Is it necessary to trim the frenulum of the upper lip? Why and how is this operation performed? Trimming the frenulum of the upper lip in children and adults: photos of the results and cost of the operation

Surgical intervention in the oral cavity (on the frenulum upper lip) is indicated for patients with certain indications; frenulum correction can be recommended by an orthodontist or speech therapist. What is a labial frenulum? This is a fold found in oral cavity and causing fixation of the lip to the jaw bones.

Under normal conditions, when trimming is not required, the frenulum is located at a distance of 0.5-0.8 mm from the necks of the teeth. Experts call a short bridle that extends beyond the front incisors, or a fold that has a low attachment. The pathological attachment of the frenulum is characterized by its origin in the middle fragment of the upper lip and attachment to the gum at a position of 0.6 mm.

A visual examination will reveal the presence of a diastema. A normally positioned frenulum does not cause speech impairment or health problems, but pathological attachment of this fold can cause some problems. To avoid troubles, specialists perform plastic surgery of the upper lip frenulum.

This is interesting

The pathological structure of the frenulum began to be corrected more than 50 years ago. Today's techniques make it possible to carry out safe surgical intervention, and the use of a laser makes the procedure for cutting the frenulum bloodless and less traumatic.

Not all parents understand how important it is to have timely surgery to correct an incorrectly secured frenulum. The fact is that the frenulum is involved in the work of the dental system, so an incorrect structure of the frenulum can provoke aesthetic problems; the child can become a regular patient of the speech therapist.

A short frenulum prevents the upper lip from functioning properly, a person cannot control his mouth easily, and problems with articulation appear. A defective structure of the frenulum causes decreased lip mobility.

An incorrectly formed or attached frenulum causes a number of problems:

The newborn cannot attach to the breast correctly, and the quality of sucking is impaired. An overly short attachment can become an obstacle to breastfeeding, and a neonatologist has the right to solve this problem surgically.
Speech problems. The quality of labial sounds may suffer, which is why the speech therapist reasonably suspects a shortened frenulum. Plastic surgery solves this problem.
A defective frenulum may be responsible for impaired chewing function and malocclusion; these problems have a significant impact on the digestive system.
The pathological length of the frenulum and the features of its attachment to the alveolar process affect the retraction of the interdental papillae. An interdental gap forms in a person, and the distance between the crowns becomes longer.
A short frenulum provokes the development of a gum pocket, which subsequently develops inflammatory conditions on the gums.
Defects in the frenulum of the upper lip are responsible for increased tooth sensitivity and instability.
If there is a wide frenulum, food debris is constantly retained on the patient’s teeth; The dentist will definitely see a lot of plaque.
Frenumplasty prevents the development of periodontal diseases.

What are the indications for plastic surgery of the upper lip frenulum?

The presence of a short frenulum is not the main indication for surgery. Plastic surgery of the upper lip frenulum is offered to the patient under certain circumstances:

The dentist notes the presence of a diastema between the incisors. The frenulum is an obstacle that prevents the teeth from approaching the center. Constant load aggravates the problem and the gap becomes even more noticeable. Impact on the interdental papilla is a traumatic situation that contributes to the development of periodontitis.
Trimming the frenulum can be a manipulation that precedes orthodontic therapy. The frenulum, due to its ability to exert pressure on the dentition, is a factor influencing the development of the bite. If manipulations to change the bite are prescribed, the location of the lip frenulum should be assessed. For pathological attachment, surgical intervention is indicated.
Existing problems with the orthodontist - indications for medical manipulations; A short frenulum helps lift the gums and expose the teeth.
People with a short frenulum may experience the phenomenon of dentures dropping, so before installing dentures, a specialist will correct the frenulum.
Sometimes speech therapy difficulties become an indication for frenuloplasty. The frenulum interferes with the correct movements of the lips, as a result of which many sounds are pronounced incorrectly.

When is the best time to trim the lip frenulum?

IN infancy Plastic surgery of the frenulum of the upper lip is performed only for absolute indications: if the structure of the fold prevents the child from eating. Plastic surgery is prescribed for children over 5 years of age. No need to worry: this simple operation, complications are very rare.

Why is this age a favorable time for surgery? At this time, the bite changes, and teeth appear in the mouth. permanent teeth. Timely plastic surgery will help speed up the process of bringing the front incisors closer to the center.

Sometimes the operation is postponed for a couple of years: seven-year-old children already have 4 front teeth. If necessary, dental correction in adolescents is possible.

Despite the popularity and simplicity of the operation, excision of the frenulum is contraindicated in the following conditions:

Radiation therapy to the head.
Progressive caries.
Problems with the oral mucosa.

General restrictions on the operation are:

Predisposition to the appearance of keloid scars.
Chronic diseases.
Oncology.
Blood diseases.
Alcoholism.
Brain lesions.

Plastic surgery of the upper lip frenulum: laser and other excision methods

When plasticizing the frenulum of the upper lip with a laser or other methods, sanitation of the oral cavity is indicated. Cautious experts advise passing the annals. The child should not be hungry: blood counts change and plastic is less tolerated in this state.

The operation is short-term: after 15 minutes the mother will be able to hug and reassure the young patient. The characteristics of the frenulum determine the method of surgical intervention. Traditional correction involves the use of a scalpel. Self-absorbing sutures are applied. Recovery takes a week - during this time the scar heals.

Dissection of the frenulum (frenotomy)

This intervention is used if the baby has a narrow frenulum. The fold is cut in the transverse direction and longitudinal seams are applied.

Excision of the frenulum of the upper lip (frenectomy)

For a patient with a wide frenulum, the interdental papilla and tissue in the bone space are excised.

Frenuloplasty

During the procedure, the surgeon moves the attachment site of the frenulum.

Laser plastic surgery of the upper lip frenulum

New technologies make frenulum trimming a bloodless, two-minute procedure. An anesthetic gel is applied to the patient, then the specialist adjusts the laser beam and dissolves the frenulum tissue. Modern technology allows you to seal and sterilize the edges of the wound.

Advantages of laser plastic surgery:

The procedure is silent (which pleases parents whose children are afraid of noisy devices).
There is no need for stitches.
The duration of the operation is reduced.
Laser treatment is less painful.
Rehabilitation is completed quickly (after a few days the child forgets about the wound).

In clinics, laser lip surgery costs 3,000-5,000 rubles. This is the price for peace of mind and absence of pain.

How is the rehabilitation period during laser surgery of the upper lip frenulum?

After the effect of the anesthetic wears off, the patient who has undergone excision of the frenulum of the upper lip may feel mild pain.

To avoid complications, you should adhere to some rules:

Regular oral hygiene is needed.
You need to eat warm, ground or soft food for 2 days.
Contact a specialist who has performed frenulum correction to avoid postoperative complications.

Exercises for muscles are useful. Fun activities that involve completing the tasks “Proboscis,” “Bud,” and “Fence” are aimed at stretching the frenulum and consolidating the postoperative result. Improvements in diction are clearly visible immediately after medical intervention. The interdental distance does not narrow immediately.

Self-rupture of the frenulum

Children are very mobile, so situations where the frenulum of the upper lip is injured in the event of a fall is not uncommon. It is worth showing the baby to the dentist: he will assess the situation and apply stitches (if the situation is serious). Without medical intervention, the edges of the wound may grow together asymmetrically, and a rough scar will injure the oral cavity and limit lip movements.

