Lingual Frenectomy: When Is It Needed?

A lingual frenectomy is a simple surgical procedure that can greatly improve your child’s oral health and overall well-being. In this blog post, we’ll walk you through everything you need to know about lingual frenectomy: what it involves, when it’s recommended, and the positive changes it can bring to your child’s development. Whether you’re just learning about tongue-tie or actively considering treatment options, this information will help you make confident decisions about your child’s care.

What Is a Lingual Frenectomy?

A lingual frenectomy is a quick procedure that addresses a condition known as tongue-tie (ankyloglossia). During this procedure, we carefully release the tight band of connective tissue (called the lingual frenum) that connects the bottom of the tongue to the floor of the mouth. Think of it like a small string that’s too short or thick, limiting your child’s tongue movement. This surgical correction is typically completed in less than 15 minutes, using either surgical scissors or a precision soft tissue laser surgery. It can be performed on patients of any age – from newborns to adults.

Many parents are relieved to learn that modern lingual frenectomies are minimally invasive and performed with either local anesthesia or, in some cases, just topical numbing gel for infants. Recovery is usually quick, with most children returning to their normal activities within a day or two.

Signs Your Child May Need a Lingual Frenectomy

There are a few signs that might suggest your child could benefit from a tongue-tie release. Here are some of the most common signs to look out for:

• Do you notice challenges during breastfeeding? The restricted tongue movement can make it difficult for your little one to achieve a proper latch, which often leads to breastfeeding difficulties and slower weight gain. As a parent, you might feel concerned or frustrated when breastfeeding becomes painful or stressful for both you and your baby. The good news is that a lingual frenectomy can make a remarkable difference – helping your baby latch more effectively, feed more comfortably, and allow you to enjoy those precious bonding moments during feeding time.
• Has your child been struggling during mealtimes? A tongue-tie can make it challenging for children to chew and swallow their food properly. When the tongue’s movement is restricted, your child may have difficulty manipulating food in their mouth, leading to struggles with different textures and food types. We often hear from parents about their children’s mealtime frustrations – whether it’s difficulties chewing thoroughly or swallowing comfortably. These challenges can affect not only your child’s nutrition but also their willingness to try new foods. The good news is that a lingual frenectomy can help your child move their tongue more freely, transforming mealtimes into a more enjoyable experience for everyone involved.
• Does your child breathe through their mouth? When we see children who breathe primarily through their mouths, a tight tongue-tie could be the underlying cause. This happens because the restricted frenum makes it difficult for your child to fully close their mouth, especially during sleep. You may notice your child’s mouth staying open throughout the day or hear them breathing heavily at night. This mouth breathing can lead to several concerns – from an increased risk of cavities (due to decreased protective saliva) to disrupted sleep patterns and daytime fatigue. If your child is experiencing these challenges, please know that a lingual frenectomy could make a significant difference. By releasing the lingual frenum, we can help your child breathe more naturally through their nose, potentially improving both their dental health and quality of sleep.
• Do you notice gaps forming between your child’s lower front teeth or see signs of crowding? These alignment issues can sometimes be traced back to a tight tongue-tie. When the tongue can’t move freely, it creates unusual pressure patterns that affect how teeth grow and align. The good news is that a lingual frenectomy can often help prevent these issues by releasing the tight tissue that’s causing the problem. Many parents are relieved to learn that this simple procedure can support more natural tooth alignment as their child grows, potentially avoiding more complex dental work in the future.
• Are you noticing challenges with your child’s oral hygiene routine? A restricted tongue can make it difficult for your child to keep their mouth clean, even when they’re trying their best with brushing and flossing. As a parent, you might feel frustrated watching your child struggle to reach certain areas of their mouth or worried when you notice plaque buildup despite regular brushing. The tongue plays a crucial role in naturally cleaning the mouth throughout the day, helping to clear away food particles and bacteria. When the range of motion is limited by a tongue tie, this natural cleaning process doesn’t work as effectively, potentially leading to more cavities and gum problems over time. The good news is that a lingual frenectomy can make a remarkable difference in your child’s oral hygiene journey. By freeing up the tongue’s movement, we can help your child clean their mouth more thoroughly – both during brushing and throughout the day.
• Does your child have difficulty extending their tongue? When you see your child struggling to stick out their tongue past their lower teeth or notice that the tip looks heart-shaped when they try, these could be telltale signs of a tongue-tie. As a parent, you might feel concerned watching your child have trouble with simple actions like licking their lips or articulating certain sounds clearly. The restricted movement happens because the tight band of tissue is holding their tongue back, making everyday activities more challenging than they need to be. The good news is that a lingual frenectomy can make a wonderful difference in your child’s oral mobility. Many parents are amazed to see how freely their child can move their tongue after this gentle procedure, opening up a world of easier eating, speaking, and self-expression.
• Is your child showing signs of gum recession? A tongue-tie can create constant tension that pulls the gums away from the teeth over time. This happens because the restricted tongue movement creates ongoing pressure on the gum tissue, gradually causing it to pull back and expose more of the tooth structure. This can cause your child’s teeth to look longer than usual, or they may complain about sensitivity when eating hot or cold foods. The good news is that a lingual frenectomy can help address these concerns. By addressing a tongue tie early, we can help ensure your child maintains healthy gum tissue and stays comfortable throughout their development.

