Thursday, July 18, 2024
HomePediatric DentistryAt What Age Does a Child Need a Frenectomy?

At What Age Does a Child Need a Frenectomy?

One of the topics that I get emailed about most often is labial frenectomies.  Not long ago, my sister called me asking me whether or not her daughter should get a labial frenectomy.  The dentist had noticed it at one appointment and said that she may have a gap between her front teeth if a frenectomy wasn’t done.

My sister never got back to the dentist.  At the following appointment, the dentist never mentioned that her daughter needed a frenectomy.

Overall, it seems like orthodontists and general dentists are recommending frenectomies more and more often. Is there a sound reason for performing all of these recommended frenectomies?  Should little children get frenectomies to avoid possibly having a gap between their front permanent teeth?  I’ll answer these questions and more in the article below.

At What Age Should a Child Get a Labial Frenectomy?

At What Age Does a Child Need a Labial Frenectomy?

A few months ago, I had a conversation via email with a reader who we’ll call Amy.  Her daughter was only 16 months old and the doctor that she went to recommended that her 16 month old daughter get a labial frenectomy.  Here’s what Amy wrote in one of her emails to me:

Our doctor told us that her gum needed to be cut at some point before her back teeth came in and before the permanent teeth came in to help with the space.  She has not had any problems with it before like pain or trouble talking. To make the story different to me, is that the doctor that did the surgery was a ear, nose and throat doctor. I always had a dentist do the work on me.

I am not sure if this has anything to do with it but we live in a very small town and area. I have talked to many people and they all acted like this was a common thing to do even on toddlers and infants. So I am a little confused with their responses and yours.

I found Amy’s email slightly troubling as I hadn’t ever heard of frenectomies being performed in such young children unless their frenum is so thick that they have trouble eating/speaking or it is causing them pain.

After combing through a few different textbooks, I found a few quotes that I think are worth sharing.  Dr. Pinkham’s book Pediatric Dentistry states the following (I put the important points in bold text – and FYI a diastema is a space between the front teeth):

“Recent trends justify significantly fewer maxillary labial frenectomies.  These procedures should only be performed after it has been shown that the frenum is a causative factor in maintaining a diastema between the maxillary central incisors.  This cannot be determined until after the permanent canines have erupted.  Therefore a maxillary labial frenectomy prior to the age of 11 or 12 is probably not indicated.”

The book Paediatric Dentistry, edited by Richard Welbury echoes Dr. Pinkham’s pediatric dentistry book.  It says, “Parents are often concerned about spacing of the upper incisors, and they can be reassured that it will often reduce as the permanent upper canines erupt…There is some disagreement about the role of frenectomy in the treatment of diastemata, but it is very rarely indicated in the mixed dentition stage and is probably best carried out during active orthodontic treatment.”

Dr. Pinkham’s book states that a frenectomy is probably unnecessary before a child is 11 or 12 years old.  Paediatric Dentistry says that a frenectomy is very rarely done in the mixed dentition (before all of the baby teeth have fallen out – around 11-12 years of age.)

Both of these authoritative books in the field of pediatric dentistry agree that a frenectomy shouldn’t be done, except in rare circumstances, before a child is 11 years old.

Labial Frenectomy After Braces

A labial frenectomy can be done after the gap between the front teeth is closed with braces.  To learn more about this topic, read the article Is a Labial Frenectomy Necessary After Braces?

When Should a Child Get a Frenectomy Before They are 11 Years Old?

There may be some situations where a frenectomy should be performed in a child who is younger than the 11 to 12 years old recommended above.

The book Carranza’s Clinical Periodontology says that “A frenum becomes a problem if the attachment is too close to the marginal gingiva.  Tension on the frenum may pull the gingival margin away from the tooth.  This condition may be conducive to plaque accumulation and inhibit proper toothbrushing.”

The book Pediatric Dentistry also states that if “the frenum attachment exerts a traumatic force on the facial attached gingiva of a permanent tooth (an uncommon situation)” then a frenectomy can also be performed.

