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8 Disadvantages of Frenectomy and Its Important Benefits

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Dr. Andreas

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Written by

Q.F. Nayibe Cubillos Morales

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Medically Reviewed by

Dr. Gustavo Assatourians D.D.S

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What are the disadvantages and also benefits of frenectomy? The tongue is attached to the floor of the mouth by a small band of tissue, similar to a web, called the lingual frenulum. Ankyloglossia, or tongue-tie, is a congenital condition where the tongue is tethered to the bottom of the mouth, typically due to a short lingual frenulum. This condition is normal during fetal development but tends to resolve after birth. 

Ankyloglossia can be Categorized into Different Types: 

young-girl-having-frenectomy 

• Type I: The lingual frenulum is inserted at the tip of the tongue, which appears heart-shaped when the baby cries or tries to stick out their tongue.

• Type II: Limited tongue mobility due to the frenulum being inserted a few millimeters further back than type I.

• Type III: A visible membrane at the back of the tongue, accompanied by submucosal anchoring. The baby cannot touch the palate when their mouth is fully open, and there is a depression in the center of the tongue.

• Type IV: The frenulum is not visible, and the tongue is completely anchored to the floor of the mouth, severely restricting tongue mobility.

Frenectomy, a procedure where the lingual frenulum is cut to release the tongue, is commonly performed on babies. While this procedure can have benefits, it is important to understand the potential negative impacts.

This article examines the potential risks and long-term complications of lingual frenectomy.

 

To Perform or Not to Perform a Frenectomy?  

Having a tethered tongue can cause multiple difficulties for babies, children, and adults, including:

 Interfering with breastfeeding

 Speech difficulties

 Affecting daily activities such as eating, swallowing, sticking out the tongue, and kissing.

 Poor oral hygiene

Despite the various problems caused by tongue-tie and the popularity of frenectomy, this procedure is highly controversial. Some healthcare professionals recommend correcting tongue-tie immediately, even before the newborn leaves the hospital, in order to enable normal breastfeeding and nutritional development. Others suggest waiting, as the lingual frenulum may stretch over time, resolving the problem naturally.

In some cases, this condition persists without causing problems. Mothers can seek guidance from a lactation consultant to assist with feeding their babies, and children can receive speech therapy to improve their speech and language sounds, enabling them to lead a normal life.

 

What are the Disadvantages of Frenectomy?

During and after the procedure, the following risks and/or complications may occur:

frenectomy

1. Pain and discomfort: Anesthesia is used to perform this surgery, so there is no pain during the procedure, but it is common to experience pain when swallowing or eating during the recovery phase, especially in the first few days after the procedure.

2. Infection: There is a high risk of infection after surgery, as is normal with any surgical procedure.

3. Bleeding: Frenectomy can be performed with a scalpel or laser technique. When using a scalpel, excessive bleeding can occur, which makes
it difficult for the professional to see during the procedure, and the risk of bleeding is higher after surgery.

4. Nerve damage: Nerve damage is usually temporary, and tingling and numbness may occur around the area where the surgery was performed,
but this sensation should disappear after a few weeks. Rarely, numbness persists.

5. Difficulty speaking: After the procedure, the patient may have trouble controlling their speech, as they have become accustomed to pronouncing words and sounds in a certain way. It is recommended that they receive treatment to reconfigure the muscles of the tongue and use it more effectively.

child-having-difficulties-in-speaking

6. Damage to the tongue or salivary glands

7. Inconsistent results:

The desired results may not be achieved as anticipated. Various factors must be taken into account during this procedure, including the size of the tongue and its level of attachment to the floor of the mouth. There is a possibility that the surgery may not yield the desired outcome and could potentially impact the patient’s speech and swallowing abilities permanently. This information is relevant when discussing the topic of tongue thrust.

8. The frenulum can reattach to the base of the tongue

In some cases, long-term complications may occur after lingual frenectomy, and this surgery may represent a temporary solution, but over time problems with speech and breastfeeding may persist or worsen.

 

Are there any Benefits to Frenectomy?

Yes, this procedure has a high success rate.

Surgery is not indicated in all cases of ankyloglossia, but in more severe cases where there is a significant restriction in tongue movements, the benefits of frenectomy are:

1. Recovery time: The recovery is effective, and significant progress in the healing process can be observed within a week.

2. Simplicity: When performed by a specialist, the surgery is quick and simple.

3. Affordability: Surgery and postoperative recovery tend to be less costly.

4. Effectiveness: In most cases, the problem is resolved.

 

Are there Other Treatment Options Besides Frenectomy?

child-having-difficulties-in-speaking

Depending on the severity of each case and the patient’s age, surgical and/or therapeutic treatments may be considered:

1. Frenuloplasty: This is a comprehensive procedure that separates the tongue from the floor of the mouth. It is performed when additional repair is needed, or when the lingual frenulum is too thick to perform frenectomy.

2. Speech therapy: In simpler cases, speech, feeding, and breathing therapies are sufficient to achieve optimal results.

3. Surgery and therapy: After a surgical procedure, rehabilitation therapies are necessary to re-educate the muscles of the tongue and achieve lasting results.

 

Conclusion

Many people in the world have ankyloglossia, and some have undergone surgery to correct it while others have not. A lingual frenectomy can be performed on babies, children, or adults. As it is only indicated in very specific cases, it is recommended to visit a dentist who will perform a clinical examination and determine whether or not surgical treatment is necessary, taking into consideration the particular benefits and disadvantages of each case.

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References

1. AAOMS. (Updated: July, 2021). What is a Frenectomy? Oral and Maxillofacial Surgeons. https://myoms.org/what-we-do/oral-soft-tissue-surgery/what-is-a-frenectomy/

2. Be aware of potential complications following tongue-tie surgery in babies. (November 19, 2019). ScienceDaily. https://www.sciencedaily.com/releases/2019/11/191120121133.htm

3. Frenectomy: What It Is, Procedure & Recovery. (Reviewed April 11, 2022). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/22714-frenectomy

4.. Iftikhar, N. (November 26, 2020). What to Know If You’re Told Your Baby Needs Tongue-Tie Surgery. Healthline. https://www.healthline.com/health/baby/tongue-tie-surgery

5. Tongue-tie. (Reviewed: March 5, 2020). NHS. https://www.nhs.uk/conditions/tongue-tie

6. Tongue-tie (ankyloglossia) – Diagnosis and treatment – Mayo Clinic. (May 15, 2018). https://www.mayoclinic.org/diseases-conditions/tongue-tie/diagnosis-treatment/drc-20378456

7. Tongue-tie (ankyloglossia) – Symptoms and causes – Mayo Clinic. (May 15, 2018). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/tongue-tie/symptoms-causes/syc-20378452

8. Watson, K. (February 13, 2020). What You Need to Know About Oral Frenectomies. Healthline. https://www.healthline.com/health/frenectomy

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