The procedure for excision of the frenulum of the upper lip should be prescribed by a specialist and have clear indications. This is a short-term operation with a quick recovery period. Traditional method excision of the frenulum with a scalpel is inferior to an innovative technique involving the use of a laser. Modern technologies Excision of the frenulum allows you to solve many aesthetic and speech problems in 10 minutes.

Frenules of the tongue, upper and lower lip

The question that one of my friends recently raised is quite relevant - it is often asked not only by mothers, but even by doctors of other specialties. Indeed, why so insignificant? anatomical features require such close attention from dentists and pediatricians. I will try to conduct some educational program on this topic. Again, keep in mind that this is the opinion of a practicing physician, and not a theoretical teacher at a medical school, so it may differ slightly from the generally accepted one.

Tongue frenulum

A shortened frenulum of the tongue is most often noticed by neonatologists and speech therapists.

In the first case, the child cannot eat normally or suck properly, sometimes this leads to the fact that the baby is noticeably behind in height and weight from his peers. Therefore, immediately after birth, doctors must examine the child’s oral cavity; in the case of a shortened frenulum of the tongue, they cut it themselves with scissors.

IN Lately However, children began to be referred to dentists. In this case, the shortened frenulum of the tongue is trimmed at any time while the child is breastfed, but the sooner this happens, the better.

The procedure itself is extremely simple - it is carried out without any anesthesia, since it is practically painless, done in one movement, no stitches are applied. The ideal hemostatic agent for a child is mother’s milk, so immediately after the operation you need to feed the baby. Neither myself nor any of my colleagues saw any complications after cutting the frenulum of the tongue.

In the second case, when the child is referred by a speech therapist, the reason for the referral is that the child does not pronounce certain sounds, burrs or has a lisp. By limiting the movements of the tongue, a shortened frenulum makes it difficult to pronounce palatal sounds - “r”, “d”, “l”, etc. It is difficult for a child to stick out his tongue when open mouth he cannot reach the upper incisors with the tip of his tongue.

In this case, not just cutting the frenulum is performed, but a full-fledged operation, under local anesthesia, with suturing and subsequent postoperative monitoring. Sometimes an appointment is also required medicines and implementation of some recommendations to prevent postoperative complications. The stitches are removed on the fourth to sixth day. In my practice, there were no complications after this operation.

The ideal age for tongue frenuloplasty is 5-9 years. Around this time, parents, and the child himself, begin to worry about speech phonetics. After the operation, you can resume working with a speech therapist within a couple of weeks. As a rule, it turns out to be more fruitful.

Surgeries on the frenulum of the tongue are the most common in our clinic. It is important for parents to recognize the problem early, especially for newborns, since malnutrition greatly affects their health.

Upper lip frenulum

The second most common operations that have to be done on the frenulum are plastic surgery of the frenulum of the upper lip.

A neonatologist, speech therapist, orthodontist and periodontist can also refer patients for plastic surgery of the upper lip frenulum.

The upper lip in newborns is also actively involved in the act of sucking, therefore, if its mobility is limited, the child cannot normally feed on mother’s milk. I have already outlined the consequences of this; I will not return. It is better not to delay the operation, so trimming (about the same as with a frenulum of the tongue) is carried out by neonatologists themselves, or referred to a dentist in the first months of life.

Speech therapists pay attention to the shortened frenulum of the upper lip when it is difficult for a child to pronounce sounds that require the participation of the lips - “u”, “o”, etc. The age of treatment is from five years and older. Naturally, simple pruning is not enough here.

But most often, orthodontists and periodontists refer for plastic surgery of the upper lip frenulum. The fact is that the frenulum of the upper lip is often woven into the interdental papilla, and sometimes into the incisive papilla, leading to an increase in the gap between the front teeth - the formation of a diastema. In addition, the shortened frenulum, when moving the upper lip, pulls along the mucous membrane of the alveolar process of the upper jaw - as a result of this, the gums move away from the front incisors, causing hypersensitivity, exposure of the roots, periodontal disease, etc. This is especially noticeable in older people. In children, the problem is even more serious - during the formation of a permanent bite, a shortened frenulum of the upper lip leads to the advancement of the front teeth forward, especially if there is not enough space in the dentition. Subsequently, correcting such malocclusions is difficult, time-consuming and expensive.

Thus, the operation of plastic surgery of a shortened frenulum of the tongue is the prevention of periodontal diseases and malocclusions, and is indicated for difficulty pronouncing sounds and problematic breastfeeding.

There are many varieties of this operation; I know of about ten authors. I myself have developed a technique for plastic surgery of a shortened frenulum of the tongue, which I have been successfully using for several years. Its difference lies in its simplicity, as well as a good cosmetic result. The operation is performed under local anesthesia, takes about ten minutes on average, stitches are applied (sometimes one ligature is enough), which are removed after 4-6 days. Routine postoperative monitoring and recommendations. In my practice there were no complications after such operations.

Some “doctors” do everything very simply - several times I saw how the frenulum of the upper lip was simply crossed with scissors, or cut off from the alveolar process - and “the operation is over.” I recommend avoiding this approach, since as a result, dangling rags of the bridle not only look unsightly, but also disturb patients, and excessive mobility of the lower lip leads to what we call a “horse smile.” In addition, the resulting adhesions and scars can seriously worsen the situation; correcting such an error will be very difficult.

Frenum of the lower lip

Unlike the previous two, this is not a constant thing; for some people it may be absent altogether, or it may be in two or more copies. Periodontists and orthodontists most often refer for plastic surgery of the frenulum of the lower lip; it is often combined with the operation of deepening and plastic surgery of the vestibule of the oral cavity.

There are several reasons why plastic surgery of the lower lip frenulum is necessary. Firstly, during movements of the lower lip, the frenulum pulls the mucous membrane of the alveolar process forward - this provokes gum retraction and exposure of the roots of the frontal group of teeth of the lower jaw, leading to periodontal diseases, which most often cause the loss of the lower anterior incisors. Also, a shortened frenulum of the lower lip leads to malocclusion, stretching the anterior lower teeth forward.

The age of patients is 6-7 years and older. Quite often, plastic surgery of the lower lip frenulum has to be performed on older people with periodontal diseases. In this case, it is combined with deepening and plastic surgery of the vestibule of the oral cavity.

Very rarely, the frenulum of the lower lip is a fairly massive cord, comparable to the frenulum of the upper lip, which interferes with both the pronunciation of sounds and the sucking of the breast in newborns. In the latter case, it is trimmed during the first months of life (in the maternity hospital or at the dentist), in the second, corrective surgery is performed.

There are quite a lot of methods by which the operation is performed. It all depends on the indications for which it is performed and what goals the operation pursues. It takes 10-15 minutes, under local anesthesia, and often requires suturing. Postoperative complications I haven't met.

Recently, the number of people who are indicated for plastic surgery of the frenulum of the tongue, upper or lower lip has decreased. This is due, first of all, to the good work of neonatologists, as well as to the improvement in the organization of pediatric dental, especially orthodontic, services. Which is very nice to know.

You should not delay with frenuloplasty, since, being largely preventive, they prevent the occurrence of other, more serious diseases. And whether you or your child needs such a procedure can only be determined by a qualified specialist.

The labial frenulum is a fold of mucous membrane that connects the lip and gum. Plastic surgery of the frenulum of the upper and lower lips is done to eliminate pathologies that can have unpleasant consequences in the form of impaired diction and the formation of malocclusion. This operation itself is very simple and has minimal contraindications. It is done if the frenulum is too short or too wide, which affects the position of the teeth and the condition of the gums. For example, due to a wide frenulum, a diastema may appear - a gap between the central incisors. In this case, either surgery using the classical method or laser plastic surgery of the upper lip frenulum will help.

