normal alignment of teeth or to constrict the movement of the tongue or lips, ti can be excised with a very simple surgery called a frenectomy.
An usually thick, large, or tight lingual frenum can seriously constrict movement of tongue. This condition is called “tongue-tie” and is, in fact, the source of this metaphorical phrase. Children who are tongue-tied may have difficulty breastfeeding as infants, and may later develop speech problems. The lingual frenum may also pull so strongly on the middle of the tongue that the tongue acquires a heart shape. An usually short range of tongue extension may indicate the need for a lingual frenectomy.
A diastema, or a large gap between the two front teeth, is occasionally the result of an unusually thick or tight labial frenum that attaches very low on the gum. In such cases, frenectomy, combined with simple orthodontics, can correct this problem.
A frenectomy is normally a relatively simple procedure. Using either a scalpel or a laser, the dentist or surgeon will excise (cut) the frenum in question. When conducted with a laser, the surgery tends to cause very little bleeding, does not require sutures, and often results in very little post-procedure discomfort. The procedure can be performed using local anesthesia on most older children and adults. Very young children may have to undergo the procedure under conscious IV sedation or general anesthesia.