Frenotomy vs. Frenectomy: What’s the Difference?

If you’ve been told your child needs treatment for a tongue or lip tie, you might have heard two similar-sounding terms: frenotomy and frenectomy. While both procedures address restricted oral tissue (also known as “tethered oral tissues” or TOTs), they differ in important ways. Understanding these differences can help you make an informed decision about your child’s care.

Let’s explore what sets these two procedures apart and why your pediatric dentist might recommend one over the other.

What Is a Frenum?

Before we dive into the procedures themselves, let’s take a moment to understand what we’re actually treating. You may have heard your pediatric dentist mention something called a “frenum” or “frenulum” – this is simply a small band of tissue that connects and supports different parts of your mouth.

There are two main types you should know about: the labial frenum and the lingual frenum. Think of the labial frenum as the tissue that connects your lips to your gums – you can feel it if you run your tongue between your upper lip and upper gums or between your lower lip and lower gums. The lingual frenum is the tissue underneath your tongue that connects it to the floor of your mouth.

While these tissue connections are completely normal and necessary, sometimes they can be too tight or thick – this is what we call a “tie.” When this happens, it can make it difficult for your child to breastfeed, eat properly, speak clearly, or even affect how their teeth develop. That’s when we recommend either a frenotomy or frenectomy to help restore normal function.

What Is a Frenotomy?

A frenotomy is likely to be recommended if your child has a mild tongue or lip tie that needs addressing. Think of it as a quick, simple snip to loosen up that restrictive tissue. During the procedure, we will make a small incision in the frenum. This creates more freedom of movement for your child’s tongue or lip, making it easier for babies to breastfeed and for children to eat and maintain proper oral hygiene.

What Is a Frenectomy?

Similar to how a frenotomy is like a simple snip, think of a frenectomy as a more thorough approach – it’s when we completely remove that restrictive tissue band. We may recommend this option if your child’s frenum is causing more significant challenges, like making it really difficult for them to move their tongue or lip freely.

We typically choose a frenectomy when we see that your child is having notable trouble with things like feeding or speaking or when we’re concerned about how their teeth might align as they grow. We perform this procedure using traditional surgical methods, and it takes less than 15 minutes to perform.

The whole point of a frenectomy is to give your child’s mouth the freedom it needs to work properly, helping them avoid complications down the road. After all, we want your little one to be able to eat, speak, and smile with comfort and confidence!

Benefits of Frenectomy and Frenotomy

Both procedures offer significant benefits that can dramatically improve your child’s quality of life. Here are some of the positive changes you might notice:

• Improved Breastfeeding: If you have an infant with a tight frenum, you might notice they’re having trouble getting a good latch during breastfeeding. When we perform a frenectomy or frenotomy, we’re essentially freeing up that restricted tissue so your baby can latch properly. This means feeding becomes easier and more comfortable for both you and your little one. You’ll likely notice your baby feeding more efficiently, gaining weight as they should, and both of you experiencing much more enjoyable feeding sessions.
• Better Oral Function: When we release that restrictive frenum, we’re giving your child’s tongue or lips the freedom to move naturally. This means everyday activities like eating and swallowing become much easier. You might notice your little one having an easier time moving food around in their mouth, taking bigger bites, or even enjoying new textures they used to struggle with. It’s all about making these basic but essential functions more comfortable and natural for your child.
• Enhanced Speech Development: When your child has a tight frenum, you might notice they struggle with certain speech sounds or have delays in their speech development. Getting that frenum released can give your child’s tongue the extra wiggle room it needs to form sounds more easily. But here’s an important tip: before we move forward with any procedure, we always recommend working with a speech-language pathologist (SLP) first. Think of the SLP as a detective who can help determine if your child’s speech challenges are actually related to their tongue tie and whether a procedure would truly help. This extra step ensures we’re making the best choice for your little one’s speech development.
• Improved Oral Hygiene: If you’ve noticed your child struggling to brush their teeth properly or having trouble getting the floss between certain areas, a tight frenum might be the culprit. This little band of tissue can make it really tricky for your child to move their lip or tongue out of the way while cleaning their teeth. This means some spots might get missed during brushing and flossing, which can lead to unwanted guests, like cavities or gum problems. By releasing that tight tissue through a frenotomy or frenectomy, we’re essentially giving your child better access to clean their whole mouth properly. It’s like opening a door that was only partially open before – suddenly, maintaining good oral hygiene becomes much easier!
• Supports Orthodontic Treatment: If you’ve noticed gaps between your child’s teeth, especially between their front teeth, a tight frenum might be playing a role. When the frenum is too tight or thick, it can actually force teeth apart or cause them to shift in ways we don’t want. By addressing this early with either a frenotomy or frenectomy, we can help your child’s teeth develop in a healthier position. This not only helps prevent alignment issues down the road but also makes any future orthodontic treatment (like braces) more straightforward and effective. It’s like removing an obstacle before it has a chance to create bigger problems!
• Better Sleep Quality: If you’ve noticed your child breathing through their mouth, snoring at night, or seeming tired during the day, a tight frenum might be playing a part. When oral tissues are restricted, they can actually make it harder for your child to breathe properly through their nose, leading to disrupted sleep patterns or even sleep apnea. By releasing that restricted tissue with a frenotomy or frenectomy, we can help your child breathe more freely, leading to more restful sleep. When your little one sleeps better, you’ll likely notice improvements in their energy levels, mood, and ability to focus during the day.
• Prevents Gum Recession: Think of your gums like a protective blanket for your teeth’s roots. When a tight frenum pulls on this “blanket,” it can actually start pulling your gum tissue away from your teeth over time – that’s what we call gum recession. By releasing that tight tissue through a frenotomy or frenectomy, we’re helping protect your child’s gums from being pulled down as they grow. This helps keep their gums healthy and in the right position. This preventive approach means your child is less likely to develop serious gum problems later in life, and their smile stays protected!