Obviously, other valid reasons to perform a labial frenectomy earlier are if the frenum is causing the child pain or making it difficult to speak or eat.


To recap, a child should only get a frenectomy after the permanent canines have come in and after closing the gap between the front two teeth.  This means that a frenectomy should normally only be performed when a child has turned 11 or 12 years old.

A child may need to get a frenectomy earlier if the labial frenum:

  • Makes it difficult for the child to keep their teeth clean
  • Is pulling on the gums causing them to recede
  • Causes the child pain
  • Makes it difficult for the child to eat or speak

Have you had your children get labial frenectomies?  Has your child’s dentist recommended a labial frenectomy before the age of 11?

I’d love to hear about your stories involving frenectomies in the comments section below.  Thanks for reading!



  1. I thought I would add one more reference from the textbook Dentistry for the Child & Adolescent. It says that a frenectomy or frenotomy can be done with “A high maxillary frenum and an associated midline diastema that persists after complete eruption of the permanent canines.”

    This reinforces that a frenectomy should only be done to correct a gap between the two front teeth if the gap is still there after the permanent canines have come in, which is around age 11.

    • Hi. i wish i would have found this website a lot sooner. My daughter had this procedure done when. She was eight and know shes almost Ten. This did not. Help her at all. Im no dentist but i believe it’s. The cause of her buck teeth. Can you. give. Me any information. On what. To do? should. I go for braces? Thank you !

  2. Our daughter, age 5, was scheduled for a labial frenectomy but it was causing such distress for her (fear of the surgery) that I decided to check it out a bit more before going through with the procedure. She does have a large gap between her baby teeth, and there is a bit of skin on the gumline, between the two front teeth. So that is why I didn’t question it in the first consultation with the oral surgeon.

    However, after reading your information along with other information online, and after having a conversation with an orthodontist, we have decided not to do the frenectomy and instead wait to see how her permanent teeth come in.

    The surgery would cost us $500 and isn’t covered by our health or dental insurance. If I felt the surgery was absolutely necessary, I’d do it. But it seems more “cosmetic” than anything. I have lived my whole life with a small gap between my front teeth, and it hasn’t cause any problems. If this surgery is just to avoid a slightly “imperfect” smile, then I think it’s very unnecessary. If we find that a gap causes problems with my daughter’s bite or causes headaches, of course we’ll take care of it. But it seems there is no guaranteed result with this surgery, and some potential for pain. The orthodontist pointed out that if she has a bad dental experience at this age, it could make routine dental visits very difficult for her.

    So thank you for taking time to have this site! I appreciate the information.

    • Hi Vicki – Thanks for your kind words – it’s comments like yours that keep me writing!

      Thank you so much for sharing your experience so that other people can see what ended up working out for you and your daughter. When working with kids it is important for us to take into account how the experience will affect their overall view of the dentist. I’ve worked with a lot of adults who simply don’t go to the dentist anymore because they had a bad experience as a kid. Hopefully your daughter will continue to have positive experiences at the dentist. Thanks for your comment, Vicki!

      • This week, my daughter accidentally got kicked in the mouth, and damaged her 2 front baby teeth. She had to have both teeth extracted, so she had the frenectomy done at the same time!

        • Hi Vicki – I’m glad everything worked out well, even though she had an unfortunate accident. Thanks for keeping us updated!

    • Wow !!! Ur post is exactly wa my dtrs dentist recommended at age 5y/o, she will be 6 nex to month ! She has never had a cavity, healthy gum and has a gap greater than the normal measurement ! But she is in no pain, no discomfort and no problems with speech ! My oldest brother had a gap and he has perfect teeth without braces or a Frenulectomy !!! I’m waiting to hear bk from Dr. cuz husband brought my Dtr & I wanted to know the “real reason” why they want to do it !!! I probably want to wait til he permanent teeth hv come in, canines as I c in a few articles when doin a search !

  3. I appreciate the information you have provided on your website. My husband took my 6 year old daughter to the dentist today and are making an appointment to have this procedure done. I am not sure about it after reading your site. She has a pretty decent gap in her front teeth but if there is a chance this could fix itself I don’t want to put her through any unnecessary procedures. She tends to be a bit scared of those things anyway. Her bottom two teeth are the only baby teeth she has lost so I think I will definitely be doing more research on this and probably decline to have it done. Thanks again!

