Frenectomy Dental: Types, Codes & 4 Amazing Procedures

Frenectomy dental is a dental procedure recommended for a person with some frenum complications. Frenum is a soft tissue that is made up of elastic and striated muscle fibers, this tissue is attached between the lips and gums. The frenum be can located or found in the top, bottom, sides of the mouth or underneath the tongue. It connects one surface within the mouth to another.

The frenum or frena (plural) has functions in the mouth like:

The Labial Frenum: This is a connective tissue that connects the lips to the gum above the top front teeth (the two front teeth) and below the bottom two front teeth. If the labial frenum is attached too low on the gum tissue, a gap can occur between the two front teeth. 

Lingual Frenum: The lingual frenum connects the underside of the tongue to the floor of the mouth. It can be felt stretching underneath your tongue when you touch your tongue to the roof of your mouth. It can come in different sizes depending on individuals. 

Superior Labial Frenulum: The superior labial frenulum or frenum is the soft tissue that joins the upper lips to the maxillary gingiva.

Buccal Frenum: Buccal frenum are those tissue strands that attaches your your gums to your cheeks. They are found in the premolar area of the mouth and allows your mouth to move freely when you talk or chew. 

COMPLICATIONS OF THE FRENUM

When these frena are compromised, it can lead to different complications like:

Labial Frenum

The labial frenum also called the lip frenum if compromised can lead to complications and effects like

1. Gum Tissue: When the lips move, the labial frenum is constantly tugged at and this makes it to pull away the gum tissue from your tooth and exposes the root.

2. Lip Ties: When the frenum is tight, latching becomes difficult resulting to lip tie. When a baby has lip ties, breastfeeding becomes difficult.

3. Poor Oral Care: A tight and low frenum can make you develop oral issues like gingivitis or tooth decay.

4. Mouth Breathing: A tight labial frenum can cause irregular airway development, abnormal jaw growth and the mouth ways open because the labial frenum cannot allow the lips to close.

5. Diastema: Popularly known as gap teeth is the space in between the teeth, it is usually found between the front teeth or sides of the teeth. Diastema can occur between the central incisors if the frena tissue are too low or tight.

Lingual Frenum

Short lingual frenum can result to tongue-tie which is also known as ankyloglossia. When the lingual frenum is short, it can limit how the tongue moves and can cause dental issues. Apart from disrupting the tongue’s range of motion, it can also hinder how a baby is able to keep his or her tongue over the lower gum to breastfeed. 

It can also result to tongue thrusting and abnormal swallowing, that is the tongue resting against the roof of the mouth when you swallow. Short lingual frenum can cause speech impediment which interferes with a person’s ability to pronounce letters like “s”, “z”, “th”, “d”, “l”, and “t”.
Other activities like eating and brushing may become painful and difficult as these soft tissues can be hurt.

Buccal Frenum

When the buccal frenum is strained constantly, the tissues around them can be damaged leading to deep pockets. Your chances of having oral dysfunction and cheeks being pulled inwards can also increase if the buccal frenum is compromised.

FRENECTOMY DENTAL

To correct or prevent these complications, a “frenectomy dental” is recommended or done. According to Stanford Medicine, frenectomy is a procedure where the lingual frenulum is cut but not completely removed and is done when the frenulum is short or tight, causing a condition called ankyloglossia or “tongue-tie”. This procedure allows more movement in the tongue.

The American Association of Oral and Maxillofacial Surgeons explained that frenectomy dental is a simple surgical procedure where an oral surgeon releases the frenulum bands or removes them. In the case of a lingual frenectomy, this helps increase the motion of the tongue. And with a labial frenectomy, it helps close the gap in the front teeth. Oral surgeons or periodontists typically perform frenectomies with a scalpel, electrosurgery, or laser surgery.

This procedure can be done in infants or adults although bit is easier and the risks are minimal in an infant as compared to an adult. It is impossible for an infant to tell you when they are feeling their frenum. However, there are ways you can tell if your baby may need a frenectomy dental procedure.