Sometimes plastic surgery is performed on the frenulum of the tongue - the membrane connecting the lower part of the tongue and the mucous membrane of the lower jaw. In children, surgery promotes the correct formation of the bite and prevents speech defects; in adults, it is a necessary measure for effective prosthetics with a removable structure or implantation. Read more about plastic surgery of the lingual frenulum.

What are the differences between upper and lower lip frenuloplasty?

Although the operations themselves to correct pathology on the upper and lower lips are similar, they require a different approach to rehabilitation. After plastic surgery of the lower lip frenulum, the wound takes longer to heal, about two weeks, while plastic surgery of the upper lip frenulum requires only a few days to recover. In the first case, anti-inflammatory therapy is often prescribed to prevent complications.

When is lip frenuloplasty required?

The pathology of the labial frenulum does not always indicate that the patient requires surgery. Sometimes it is minor and does not cause any particular inconvenience. As a rule, surgery is necessary in the following cases.

Diastema. The excess gap between the central incisors tends to widen, causing the teeth to move forward and move apart. different sides. Also constant load on the gums leads to periodontitis.
Orthodontic treatment. Bite correction with braces requires that the frenulum be correct form and had anatomical location. Therefore, before starting treatment, the orthodontist often sends the patient for plastic surgery.
Periodontal diseases. A short frenulum can expose the roots of the teeth.
Complete prosthetics. A short bridle does not allow it to be firmly and securely fastened removable denture. This is one of the most common cases when plastic surgery of the lower lip frenulum is performed in adults.

Photo of a short frenulum of the upper lip in a child.

Contraindications

Lip frenuloplasty cannot be performed if the following contraindications exist:

oncological diseases;
poor blood clotting;
psychical deviations;
infectious diseases.

Is it necessary to perform labial frenuloplasty in children?

Pathology of the labial frenulum in a child can lead to many unpleasant consequences, both medical and aesthetic. Therefore, if a specialist recommends plastic surgery, you should definitely take his advice. In children, this anomaly can cause the following problems:

The upper lip in newborns is actively involved in the sucking process along with the tongue, therefore, if the frenulum is shortened, the child will not be able to feed normally;
A frenulum of the upper lip that is too short does not allow the correct pronunciation of labial sounds and some vowels, as a result of which the child will experience difficulties with diction;
Frenum defects are directly related to malocclusion and chewing functions. Thus, there is a risk of digestive problems.

According to doctors, it is best to perform plastic surgery of the upper lip frenulum in children aged 5 to 8 years (the indications for surgery on the lower lip are identical). At this time, the child’s baby teeth are replaced by permanent teeth, and it is important that this process proceeds correctly. However, if necessary, plastic surgery of the upper lip frenulum can be performed in adults or adolescents. As for newborns, it is recommended that they undergo surgery only in case of serious nutritional disturbances.

Methods of lip frenuloplasty

There are three main methods of lip frenuloplasty: frenotomy, frenectomy and frenuloplasty. The choice of technique depends on the characteristics of the pathology.

Frenotomy is a dissection of the frenulum. It is performed when the process is too narrow and is not attached to the edge of the alveolar ridge. The frenulum is cut transversely.
Frenectomy - excision of the frenulum. This method is used for excess soft tissue width, with the incision along the ridge.
Frenuloplasty - relocation of the frenulum attachment site.

In all three cases, self-absorbable threads are used to suture wounds. The operation usually lasts about 15 minutes and is painless using local anesthesia.

Recently, laser lip frenuloplasty has become widespread. This operation is more expensive, but easier to tolerate. A focused laser beam removes excess tissue while sealing the edges of the wound. This means that there is no need for stitches, the operation is completely bloodless, and recovery takes less time. Laser plastic surgery of the upper lip frenulum in children is preferable to the classical technique, since it is performed with less trauma. Of course, we also recommend giving preference to laser frenuloplasty of the upper lip in adults.

Post-operative care

The rehabilitation period takes one to two weeks. To avoid complications, you must follow your doctor's recommendations:

monitor the hygiene of the oral mucosa and perform procedures prescribed by a specialist;
exclude hot, sour and solid foods;
undergo a follow-up examination with the surgeon who performed the operation;
do gymnastics to strengthen the chewing muscles.

The above rules will help you return to your normal lifestyle in short time and prevent deterioration of health after lip frenuloplasty.

How much does lip frenuloplasty cost?

The price for lip frenuloplasty usually starts at 3,000 rubles and reaches 5,000 - 6,000 rubles. In this case, there is usually no difference whether we are talking about the price of plastic surgery of the frenulum of the upper lip or the lower lip. Plastic surgery of the frenulum of the upper lip with a laser is more expensive and can cost from 3,500 to 8,000 rubles. Traditionally, the cost of the operation already includes anesthesia, but this must be clarified in advance. Parents often ask how much it costs to have upper lip frenuloplasty in children. Typically, the costs for this procedure are no different from those for surgery in adults.

These small mucous strands can affect the clarity of speech, the aesthetics of a smile; in infants, the frenulum of the oral cavity can affect the quality of attachment to the breast, or the ability to suck a bottle. It is for this reason that parents should pay attention to these anatomical formations.

If the frenulum(s) of the oral cavity are short, the baby will not be able to eat properly, attach to the breast, and therefore will get tired faster, remaining hungry. There can be no talk of any increase in the child’s weight or height. Parents should remember and be aware of this problem and be able to notice alarming symptoms. According to statistics, a large percentage of short frenulums are registered in children, on average every 14 children. If the problem is diagnosed in time, it is possible to avoid those complications that can cause short frenulum.

Oral anatomy

There are three frenulums in the child’s mouth, and not alone, as many parents believe. After all, more " famous» frenulum of the tongue, which is attached to the underside of the tongue and sublingual space. The frenulum of the tongue is rightfully considered the most insidious, but at the same time practically the most important.

In addition to the frenulum of the tongue, in the baby’s mouth there are also frenulums of the upper and lower lips, which are also assigned certain functions. The frenulum on the upper lip should be woven into the upper lip and into the mucous membrane of the gums, just above the level of the front incisors. The frenulum on the lower lip is woven in the same way as the upper lip.

Diagnose short bridle in the mouth, as a rule, they can still be in the parental department; this is more true for the short frenulum of the tongue. As for the rest of the frenulum of the oral cavity, diagnosis mainly occurs in the dentist's chair at a random appointment. There are cases when a tongue frenulum is not immediately diagnosed, and the frenulum in no way interferes with the feeding of the baby. But subsequently, the child may pronounce incorrectly defined sounds, and then the question of a short frenulum of the tongue comes up again, which, as a rule, is diagnosed at an appointment with a speech therapist.

Upper lip frenulum

When diagnosing a short frenulum, there are usually no difficulties, even for parents. To do this, you just need to carefully pull back the upper lip at rest and see at what level the mucous cord is attached. Normally, attachment should occur 5–8 mm from the neck of the child’s incisors. If the frenulum is attached lower or its attachment is not visible at all, then we can talk about a short frenulum.

What are the dangers of having a short frenulum?