If you notice any of these signs in your child, don’t worry – these symptoms are common and treatable with oral surgery. The first step is scheduling an evaluation with our experienced pediatric dentists, who can determine if a lingual frenectomy would benefit your child’s development and well-being.

What’s the Best Age for a Lingual Frenectomy?

While a frenectomy procedure can be safely performed at any age, certain developmental stages can offer the most benefits for your child’s growth and well-being. Let’s explore these key timeframes together:

• During Infancy: Many parents learn about tongue-ties shortly after welcoming their little one into the world, especially when breastfeeding becomes challenging. If you’re noticing feeding issues with your newborn, early intervention – sometimes within the first few weeks or months of life – can make a remarkable difference.
• In Early Childhood (6 Months to 2 Years): This window represents an ideal time for a frenectomy since your child’s tissue is naturally more elastic and less developed. The procedure tends to be gentler, with faster healing times, and children this age often adapt quickly to their new tongue mobility.
• During Later Childhood (6 to 18 Years): While frenectomies are still highly effective at this age, the piece of tissue may be more developed and established in its pattern. However, don’t let this discourage you – many older children and teenagers experience significant improvements in speech articulation, eating comfort, and oral hygiene after the procedure.

Remember, every child’s journey is unique, and the right timing depends on your little one’s specific needs. Our experienced team at Children’s Dentistry of Knoxville has extensive experience working with patients of all ages, ensuring your child receives appropriate care and support throughout their treatment journey.

The Lingual Frenectomy Procedure: What to Expect

Understanding what happens during a lingual frenectomy can help both you and your child feel more confident about the procedure. Here’s a step-by-step guide to what you can expect:

• Before the Procedure: We’ll thoroughly review your child’s medical history and conduct a gentle oral examination. Our team will take the time to explain the procedure in detail and answer any questions you may have, ensuring you feel fully informed and comfortable. For older children, we’ll demonstrate some simple exercises they can practice after the procedure to support optimal healing and results. We’ll also discuss comfort measures, including appropriate anesthesia options for your child’s age, so you know exactly what to expect during treatment.
• During the Procedure: Your child will be comfortably positioned in the dental chair, and for our youngest patients, we often use a special swaddling technique to help them feel secure and peaceful throughout the procedure. The area under the tongue will be gently numbed using either a topical gel or local anesthetic, ensuring your child’s comfort. Using a precise instrument – like a surgical scissor – we’ll carefully release the restricted tissue with minimal discomfort. The entire procedure typically takes just 10-15 minutes from start to finish, making it a quick and manageable experience for both parent and child.
• Immediately After: For infants, we encourage immediate feeding to comfort the baby and to ensure proper oral function. Older children can have a drink of water and will be monitored briefly before heading home. We’ll provide detailed aftercare instructions and demonstrate gentle stretching exercises that help prevent the tissue from reattaching during healing.