    • Hi Matissa – I’m glad the article helped – Hopefully your daughter’s gap will close on its own (many do) and she won’t end up needing a frenectomy. Thanks for your comment!

  4. Hi!

    I was told by my lactation consultant that the reason my baby can’t latch on to breastfeed is because he has an upper labial frenum, and I should have this skin removed. Should a 3 month old have this procedure done? Our ENT said the same thing. What should we do?

    • Hi Annamaria – I have heard of lingual frenectomies being done on infants as young as a few days because they were unable to latch on. I assume that a labial frenum could have the same effect of not allowing a baby to suck properly.

      If your ENT and lactation consultant both think that your baby needs it, then I would say that it’s probably a good idea to get it done. I hope that helps. Let me know if you have any other questions, Annamaria. Thanks for your comment!

      • I have heard of several dentists who perform laser labial frenectomies on infants, many 2 weeks or under. They all cite that the procedure is only done to correct tight frenums that do not allow proper latching during breastfeeding. There is definitely an argument now between medical professions / opinions about whether or not to perform lip tie revisions or not. I have heard great success stories from mothers and doctors who have had the procedure done. Here is an example video where a labial frenectomy is performed using a CO2 laser on an infant in under a minute with no bleeding.

    • Annamaria- Did you have the procedure done? Did it improve baby’s latch? I have it scheduled for my son on August 9th. He’ll be 11 weeks old. We have had CONSIDERABLE trouble with breastfeeding and finally deemed the frenum as the cause. The dentist recommended we move forward with the procedure but also said results are “inconclusive” in regards to improving latch and lessening pain for the mother. I am anxious to hear how it worked out for you and your little one!

      • Hi Becky – Sorry I didn’t get back to you earlier – I was taking finals last week.

        I sent Anamaria an email with a link to your comment. Hopefully she’ll be able to provide some insight for you. Thanks for your comment!

      • We did not have it done… The ENT we recently saw felt that it was unnecessary… We only had a frenulectomy on his tongue done. That’s removing the tiny skin that connects the tongue to the bottom roof of the mouth in some babies. Now he can move his tongue freely. Never latched, but we get donor breastmilk, so it worked out.

        • It’s unfortunate that you did not get the frenum released. It is obviously a needed procedure for your babies breastfeeding to be successful. Please let your ENT know that he needs to update his education on the topic. There are many excellent providers who will release the restriction for your baby and you could go on to have a wonderful nursing relationship. I you let me know your area of the country I can direct you to a knowledgable provider. The tongue and lips are very, very important for breastfeeding. A babe’s mouth does not just open to catch the flow, it is work and wonderful oral exercise for the proper development of you infant’s oral anatomy. ENT’s are not usually the most up to date on the subject, with just a few exceptions. (Dr. Bobby Ghaheri is one of them. His practice is in Oregon)

  5. I should have had a frenectomy as a young child, but parents thought large gap was cute ! Not so….. I was teased all my life about the space. Finally, as an adult , I had the surgery done and had to have crowns put over my permanent two front teeth to fill the gap. I never smiled for a picture until I had this done at age 24. Sad….could have been avoided with the surgery when I was a child.

    • Hi Kay – Thanks for sharing your experience. Some people like having the gap, even when it can be fixed. I’m glad you got what you wanted eventually and can now be proud of your smile!

  6. Im 16, and my dad wont sign to let me get a frenectomy, ive already had braces, my teeth are straight, and I don’t have a gap anymore. There’s a little ugly tiny piece that hangs down now right in between my two front teeth. I do have a splint rainter, thus this has been irritating it. My dentist has wanted to do a labial frenectomy for awhile now, but my dad doesn’t approve of anything having to do with “knives on skin for appearance”. what do i do? live with the irritation till im 18? And, Tom, I love these articles:D

    • Hi Sharon – I’m sorry your dad won’t allow you to get the frenectomy, it sounds like it’s something you really need. Is there any way to change his mind? If the excess tissue is really irritated, you could show your dad what’s happening and you might get him to sign off on the frenectomy. I wish I could be of more help. Hang in there, Sharon!