In a newborn baby, a short frenulum on the upper lip can affect breastfeeding; the baby simply cannot position the upper lip correctly and correctly grasp the mother's breast. Only in this case can the frenulum of the upper lip be corrected while maternity hospital. Fortunately, this happens quite rarely.
At an older age, a short frenulum in the oral cavity can affect the aesthetics of a smile, since a gap is formed between the child’s front teeth - a diastema (trema). Typically, children are embarrassed by such diastemas, especially teenagers, and try to smile or talk less.

Such spaces between teeth are considered dental defects that require orthodontic treatment, sometimes in combination with surgery. But it is worth remembering that an aesthetic defect is not the only problem that can be caused by a short frenulum of the upper lip; the most serious complication is problems with bite, namely the protrusion of the front incisors forward.

The protrusion of the front incisors occurs as a result of pressure. The fact is that when talking or eating, the lips are involved, and the frenulum connects the lip and the alveolar process and pulls it along with it, while mechanically acting on the jaw in the area of the incisors, promoting their advancement forward. The solution to this problem is orthodontic, and requires a fairly large investment of time and money. In fairness, it is worth noting that such a scenario can only develop in children with permanent incisors; if the baby still has a milk bite, then there is no need to worry.

Excessive tension on the gum mucosa can cause inflammatory diseases in the area of the anterior incisors – gingivitis, periodontitis. As a result, the child may develop increased sensitivity teeth. Speech defects can also be characteristic of a short frenulum; the toddler cannot correctly pronounce some sounds that the baby uses his lips to pronounce, for example, “o”, “u”, etc.

In addition, inflammatory diseases in the gum area can provoke caries in the neck area of the teeth. Due to the low attachment of the frenulum, it accumulates in the incisor area. a large number of plaque, and it is quite difficult to remove.

How does the correction happen?

Correction can be done exclusively surgically, but it is worth remembering some features. Correction of the frenulum on the upper lip is indicated only after or during the eruption of the permanent incisors! Usually this is 6 - 8 years old; until this age, parents should not worry.

It is not recommended to perform the operation before this period, with the only exception in the maternity hospital. Otherwise, such actions may result in bite pathology. A shortened and thick frenulum of the upper lip in a primary occlusion is not a pathology, but a variant of the norm; as the jaws grow, the frenulum can self-correct, i.e. stretch out and change its place of attachment.

It is for these reasons that the most optimal time for correction is the time when all the permanent incisors on the upper jaw have erupted, and active eruption of the canines begins, or when the anterior permanent incisors erupt, and when the lateral incisors actively erupt. The fact is that when the frenulum is corrected at this time, the erupting teeth will move the teeth towards each other and the gap between the teeth will close on their own, and there will be no need for orthodontic treatment.

If it was not possible to correct the frenulum in time, it is necessary to use orthodontic treatment, when the doctor places a “brace” on the front teeth, which will bring the incisors together.

Surgery

Dentists can use 3 types of surgical treatment:

Frenotomy - dissection;
Frenectomy - excision;
Frenuloplasty – relocation of the frenulum attachment site.

Children can cut the frenulum on their own, and cases of such injuries are quite common. For example, if you fall or chew toys too hard, the frenulum may rupture, which is accompanied by bleeding and hematoma. In case of injury, you must immediately consult a dentist to decide the future fate of the injured frenulum. Frenectomy solves this problem, and even with trauma to the oral cavity, frenulum ruptures, as a rule, do not occur.

The operations themselves are performed in a surgical clinic, using local anesthesia, and the procedure usually does not take more than 30 minutes. After cutting the frenulum, the doctor applies sutures made of a special biomaterial that dissolves on its own, which helps avoid unpleasant procedure for their removal. The recovery period after the procedure is not long and takes from several hours to several days. And as soon as the swelling subsides after the operation, parents note that the child begins to pronounce sounds more clearly, or grasps the mother’s breast more freely.

The operation can be performed using various instruments - surgical scissors or a scalpel, or using a laser. Using the latter technique is the most acceptable, as it avoids stitches and significantly reduces the baby’s recovery time. Most often, the frenulum is corrected in young children using a scalpel, the amount of time spent is reduced, and immediate attachment to the chest is a prerequisite.

Frenum on the lower lip

There may be no frenulum of the lower lip or it may be forked. In order to diagnose a frenulum on the lower lip, it is necessary to retract the lower lip. At the same time, the frenulum itself becomes noticeable, which runs from the middle of the alveolar process of the lower jaw, intertwining below the area of the lower incisors, and attaching to the lower lip.

Under normal conditions, the frenulum should be thin and almost invisible, in addition, it should be flush with the center line. If the baby's frenulum is thick, short and attached at the base of the lower incisors, the frenulum is short.

Why is a short frenulum of the lower lip dangerous?

By analogy with the frenulum on the upper jaw, the sucking function of a toddler may suffer. When sucking, the short frenulum pulls the lower lip along with it, thereby breaking the vacuum that is formed during sucking. The baby needs more effort, the baby quickly gets tired, remaining hungry and abandoning the breast. In this case, frenuloplasty can be performed in the maternity ward.

A short frenulum can also cause malocclusion, inflammatory and carious diseases in the area of the lower anterior incisors. The formation of spaces between the lower anterior incisors is a rather rare phenomenon, but can still be diagnosed if the frenulum is woven into the area of the gingival papilla between the anterior incisors of the lower jaw.

Treatment

The operation can be performed on children of various ages, but most often these are children with fully erupted permanent incisors. No less often, the frenulum can be cut already in adulthood, when it comes to prosthetics of the lower jaw.

The operation itself is carried out in a clinic, using local anesthesia, and 2 operations can be used to correct the frenulum - frenotomy, frenectomy.

Tongue frenulum

It is this frenulum that can influence the movement of the tongue; most often it limits these movements. Language is most important organ in the oral cavity, which is involved in many functions - speech formation, nutrition, breastfeeding and much more.

Normally, the mucous cord is woven from the inside of the tongue approximately in the middle, and connects to the sublingual space. The normal length of the frenulum is about 8 mm. If a toddler’s frenulum is attached almost to the tip of the tongue, then this is a clear indication for correction.

This classic sign of a short frenulum of the tongue is not always found; there are other symptoms that can be used to diagnose its shortening. Doctors usually use a simple test that parents can use too. When the baby’s mouth is open, you need to ask her to touch the very roof of her mouth, and if the baby reaches without difficulty, everything is normal. But if a child experiences a painful reaction, or the child simply cannot perform this operation, this is a reason to contact a doctor.

The only drawback of this test is the age restrictions for children; such a test can only be performed on children over 3 years old. If the baby is younger, then he can simply refuse to carry out such manipulation. There is also a set of tests for younger children; doctors usually ask or provoke the child to show his tongue. And at the same time, the doctor evaluates how much the baby’s tongue can come out of the mouth.

Why is a short oral frenulum dangerous?

Every mother should pay attention to feeding the baby, monitor his reaction, pay attention to the sounds the baby makes, and weight gain. With a short frenulum of the tongue, the baby simply cannot properly place his tongue under the mother’s nipple, it turns out that the baby cannot grasp the breast correctly, and “clicking” sounds may occur during feeding.

In addition to inadequate breastfeeding and problems for the mother, the baby spends more effort to get enough, the baby's sucking activity gradually decreases, and the feeding time itself increases, during which the baby takes a short break. The baby tries to compensate for the greater amount of effort by clenching his jaws, and often when feeding, babies bite their mother's breast.