You can notice the following;

  • The tongue looking like a heart or notch shaped when it is stuck out.
  • Difficulty in lifting the tongue or moving it from side to side.
  • Difficulty in sticking the tongue out past the lower gums.

The adult frenectomy dental procedure may require a longer recovery time than an infant frenectomy.

TYPES OF FRENECTOMY DENTAL

There are two types of frenectomy procedures that can be preformed – a lingual frenectomy and a maxillary frenectomy. 

1. Lingual Frenectomy Dental

The tissue that joins the underside of the tongue and the floor of the mouth is removed in order to give the tongue a greater range of movement. This procedure is used to correct tongue-tie or ankyloglossia. If this procedure is not done, breastfeeding and speech development in infants are affected as the child grows older and speech becomes difficult for the adult.

2. Maxillary Frenectomy Dental

Maxillary frenectomy dental is done by cutting off the tissue that joins the upper gums to the front teeth. When this tissue is tight or large in babies, they find it difficult to latch onto the breast while breastfeeding.

If the frenectomy dental procedure is not done in older children or adults, the front teeth can be pushed apart resulting to a gap between them. It can also cause difficulty in speech production. When the maxillary frenectomy is carried out, the upper lip will have more room for movement and mobility.

FRENECTOMY DENTAL PROCEDURES

This procedure takes only few minutes at least 15 minutes and is simple. The procedures frenectomy dental are as follows;

  1. The patient will need to lie down facing up. If the patient is a child, the parent may have to hold him or her during this procedure.
  2. A topical anesthesia is applied to the area to numb any pain
  3. The doctor will use a scalpel, surgical scissors, or a cauterizing instrument to quickly snip the soft tissue.
  4. If there is a severe or complicated lip-tie, stitches will be required to close the incision.


FRENECTOMY DENTAL COST

For those with medical insurance, dental frenectomy is covered. As long as you or your child have a referral from a licensed practitioner, the procedure will likely only cost you a copay amount. Without insurance, the cost of having this procedure can vary. A study in 2014 by the National Library of Medicine, the surgical fee for a frenotomy in the office is $850 and is the same as if the procedure is performed in the operating room. Performing a frenotomy under general anesthesia includes extra cost which consists of an anesthesia fee of $500-$900 and hospital charges ranging from $500-$8,000.

FRENECTOMY DENTAL CODE

Frenectomy dental codes are updated by the American Dental Association (ADA) everyday to document the patient care they provide and submit insurance claims. In 2021, ADA announced 28 new CDT codes, many of which reflect changes the industry has undergone because of both advances in dental technologies, and the influence of the coronavirus disease 2019 (COVID-19) pandemic. 


Out of the 28 codes, D7961 and D7962 are for frenectomy. These codes were used to replace the now removed D7960 code that previously covered both lingual and buccal/labial frenectomies. While D7961 is for buccal/labial frenectomy (frenulectomy), D7962 is for lingual frenectomy (frenulectomy) and D7963 is for frenuloplasty which is the excision of frenum with accompanying excision or repositioning of aberrant muscle and z-plasty or other local flap closure.

CDT code D7960 ( separate procedure not incidental to another procedure) has been deleted from the 2021 Current Dental Terminology (CDT) and replaced with CDT codes D7961 and D7962 and this took effect from January 2021.

FRENECTOMY DENTAL RECOVERY

After the frenectomy dental procedure, the recovery process is straightforward. For infants, the area where the procedure is done is to kept clean always. For adults, some food intake may be reduced for the first few days, this is because there is risk of you getting an infection if food gets trapped in the affected area.
Oral antibiotics can also be prescribed by your doctor to prevent infections or complications. Healing can start after a day or two, in fact, the area will become to scar over a week after the procedure.

CONCLUSION

Frenectomy dental or oral frenectomy is a simple procedure that is common and used in removing soft tissues. It can be done in infants or adults to correct short or tight frenum. If the complications associated with tight or low frenum is not treated and overlooked, it can result to lots of harm and pain. Modern frenectomy procedure uses lasers which can minimize bleeding, tissue damage and help in fastening the healing process.

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