Lingual Frenectomy

The lingual frenulum is the band of tissue that connects the tongue to the floor of the mouth. Some people have a lingual frenulum that is too tight, too thick, or too large. This condition is present at birth (congenital) and is commonly referred to as tongue-tie (ankyloglossia). Ankyloglossia can greatly reduce the movement of the tongue. Infants with ankyloglossia may have difficulty breastfeeding. Children with ankyloglossia can develop speech problems. Lingual frenectomy is a surgery to remove the lingual frenulum to allow the tongue a greater range of motion.

LET THE CAREGIVER KNOW ABOUT:

  • Any recent head colds, sinus infections, ear infections, or sore throats.

  • History of allergies.

  • Any medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Problems with numbing medicines (local anesthetics) or medicines to make you sleep (general anesthetics).

  • History of blood disorders.

  • Previous surgeries.

  • History of long-term health conditions you have, such as diabetes. 

RISKS AND COMPLICATIONS

Generally, lingual frenectomy is a safe procedure. The following complications are very rare, but they can occur:

  • Infection.

  • Formation of an ulcer under the tongue.

  • Damage to the tongue.

  • Bleeding after the procedure.

BEFORE THE PROCEDURE

A lingual frenectomy usually can be performed in an office setting, with the use of a local anesthetic. Infants and children who cannot tolerate being awake during the procedure may need medicine that helps make them calm and relaxed (sedative) or a general anesthetic. If a sedative or general anesthetic is used, an intravenous (IV) tube with a needle is inserted into a vein in the arm or hand. Fluids and medicine flow into the body through the IV tube.

THE PROCEDURE

Using surgical scissors or a surgical knife (scalpel), the caregiver will cut and remove the lingual frenulum. Sometimes the caregiver may use a laser or an instrument that uses electric heat to cut out the frenulum and seal the incision (electrocautery). Sometimes stitches (sutures) are needed to seal the incision. These sutures will dissolve after a few days. If no sutures are used, a diamond-shaped wound will remain under the tongue. This wound takes from 5 days to 7 days to heal.

AFTER THE PROCEDURE

If a local anesthetic is used during the procedure, the patient will probably be allowed to go home shortly after the surgery. If a general anesthetic is used, the patient will be taken to a recovery room after the procedure. The patient will stay there until the anesthetic wears off.

For the first couple of days after the procedure, a little blood may be noticed in the saliva or the saliva may be pink. This is normal. A little bruising under the tongue is also normal as well as a slight fever. If stitches (sutures) are used to close the wound, they will eventually dissolve. There may be pain for 1 to 2 days after the procedure.