Often such children set their own feeding schedule, since full saturation occurs over a longer period of time; usually babies eat approximately every two hours. Weight gain is achieved by lower limit norms, or even lags behind.

The frenulum may not be diagnosed in infancy, and can be detected during the period when the baby begins to actively talk. Babies with a short frenulum of the tongue cannot correctly pronounce quite a lot of sounds, namely those sounds in which the tongue should touch the palate or upper incisors - “r”, “sh”, “sch”, “ch”, “ry”, etc. Diagnosis of the frenulum often occurs at an appointment with a speech therapist, from where parents receive a referral to a dentist.

Treatment

Treatment can take place in two ways - surgical or speech therapy; often a combination of these two methods occurs. Parents should remember that the choice of treatment method lies entirely on the shoulders of the dentist, and not the speech therapist.

Surgical correction of the frenulum

The frenulum can be corrected in the maternity hospital, the operation is carried out in the obligatory presence of the mother, and after the operation the baby must be immediately applied to the breast. There are no nerve endings in the frenulum itself, but there are blood vessels, in the place where the dissection occurs there are no them, therefore, there is no pain and bleeding. Babies can simply get scared, and applying to the breast is more of a calming maneuver.

In young children, correction is most often carried out using a laser, which eliminates the need for stitches and reduces recovery time.

In older children, namely school children, it is performed under local anesthesia. In this case, the doctor cuts the frenulum and applies sutures using a classic set of instruments. It is more expedient to use laser scalpel. When using it, the time of the operation itself is reduced, and there is no need for sutures.

After rehabilitation, the baby must follow a special gentle diet and perform the exercises recommended by the dentist or speech therapist. These exercises are aimed at training the frenulum. If the frenulum is not very shortened, then it is possible to solve the problem without surgery, but only if the child is less than 5 years old.

Speech therapy exercises

Exercises can be different, and the choice will depend on the age of the child. For the little ones, you can offer play exercises where the baby’s tongue will be used, for example, the “kitten” exercise - the baby is asked to lick a saucer like a kitten.

You can use the exercise " horse", ask the baby to click like a horse, while the tongue rises to the sky, tension and stretching of the frenulum occurs, which trains it.

At the appointment, the speech therapist can massage the frenulum using special tools or with the help of hands. It is worth remembering that the child gets tired quite quickly, and there may be discomfort up to painful ones. That is why the load must be increased gradually, and it is precisely this fact that is associated with the fact that speech therapy treatment does not give quick results, and in most cases it is impossible to do without surgical intervention. And when diagnosing a short frenulum, it is necessary to obtain

Plastic surgery of the frenulum of the upper lip is a corrective operation to trim the frenulum, which is performed on a patient who has appropriate indications for surgical intervention with a referral from an orthodontist, periodontist or speech therapist.

A little anatomy

The frenulum of the upper lip is an elastic cord of the oral mucosa that connects the upper lip to the bones of the jaw and allows a person to move his lips freely and open and close his mouth without difficulty.

Normally, the frenulum is attached at a distance of 5-8 mm from the necks of the frontal incisors. If it is attached below or even extends beyond the frontal incisors and the attachment point is not visible, then they speak of a short frenulum of the upper lip.

In such patients, it begins in the middle of the upper lip, and is attached somewhere 4-6 mm above the gums, in the area of the gap (diastema) between the frontal incisors. Pathology of the frenulum can be detected during external examination.

Why do they trim the frenulum of the upper lip? The thing is that its abnormal location can cause a number of complications.

Why is plastic surgery performed?

Trimming the frenulum is necessary to avoid the following consequences:

Indications for surgery

Indications for correction are:

When is the best time to have plastic surgery?

Despite the fact that this procedure is considered easy and usually does not cause any complications for newborns, it is rarely done only when there are problems with natural feeding.

It is better to carry out the correction when the child turns 5 years old and the front teeth have erupted by 1/3. If plastic surgery is performed at this time, a diastema will not form, and the front incisors will grow correctly.

Some doctors advise having surgery at 7-8 years old, when 4 upper incisors already got out. According to indications, correction is carried out for adolescents and adults.

Existing restrictions

Contraindications to plastic surgery are:

Preparing for the intervention

Before the operation, you need to sanitize the oral cavity, since infectious foci can cause a number of complications.

Some doctors require tests and X-ray fluorography, but there is no particular need for this, since the operation is low-traumatic.

Before plastic surgery, the child needs to be fed, since the intervention is more difficult to tolerate on an empty stomach and can worsen blood clotting in an hungry person.

Types of operation

There are several methods of performing plastic surgery; the choice of a particular method depends on the anatomy and fixation of the frenulum of the upper lip:

If it is very narrow in the form of a transparent film and is not attached to the edge of the alveolar process, frenotomy, or dissection of the frenulum. They cut it across and apply a suture along it.
With a wide frenulum, they resort to frenectomy, or its excision. It is cut along the tense ridge, and at the same time the interdental papillae and tissues localized in the bone space between the roots of the spread frontal incisors are excised.

During frenuloplasty, the attachment point of the frenulum is moved.

The procedure is carried out in two ways:

Laser plastic surgery

Laser removal of the upper lip frenulum is becoming increasingly popular. The operation site is treated with an anesthetic gel, then a laser light guide is directed to the frenulum, forming a beam of light that “dissolves” the frenulum. At the same time, the laser disinfects and seals the edges of the wound.

Advantages of laser plastic surgery:

absence of vibrations and various sounds that can frighten a child;
bloodlessness;
no need for stitches;
there is no risk of infection;
absence of pain and postoperative scars;
reducing the duration of plastic surgery;
fast rehabilitation.

The cost of the procedure varies from 3 to 5 thousand rubles.

Familiar firsthand

My son had problems with diction. The speech therapist said that this was due to a short frenulum of the upper lip and advised it to be corrected.

After the operation, the child began to pronounce sounds more clearly. During the procedure itself I did not feel any pain, and after the operation there was no stitch left.

Valentina Semyonovna, 36

Possible complications

In most cases, there are no complications after surgery. However, if correction is carried out too early in the stage of baby teeth, permanent teeth will begin to grow crookedly, upper jaw may form small and narrow, which will cause progeny.

When lower jaw is pushed forward, and the upper one is poorly developed and when the jaws are closed, the lower row of teeth overlaps the upper one, which will lead to problems with diction.

However, in each case, the doctor must decide individually at what age to carry out surgery.

Rehabilitation period

Usually the recovery period passes without complications.

Sometimes, after the anesthesia wears off, mild pain may appear.

To make rehabilitation go faster, you need to follow some rules:

Every day practice good oral hygiene. Do not eat anything solid or hot for two days.
Visit a doctor on day 2-3 for postoperative examination.
A week later It is advisable to start doing myogymnastics, which will strengthen the facial and chewing muscles. It will take some time to get used to the fact that your lips will move more freely. Your diction will improve almost immediately. If a gap has already formed between the teeth, then longer treatment will be needed.

The rehabilitation period lasts a maximum of 5 days, during which all discomfort passes and the wounds heal.

Timely plastic surgery will help prevent the development of a number of dental problems. The procedure itself is painless and usually does not cause complications, so you should not be afraid of it.

A short frenulum of the upper lip in a child - why is it dangerous and what to do?

The frenulum of the upper lip is the thinnest fold of the oral mucosa that connects the mobile lip to the upper gum. Often mothers notice in their babies that the frenulum is too short or looks unusual.