The best part? Both procedures are quick, safe, and can provide immediate relief. While recovery time varies, most children adapt quickly to their new oral freedom and start enjoying the benefits right away. Your pediatric dentist will help you choose the most appropriate procedure based on your child’s specific needs and circumstances.

Is Frenotomy and Frenectomy a Cosmetic Procedure?

No, frenotomy and frenectomy are not considered cosmetic procedures. These are functional treatments that address real medical concerns affecting your child’s oral health, development, and overall well-being. While they may improve appearance (like closing gaps between teeth), the primary goal is to enhance function and prevent health complications.

Most insurance plans recognize these procedures as medically necessary when properly documented. Coverage typically applies when the procedure is recommended to:

• Resolve feeding difficulties in infants
• Address speech impediments
• Prevent or treat dental problems
• Correct functional limitations
• Manage symptoms affecting daily activities

However, coverage can vary depending on your specific insurance plan and the documented symptoms. Some insurance providers might require:

• Prior authorization
• Documentation of symptoms
• Letters of medical necessity
• Evidence of attempted conservative treatments
• Evaluation by specialists (like lactation consultants or speech therapists)

Rest assured, our team is here to help you every step of the way! We’ll work closely with you to document all necessary symptoms and clinical findings, making sure we have everything needed to support your insurance claim. Our friendly staff will help gather all the required paperwork, guide you through insurance requirements, and discuss comfortable payment options that work for your family.

Remember, we’re always here to answer any questions and make this process as smooth as possible for you!

Which Procedure Is Right for My Child?

There are a few things to look at when you’re considering between a frenotomy and a frenectomy. Let’s look at the key factors we consider when making this choice:

Several important factors influence whether a frenotomy or frenectomy is the right procedure for your child. These considerations help our pediatric dentist or orthodontist determine the best approach to resolve issues related to the frenum. Here are the key factors:

• Severity of Restriction: If your child has a mild restriction – just a little tightness that’s causing some challenges – a simple frenotomy might do the trick. But if that tissue band is really thick or tight and makes it hard for your child to move their tongue or lip freely, we might recommend a frenectomy to give them the full range of motion they need.
• Impact on Oral Function: We look closely at how the restricted tissue affects your child’s daily life. Are they having just a bit of trouble with feeding? Or are we seeing bigger challenges with things like speaking or maintaining good oral hygiene? The more significant the impact, the more likely we are to recommend a frenectomy over a frenotomy.
• Age of the Child: When we’re treating little ones, especially infants, we often lean toward a frenotomy because it’s quicker and less invasive. After all, our tiniest patients tend to bounce back pretty quickly! But don’t worry – if your child needs a frenectomy for better results, we can absolutely go that route regardless of their age.
• Recovery Considerations: Both procedures have relatively quick recovery times, but they do differ slightly. A frenotomy usually takes about 1-2 weeks to heal completely. A frenectomy usually takes about 3-4 weeks to heal completely, especially if sutures are used.

The most important thing to remember is that we’re here to help you make the best choice for your child. We’ll walk you through all these factors, answer your questions, and work together to decide on the right approach for your little one’s specific needs.

Ready to learn more about frenotomy and frenectomy options for your child? Schedule a consultation with our experienced pediatric dental team at Children’s Dentistry of Knoxville. Our friendly staff is ready to help your child achieve their healthiest, happiest smile!