Your child will be in caring, experienced hands throughout the entire process. Our team specializes in creating a calm, supportive environment, ensuring both you and your child feel comfortable and confident about the procedure.

Aftercare and Recovery Tips

Proper aftercare plays a crucial role in your child’s healing process and the long-term success of their surgical correction. Here’s how you can support your child’s recovery:

• First 24 Hours: During the first 24 hours after the procedure, it’s important to keep the surgical area clean. For older children, gentle rinsing with warm salt water works well, while infants benefit from the natural cleaning properties of breast milk or formula. You can help manage any minor swelling by applying a cold compress to the outside of the mouth. It’s essential to maintain regular feeding schedules – for infants, continuing to nurse or bottle-feed actually helps prevent tissue reattachment. If you have an older child, offering soft, cool foods like yogurt, smoothies, or ice cream can provide comfort during the healing process. During this time, be sure to avoid hot, spicy, or acidic foods that might irritate the surgical site.
• Essential Stretching Exercises: Gentle stretching exercises play a vital role in your child’s recovery and usually begin about 4-6 hours after the procedure. These exercises need to be performed 3-4 times daily for about 2-3 weeks to ensure proper healing and prevent the tissue from reattaching. For older children, we recommend making these exercise sessions more enjoyable by turning them into a game or offering positive reinforcement for their cooperation. When working with infants, we’ve found it helpful to incorporate the stretching exercises during regular feeding times, making it part of your natural routine and ensuring consistent follow-through with this important aspect of recovery.
• Pain Management: Most children experience minimal discomfort during and after the procedure. Infants often return to feeding immediately, while older children might notice a mild sensation similar to having bitten their tongue. If needed, you can use recommended over-the-counter pain relievers to help manage any discomfort. For infants, pain relief through nursing or skin-to-skin contact often works well, and cold foods and drinks can help soothe the area for older children. Most children return to normal activities within 24-48 hours, making this a relatively quick recovery process.

While most children experience a smooth recovery, there are certain situations when you should contact our office. Please reach out to us if:

• Bleeding continues beyond a few hours after the procedure
• Your child develops a fever
• The pain seems excessive or worsens after 48 hours
• You notice any unusual swelling or signs of infection

Remember, we’re here to support you throughout the healing process – if you have any concerns at all about how your child is recovering, don’t hesitate to call us. Your child’s comfort and well-being are our top priorities, and we want to ensure their healing journey goes as smoothly as possible.

Are There Any Risks or Complications?

A lingual frenectomy is considered a very safe procedure with minimal risks, especially when performed by an experienced pediatric dental team. However, as with any medical procedure, it’s important to be well-informed about potential complications:

Common and temporary effects:

• Mild swelling or soreness under the tongue (typically resolves within 24-48 hours)
• A small amount of bleeding immediately after the procedure (usually stops within minutes)
• Temporary changes in feeding or speaking patterns as your child adjusts to their new tongue mobility

Rare complications:

• Minor infection (preventable with good oral hygiene)
• Tissue reattachment (can be prevented by following post-procedure stretching exercises)
• Scarring (minimal with proper healing)

We take several important precautions to minimize these risks. Our practice maintains strict infection control protocols and uses only sterile instruments during every procedure. Our team will provide you with detailed aftercare instructions to support optimal healing at home.

We also schedule follow-up appointments to carefully monitor your child’s progress, and we remain available to address any concerns you may have during the recovery period. These measures help ensure your child’s procedure and healing process go as smoothly as possible.

Take the first step toward helping your child eat, speak, and smile with confidence. Schedule a consultation with our experienced pediatric dental team today by calling 865-357-5560 or requesting an appointment online. We look forward to supporting your family’s journey to better oral health.