The situation is aggravated by the fact that different doctors have completely opposite opinions regarding the treatment of this deficiency. What to do, whether to have surgery or not, whether to wait for a certain age for the child or to have surgery right now are the main questions that torment the parents of the baby.

Short frenulum of the upper lip in a newborn: etiology and pathogenesis

The reason for the appearance of this feature in a newborn is a violation of the formation of the mucous membranes of the mouth and congenital anatomical anomalies of the oral cavity. The etiology of this defect is determined by various hereditary and external factors risk during the first trimester of pregnancy, when the embryo develops the facial skeleton and oral cavity.

The labial frenulum is a thin triangular mucous bridge located vertically between the middle of the lip and the middle of the gum (alveolar process of the jaw). These movable thin bridges serve as limiters for lip mobility.

Most often, the pathogenesis of the defect is caused by the fact that the connection of the frenulum with the gum occurs below the base of the gingival papilla, that is, too close to the teeth. There are also different kinds defects in the shape of the bridle itself - compaction, thickening, curvature of the shape, shortening of the free side. These defects lead to the fact that the upper lip becomes inactive, does not completely cover the upper row of teeth, and the patient experiences difficulty closing the lips.

The ICD-10 code is Q38.0 (Congenital anomalies of the lips, not elsewhere classified).

Dangerous consequences for the child

In addition to aesthetic defects, a shortened frenulum of the upper lip without timely treatment can lead to various serious problems:

Inconveniences when breastfeeding a baby can occur if the frenulum ties the upper lip too tightly to the alveolar process - the baby cannot correctly position the nipple in the mouth and suck normally. This problem is fraught with poor weight gain in the baby, he is nervous during feeding and often abandons the breast.
At an older age, in the absence of any treatment, a child may develop a fairly wide gap between the front teeth. Only an orthodontist can correct such a defect.
During the formation of a permanent bite, a short frenulum of the upper lip contributes to the advancement of the front teeth, which leads to serious violations.
Due to excessive tension upper frenulum Various inflammatory processes may develop, leading to gingivitis and periodontitis.
Exposing the roots of the teeth can occur if the frenulum pulls too hard on the interdental gum when talking or eating.
In serious and advanced cases, the child experiences problems with speech, namely with the pronunciation of sounds that require lip movements (vowel sounds).

Which doctor should I contact?

If your baby is unable to eat normally or has problems gaining weight, you should consult a neonatologist. This doctor will examine the baby’s oral cavity and, if a shortened frenulum is diagnosed, will carry out all the necessary procedures.

If a child has problems with the pronunciation of individual sounds, and this cannot be corrected with the help of a speech therapist, at the age of 5-6 years the child is sent to see pediatric dentist or an oral and maxillofacial surgeon. This doctor makes a diagnosis and prescribes surgery to excise the frenulum of the upper lip.

Treatment methods

The frenulum of the upper lip cannot be stretched. If it creates serious problems in the child's nutrition and development, the only way treatment - medical intervention.

Self-dissection

Cutting during outdoor play or eating by a child.

Children aged 5-6 years are very active, and the frenulum can break in the event of a fall, an unsuccessful jump, or in the process of biting something very hard - this is considered the norm.

If your child has damaged the frenulum above the upper lip, treat the wound and be sure to consult a doctor.

Surgery

The intervention is performed under local anesthesia and lasts no more than an hour.

The doctor uses scissors or a scalpel to trim it and apply sutures using special absorbable threads that do not need to be removed.

Recovery after surgery will take approximately 4-5 days.

Based on the characteristics of the shape and attachment of the frenulum to the lip, the doctor chooses one of three methods of plastic surgery:

Frenuloplasty – relocation of the frenulum attachment site;
Frenotomy - transverse dissection;
Frenectomy – excision along the tense frenulum and interdental papilla.

Laser excision

The most popular and painless procedure is performed using local anesthesia. The doctor directs a laser device at the frenulum, under the influence of which it “disappears”. After this manipulation, there is no need to apply stitches or treat with an antiseptic - the laser itself seals and sterilizes the edges of the wound.

Indications for surgery

No doctor will perform an operation without special indications, especially for a child. Surgical correction Upper lip frenulum is performed if:

The patient has developed a very wide gap between the front incisors, which is gradually increasing. This leads to displacement of teeth forward and to the sides, contributing to the development of inflammatory processes.
In preparation for the installation of braces or plates to correct the bite. A short frenulum, creating additional stress on the dentition, will interfere with the alignment of the bite;
Gum recession is when the roots of the teeth become exposed. This unpleasant phenomenon can lead to various serious inflammatory processes in the oral cavity.
When planning to wear removable dentures. A shortened frenulum will not allow the dentures to stay firmly on the gums, which will cause a lot of trouble for the patient.
For serious problems with pronunciation that interfere with the patient’s ability to communicate with other people.

When should the bridle not be trimmed?

Most doctors agree that the short frenulum of the upper lip cannot be trimmed earlier than at the age of 5-6 years. After baby teeth fall out, you need to carefully monitor the growth of your front incisors and work with your doctor to determine whether surgery is really necessary.

Well-known pediatrician Evgeniy Olegovich Komarovsky notes that if your child really has a shortened frenulum of the upper lip, but it does not cause problems (difficulties in feeding, a large aesthetic defect, problems with speech), the operation is not worth doing. If a mother simply does not like the way her child’s upper lip frenulum looks, this is not at all a reason for surgical intervention.

Caries with complications;
Diseases of the oral mucous membranes;
Osteomyelitis is an infectious inflammation of bone tissue;
Cerebral lesions;
Blood diseases;
Oncological diseases;
Exacerbation of chronic diseases;
Mental problems.

Whether or not to operate on a shortened frenulum of the upper lip - only a competent doctor can answer this question based on the individual characteristics of your baby. Do not worry ahead of time and do not needlessly perform unnecessary operations on your child if this is not the case. urgent need. Remember that a shortened frenulum is not a disease, but just a feature.

Trimming the frenulum of the upper lip - is it better than plastic surgery or surgical intervention?

Under normal conditions, every person has a special membrane on the mucous membrane in the mouth, which helps attach the lips to the jaw bone. It should not in any way interfere with the natural process of chewing food and speaking, but sometimes deviations can occur, most often in children.

Below we will discuss the nuances of when it is necessary to trim the frenulum on a child’s lip, how the procedure is carried out, at what age it is best to do this, and also what is the difference between plastic surgery and surgery.

What is a frenulum and where is it located?

You need to carefully and carefully pull back and then lift your upper lip towards your nose. Then it will be possible to see the bridle, which resembles a triangle. Its sides are securely attached to the mouth: one is securely attached directly to the inside of the lip inside the mouth, the other is attached to the gum near the incisors.

The beauty of a person’s unique smile will depend on how the latter connects to the gum. In a normal situation, the lower edge of such a connection should be located slightly above the gum papilla by a couple of millimeters. If such a fastening is located lower, at the very junction of the incisors, some difficulties may arise.

The situation becomes more complicated when the bridle is very strong and weighty. This significantly reduces motor functions lips: it can look very upturned or show your teeth unattractively.

Indications for cutting the frenulum and contraindications

In the situation of pathology of the structure of this mucous fold, there are a couple of treatment options, the most well-known of which today are considered standard plastic surgery, laser treatment and surgery. Only surgery will help correct this kind of defect - it cannot be cured simply by diets, physiotherapy, medications or acupuncture.