      Thanks for letting me know the articles have helped you – it gives me that extra motivation I need to keep writing 🙂

      Let me know if you have any other questions.

  7. I am having trouble deciding what to do with my four year old. She has a good size gap between her baby teeth and I would like to do the frenectomy. Not because of her looks but because I would rather take care of it now then wait and see what happens. If we don’t have to risk her permanent teeth coming in with a gap or risk having to pay for braces, then I say get it over with. My husband had to have this procedure done also when he was in elementary school and remembers it hurting. I just think why not get it done with before it affects anything??

    • Hi Stacy – That might end up working out fine. Some experts believe that the scar tissue that forms could make it so that there’s always a gap between the front teeth. I usually will take the conservative approach and wait for the permanent canines to come in.

      I hope that helps – Thanks for your comment, Stacy. Let me know if you have any other questions.

      • Hi Tom. My daughter is going on 8 and has this. The dentist was very pushy about having it removed but with further research I came across the same information, that if removed could cause scar tissue to keep them from permanently coming together. I read somewhere it was best to wait until after braces to cut it. I won’t take any chances for my daughter. We will wait until all of her permanent teeth come in, get braces, then clip it. What is more important to me as a mother is that my daughter has straight teeth not only for appearance (confidence) but for cleaning purposes and of course CHEWING! If your child’s teeth are straight and flesh together cleaning will be easier, less cavities. People forget there are MUCH more benefits to straight teeth than just appearance. As a child my parents couldn’t afford braces for me. Although they offered I declined. I didn’t want my parents to be financially burdened. I think as a parent it is in the best interest of your child to offer them braces. It is not a waste of money not in the least bit.

        I had trouble with her as a baby breast feeding. I breast fed her exclusively for two months and it was painful. I was never told about the flap of skin until a few weeks ago. All makes sense to me now. In my opinion, I want to do what is best for my daughter long term and although I was unable to breast feed her for as long as I wanted I still pumped milk as long as I could but to be honest waiting until all permanent teeth come in is going to have a life long benefit for healthy straight teeth healthy body. Your teeth can have a great impact on your overall health or they can cause huge life threatening problems later in life. Whatever anyone decides please keep your child’s best interest in mind talk to your families and friends health professionals. It takes a village to raise a child we have support for big decisions like this look at all angles and chose the best option for your child not what you want. God bless.

  8. My 14 month old daughter has the skin from her lip attached all the way down to the bottom of the gum. This skin makes it very difficult to brush her teeth as the skin makes it hard to reach the top of her two top teeth effectively. Often the skin starts to bleed, even though I am gentle. Where can I go for advice. Thank you

    • Hi Anita – Pediatric dentists recommend taking your daughter to the dentist for the first time between the ages of 6 months and 1 year. I would have your daughter examined by a pediatric dentist to see if they recommend doing anything to allow you to be able to brush her teeth without any problems.

      I hope that helps – Thanks for your comment, Anita. Let me know if you have any other questions.

    • glad to hear that i’m not alone in this boat:-( my 13 month old has developed a viral mouth infection & mouth sores, thats the only time my gp had found out that he has an attachment on the inside of his upper lip that goes way down to his front teeth. he has advised that it would be best to have it cut, as it will affect my babys speech later on. I’m so scared about the whole thing & dont know if ca put my baby through the pain. But i also dont want anything to affect his natural development. please help!!

      • Catherine,

        A lip-tie can cause speech problems, your dentist is correct. It won’t always cause one, but it certainly can.

        If he or she is 25 pounds, then nitrous (laughing gas) can be used safely to make the visit enjoyable for your child when having the procedure done. And find a laser dentist to do the procedure, as healing will be faster and less discomfort afterwards. I recently performed this procedure on a 16 month old, and the mother told me their kid was running all around the house later that day.