If the baby has a noticeable short frenulum on the upper lip, you need to consult with the following doctors: neonatologist, orthodontist, speech therapist and periodontist. A dentist or surgeon will not be able to give completely objective indications for this operation;
A neonatologist may prescribe a procedure when a frenulum defect will interfere with natural breastfeeding of the baby. Most often we are talking about pathology of the lip structure, since it is most actively involved in sucking. Sometimes the neonatologist will be able to excise the membrane himself or write a referral to a special surgeon;
A speech therapist is able to identify a short frenulum in a baby when the speech function is upset, there is underdevelopment in the speaking function. Most often, this diagnosis is made when children clearly pronounce vowel sounds such as “o, u” and others, in the pronunciation of which the child’s lips are involved. A speech therapist, unfortunately, often reveals a violation at the most later(pupils). In this situation, ordinary pruning will not help; real surgery will be needed;
often the need for cutting the frenulum in children is determined by orthopedists or periodontists;
The pathology of the lip attachment causes malocclusion in a person and a change in the arrangement of teeth in a row, and tooth mobility. If the operation is not performed at a very young age, subsequent treatment can be very long-term, unpleasant and costly. Adults have a much harder time with surgery.

There is a whole list of contraindications for performing this type of plastic surgery:

chronic relapses, as well as acute diseases in the mouth, inflammation, viral diseases, as well as fungal infections of the body and frequent infections;
osteomyelitis;
very weak blood clotting;
caries of the upper front teeth;
Availability oncological diseases and a course of chemotherapy;
dysmorphophobia;
severe psychological disorders and significant mental deviations;
illnesses nervous system, disorders in the cerebral system;
blood diseases (hemophilia or leukemia);
systemic diseases of the whole body;
collagenosis, strong predisposition to scar formation.

Operation description

Frenum cutting is always performed in a hospital. Used for pain relief local anesthesia, during which the doctor can calmly talk to the baby. The duration of the operation most often is up to half an hour.

There are three various types plastic surgery of the mucous fold:

Dissection - used when the frenulum is excessively narrow and does not connect with the edge of the alveoli in any way. With the help of competent manipulations, the doctor can cut it across, making almost invisible longitudinal sutures.
Excision - on the contrary, there is a very wide frenulum. The surgeon should make an incision that will slightly touch the top of the stretched mucosa, and then excise the papilla between the teeth, and with it the tissue that is located between the roots of the incisors.
Ordinary frenuloplasty is the name of the method during which the attachment site of the mucous fold is changed.

Such operations are most often carried out when four incisors are completely cut through. After the correction is completed, sutures are carefully applied. They are made from a special material that will later dissolve on its own. The main feature of the operation is that the recovery process will only take a couple of hours.

If the operation was performed on a small child infant, the result will be noticeable immediately - the baby will begin to babble and coo more clearly, and will begin to suck the breast more correctly.

Application innovative methods will help bypass even minor complications, for example, severe swelling. The child will only need to follow proper rehabilitation.

Trimming the frenulum of the upper lip using a laser

Laser cutting will help avoid hemorrhage during the operation, since the heated rays simply “seal” the vessels that are excised. Anesthesia in this position means the application of a special gel with a strong cooling effect, which is felt instantly.

After this technique there is no swelling, pain or scar, and the procedure itself takes from 5 to 10 minutes. In addition, laser beams under the influence of high temperature completely disinfect the wound, and this helps it quickly recover and heal. The absence of a scar means that there is no need for stitches.

Using a laser will help break up a trip to the doctor into a couple of sessions, which significantly reduces the level of stress for the baby and makes the procedure much more convenient and quick.

Rehabilitation

The recovery period after the procedure may take a couple of days. The baby may experience disorientation for the first couple of hours as the anesthesia wears off, and then quite unpleasant feelings arise.

The task of adults is to help the wound heal as quickly as possible, and for this purpose it is necessary to do the following:

carefully monitor the child’s constant and high-quality oral hygiene;
prepare special dishes for the baby for a couple of days (liquid, even slimy, in the form of porridge or soufflé, minced meat), and also serve the child only foods and drinks of moderate temperature;
be sure to see a doctor in a couple of days;
Perform basic muscle exercises with your child, which will help to develop the functions of chewing and facial expressions well.

Initially, the baby will still begin to feel severe disorientation due to the appearance of a completely different amplitude and strength of motor activity of the tongue itself. The child’s diction may also change, so you need to train with the correct pronunciation of sounds.

Most often, rehabilitation takes up to 7 days. Within 5 days, wounds usually heal and all discomfort during chewing movements disappears.

Video: plastic surgery of the upper labial frenulum (personal experience).

Consequences

What happens if you don't trim the bridle?

In small children, very short frenulums can significantly disrupt the sucking function, preventing them from correctly taking the mother’s nipple. In this situation, after examination by a doctor, the frenulum can be trimmed in the maternity hospital itself. But if the child quickly gains weight well during feeding, no correction is made;
V early age the low location of the frenulum has very little effect on the motor activity of the lips and facial skeleton. But after cutting through the incisors, the frenulum can strongly fall into the gum papilla between them; this can cause a gap to appear - a real nuisance that will only intensify over time;
protrusion of the incisors from above in the center, and then - a bad bite and severe deformation of the entire row of teeth;
turn general view the upper lip, its strong upturning, which prevents the teeth from being covered from above;
too much tension of the gum mucosa, and then its severe recession and complete exposure of the tooth root. Afterwards are possible frequent inflammations in the area of the incisors in the front: gingivitis, periodontitis.
disturbances in the pronunciation of many sounds.

My baby had surgery last year. Before this, my child suffered greatly from incorrect diction. I took Tolya to a speech therapist. I am very pleased with the fact that this specialist was so reliable: he immediately found the reason for such diction and advised us on a regular correction operation. Just ten minutes in the chair - and everything is fine: excellent diction, no pain and no scars.

I was recommended plastic surgery of the mucous fold by the dentist who treated me for periodontitis. He noted that real reason my disease is short frenulum. Laser correction was performed. Just a few minutes - and everything is ready. Only for a couple of days I couldn’t eat my favorite chips.

I decided to have an operation on my daughter because the doctor said that due to a frenulum defect, Sasha’s teeth might develop incorrectly. I worried about this for a very long time (later it turned out that it was in vain). The daughter didn’t even realize that something had been cut.

Additional questions

Now in Moscow clinics the average cost for plastic surgery of the upper lip frenulum is approximately three to five thousand rubles. It goes without saying that the price category will fluctuate greatly depending on the complexity of the situation and the number of stages in which the operation itself can be carried out.

Trimming the frenulum of the upper lip in children

Normally, each person has a special bridge on the mucosa that helps attach the lips to the jaw bone. This frenulum should not interfere with normal chewing of food and speech, but sometimes deviations occur, especially in young children. In this article we will look at when and whether it is necessary to trim the frenulum of the upper lip, at what age this can be done, what is the difference between plastic surgery and surgery, etc.

What threatens the pathology of frenulum development?

Young children often develop a gap between their front teeth. As a rule, the cause of the pathology is too short a frenulum on the upper lip. In order to bring the teeth closer together and give the oral cavity an aesthetic appearance, a suitable orthopedic system (plates, braces, etc.) should be installed. However, this becomes possible only after correction of the frenulum of the upper lip.