        I will posting some before and after pics on my website soon, showing how fast healing occurs and how non-invasive the procedure really is.

        Dr. Brian

        • I’m in the same boat and I really need some advice. My 19 month old daughter had a dentist appointment this morning. The dentist pointed out that her top lip is attached to her gums all the way down to her front teeth. It literally looks like the inside of her top lip is stuck between her front teeth. I knew there was an attachment, but I had no idea it was so bad. My daughter already has problems with speech and is seeing a speech therapist. I don’t care about the cosmetic issue at all, I just want my baby to not have any pain (it looks pretty painful) and if it’s causing her problems with speech, then I want it gone. The dentist recommended waiting for her permanent teeth to come in first, but I’m wondering if my daughter’s case might be one of those situations where it’s better to have it done sooner rather than later, especially where her speech is concerned.

  9. Found this as I was doing some research on whether or not to do a frenectomy on my 6 year old daughter. She had her check up yesterday and the dentist recommend she get one as soon as possible before her two front teeth start growing in. (The front baby teeth are loose right now.) The dentist seemed concerned that the permanent teeth on either side of her front teeth will not have enough room when it’s time for them to shed and grow in and that she will have a large space between her permanent front teeth. She does have a considerable space between her baby teeth but I’m really hesitant to get this done if it’s purely for cosmetic reasons. On the other hand, I have no idea if it’s true that her other teeth won’t have room to grow in. I’m wondering if I can let all the permanent teeth start coming in and if problems do crop up later with spacing, if we can do something about it then?

    • Hi Brooke – From what I’ve read, it’s usually best to leave it alone. My front teeth had a gap so wide that I could fit a nickel between them (I tried weird things as a kid, I guess!) Eventually, after the canine teeth came in, the front two teeth were pushed together and the gap was nearly gone. I only needed a retainer (no frenectomy) to finish closing the gap.

      If there are problems with spacing, these can usually be corrected with braces. One problem that many experts have said is that by doing the frenectomy so early, scar tissue can form where the frenum was and make it so that the gap is very difficult to close. You may want to get a second opinion or even ask your dentist about the research that supports doing a frenectomy so early. After researching it quite a bit, it seems that most people recommend waiting to get a frenectomy until the permanent canines come in (that’s what is recommended by the pediatric dentistry dept. at my dental school.)

      I hope that helps – let me know if you have any more questions, Brooke.

  10. Hi Tom,

    Yesterday my 6 year daughter was told by her dentist she needs to have a frenectomy. Her permanent front two teeth have come through recently and there is a big gap. The dentist sent her this morning for an x-ray to see how her other second teeth are coming through but he is concerned about lack of space, that the gap is going to cause space issues for the other teeth on either side. He mentioned to me that my daughter when she swallows pushes her tongue forward rather than back which apparently is an issue, plus he mentioned she also must have some trouble pronounciating some words and speak with a bit of a lisp but this is not the case, it definitely has not effected her speech in any way. When you mention perhaps waiting to have a frenectomy until the permanent teeth are through, do you mean all the permanent teeth or just the front two? Will wait to see what the x-ray shows but would really appreciate you thoughts regarding this situation. Many thanks

    • Hi Vanessa – What we were taught in dental school (and what is confirmed by the textbooks that I cited in this article) is that a frenectomy should be performed only after the front six permanent teeth have come in. Many times the canine teeth will push the front four teeth together, getting rid of the gap. With that in mind, your dentist knows your daughter’s situation better than me. If you are concerned, you may want to get a second opinion.

      I hope that helps – Let me know if you have any other questions. Thanks for your comment, Vanessa.

  11. I am so relieved after reading the information on this website! My cousins baby boy had a frenectomy because of a gap in his two front teeth. My daughter will be 2 in December and I’ve had people remark about her gap. But I have never wanted to put her through the surgery unless I thought it was absolutely necessary. She doesn’t seem to have any pain or trouble eating and she’s learning to talk very well. I will definitely wait to see how her permanent teeth come in. I would rather she get braces when she’s 12 or 13 than a pointless surgery now that could make the gap worse (scar tissue) in the long run.