Upper lip frenulum in a child

What problems may await the baby if the mucous fold is thickened or too short:

an interdental diastema (gap, gap) is formed;
the baby cannot part his lips normally and widely, which is why the smile becomes skewed, weakly expressed and unaesthetic;
possible speech impairments, distortion of the pronunciation of various letters;
the mucous fold pulls the interdental papilla, which leads to malocclusion (the front teeth move forward strongly).

The most common pathology can be considered a low attachment of the fold of the upper or lower lip. Failure to correct the frenulum of the upper or lower lip in this case leads to complications:

disruption of the sucking process in infants;
speech defect, pathology of speech organ development;
problems while chewing foods;
the appearance of characteristic pockets in the gums, where food debris, bacterial plaque and stone get trapped, and this in turn leads to inflammatory processes and suppuration;
tooth roots are exposed;
enamel sensitivity increases;
development of periodontal diseases (periodontal disease, periodontitis, gingivitis and others);
violation of the stability of teeth, the appearance of gaps between them.

Also, a wide frenulum under the upper lip can cause the accumulation of pathological microflora, plaque, stone, and food debris in the teeth and between them. In this case professional hygiene oral cavity will be needed every 2-3 months.

Indications for the procedure

In the case of pathology of the development of the mucous fold, there are several treatment options, the most popular of which are laser and conventional plastic surgery, as well as surgical excision. Only surgery can correct this defect - it cannot be treated with diets, physiotherapy, acupuncture and medication.

Laser plastic surgery of the frenulum

If you notice a short fold of the upper lip in a child, you should contact the following specialists: neonatologist, orthodontist, orthopedist, speech therapist, periodontist. The dentist or surgeon does not establish objective indications for the operation.

A neonatologist has the right to prescribe a procedure if a mucosal defect prevents normal breastfeeding of the baby. As a rule, we are talking about pathology of the structure of the upper lip, since it is most actively involved in the sucking process. In some cases, this specialist is able to independently excise the bridge or write a referral to a pediatric surgeon.

A speech therapist can detect a short frenulum of the upper lip in a child when speech dysfunction and underdevelopment of the speech organs are identified. This diagnosis is especially often made when the baby slurs or incorrectly pronounces the vowel sounds “o, u” and others, the pronunciation of which involves the lips. The speech therapist, unfortunately, identifies the disorder at a later stage (preschool and school age). In this case, ordinary trimming will not correct the situation and a full-fledged surgical intervention will be required.

Often the need to trim the frenulum of the upper lip in children is determined by orthopedists, orthodontists and periodontists.

The pathology of the attachment of the lip to the jaw bone leads to a malocclusion and a change in the position of the teeth in a row, the appearance of their mobility. If you do not carry out the procedure in childhood future treatment may be lengthy, unpleasant and expensive.

When should surgery be performed?

The optimal age for surgery is considered to be 5-6 years. Despite the difficulties that arise during breastfeeding, children under 4 years of age are not subject to correction. If the doctor suggests performing a full surgical procedure infant, you should contact another clinic, since early intervention in this area can have a number of consequences.

Trimming the frenulum of the upper lip in children before and after

Trimming of the mucous membrane should begin when the permanent central teeth have already fully erupted, and the second incisors are just at the eruption stage. This is why most doctors try to prescribe surgery at school age.

What complications can arise from correction or removal of the frenulum of the upper lip under the age of 5 years:

jaw formation continues after surgery, which may necessitate repeat surgery in the future;
the upper lip of a baby performs only a third of its intended functions (the baby does not speak, does not bite through solid food, etc.), and changes in the structure of the mucous membrane can cause scarring of the tissue, which can subsequently pull the lip and cause discomfort just like a regular frenulum;
surgery in the mouth without permanent teeth is carried out almost “blindly”, so the doctor can touch the rudiments of the molars, disrupt their nutrition, provoke inflammatory and pathological processes oral cavity.

Types of procedure

The most common types of changes to the baby's frenulum are surgical intervention (cutting, removal, changes in position, etc.), as well as plastic surgery (including using a laser).

Surgical intervention.

This procedure

Wound on the 3rd day after surgical excision of the frenulum

The wound heals within 10 days, during which the little patient adheres special diet(liquid food room temperature), pays increased attention to oral hygiene (antiseptic baths and applications, rinsing with herbs and soda-salt solution). After healing, a small scar remains in the area, which resolves over time. Typically, the procedure is performed by oral surgeons or periodontists.

Plastic. This event allows you to trim the frenulum of the upper lip of a child without using anesthesia (or a small amount of it). It includes 3 different procedures:

frenuloplasty(the method of fastening and the position of the jumper changes);
frenectomy(the mucous fold is excised);
frenotomy(dissection of this fold).

A narrow bridge is a transparent or translucent septum that is not attached to the edge of the alveolar process. This frenulum is cut across, after which sutures are applied.

If the bridge is wide, the doctor tightens it and makes an incision along the ridge. This involves excision of soft tissues, including the interdental papilla of the central teeth.

Plastic surgery is performed in an outpatient clinic and lasts no more than 20 minutes. The stitches dissolve on their own after the session.

Laser lip frenulum trimming. This type of plastic surgery allows you to avoid bleeding during surgery, since the hot rays literally “seal” the excised vessels. Anesthesia in this case involves the application of a cooling and anesthetic gel with an immediate effect.

After this modern techniques there is no swelling of the area, pain or even scarring, and the event itself lasts up to 5 minutes. In addition, laser beams under the influence high temperatures disinfect the wound, which promotes its speedy healing. The absence of a scar eliminates the need for sutures.

Usage laser therapy allows you to split a trip to the doctor into several sessions, which reduces stress for the baby and makes the procedure more comfortable and faster.

Rehabilitation after the procedure

Recovery after plastic surgery or surgery takes several days.

During the first few hours, the child may experience disorientation as the anesthesia wears off and unpleasant sensations and discomfort appear. The goal of the parents is to help the wound heal faster, and for this you should follow a few simple rules:

Recovery after plastic surgery or surgery takes several days

monitor regular and high-quality oral hygiene of the baby;
prepare special dishes (liquid, slimy, mushy, soufflé, minced meat) for several days, as well as serve food and drinks only at room temperature;
in a few days, go to the doctor for an examination;
perform myogymnastics with your baby, which allows you to develop chewing and facial muscles.

The first days after the procedure, the child will feel disorientated due to the emergence of a new amplitude and strength of tongue movement. His diction will also change, so you should practice with your baby the correct pronunciation of sounds.

On average, rehabilitation lasts up to a week. In 4-5 days, the wounds heal and discomfort during chewing goes away.

Contraindications for plastic surgery

We learned in the article how the frenulum of the upper lip is trimmed. The event involves surgery, which is stressful for the body.

It is not surprising that there are a number of contraindications to plastic surgery:

chronic recurrent and acute diseases oral cavity, inflammatory, viral, fungal, infectious lesions;
osteomyelitis;
poor blood clotting;
presence of caries front teeth with consequences;
chemotherapy and oncology;
irradiation of the neck and head area with rays;
dysmorphophobia;
psychical deviations;
diseases of the nervous system, cerebral disorders;
blood diseases (hemophilia, anemia, leukemia and others);
systemic diseases of the body in the active stage;
collagenosis, predisposition to scarring.

Cutting the frenulum is a common procedure for children and can save them from a number of problems in the future.

The procedure of cutting the frenulum itself is common for young children and can save them from a number of physical and aesthetic problems in the future.
Following the rules of hygiene and the doctor’s instructions will allow you to go through this event quickly and with the least discomfort and provide your baby with a full future.