    Thank you for the sigh of relief!!!

  12. I’m glad I found this article. My 7 year old went to the dentist at the beginning of September. When she was there in April, the dentist had told us that our daughter will most likely need braces when she grows up due to severe spacing issues we could clearly see as she began to lose baby teeth and saw permanent teeth growing in almost sideways due to lack of space. This is present on both teeth that are on the bottom as well as teeth on the top of her mouth. At the appointment last month though, the dentist pointed out again her need for braces and then stated that my daughter would need to have this surgery done. I had never heard of such a thing. She never had a gap in her teeth when she only had baby teeth, prior to her permanent teeth growing in. Of course, her permanent teeth are much larger than the baby teeth, which explains the lack of space for them to rest comfortably in her mouth.

    It was quite a production finding a dentist that even performs this surgery in our state. So, it’s hard for me to get a second opinion. Anyway, why does this procedure seem to be so uncommon in New England? Will it really help? Will it hurt anything to wait until she is 11 or 12? I had a small gap in my teeth until I was 13 years old. What do you make of this??? I don’t know what to do…

  13. I am just in the researching phase of frenectomies. My son will be four in February, and I am concerned about speech issues. To be honest, I had never even considered the impact it may have on his teeth in the future. He is slowing slight signs of speech trouble because he is so tongue-tied. I absolutely do not want to put him through unnecessary procedures, especially prematurely, but I am a little worried about him not having unimpeded speech development.

    Thank you so much for such an informative article on the subject!

  14. Hi Tom. My 14-month-old daughter has a severe labial frenum tie (extends to the hard palate) that I discovered just a few months ago. We had difficulty breast-feeding, and no one told me that this was a potential cause for our troubles until she was almost a year old (and still nursing, thankfully). The fact that neither our midwife or two pediatricians who had consulted on our nursing issues ever mentioned a labial tie sent me off to do some research and figure out what the heck is going on and what our best options are for future treatment.

    I have discovered two very different approaches, and wonder if you could comment. Perhaps not surprisingly, there is the wait-and-see approach (outlined above), and the fix-it-now approach, ideally using lasers instead of more “traditional” methods of oral surgery. Are you familiar with the work and research done by Dr. Lawrence Kotlow, and/or with the use of lasers to correct labial and lingual ties without the use of general anesthesia or even sutures? My daughter has a very large diastema between her two front teeth, and while I understand that some diastemas close with the eruption of the adult canines, given the severity of her labial tie I am inclined to think that hers will be an ongoing issue. I am also concerned about the potential for dental carries on her front teeth due to retention of material in the area, although we are able to brush them pretty well (we brush her teeth once a day, which is about all she will tolerate!).

    I have read the information above, and understand your recommendation to wait until the adult teeth come in before having corrective surgery. I guess my questions are: have you had any conversations with instructors or fellow dental students about the impact of labial and lingual ties on the success of breastfeeding, and if so, was there any consensus on treatment options for very young babies? That’s a bit after the fact for my daughter, but we plan to have more children. How common is the use of lasers in pediatric dentistry? Correcting a labial frenum tie can allow a diastema to close on it’s own, and may negate the need for orthodontics, but it’s impossible to know beforehand what the outcome of surgery will be. Is there any guideline or “rule of thumb” that relates the severity or type of labial tie to the extent (and possible closure of) a diastema? I would be hesitant to put my daughter under general anesthesia until she is much further along in her dental development, but I don’t see any downside to correcting her labial tie much sooner if I could find an expert in using the laser approach (vis-a-vis, Dr. Kotlow). Any comment on that?

    Many thanks for any feedback that you can provide!

    • Amanda, I am researching the same procedure for my 8-month-old infant and am wondering what other parents have concluded from their research. Where did you all land? The pediatric dentist we saw leans toward avoiding the procedure. Dr. Kotlow has classified my son as Class IV labial frenum and advised revision.

      I have the same concerns you have (or had).

      Thanks for your reply!

      • Hi Kristen. It seems that there are very few pediatric dentists who favor revision before the adult teeth erupt. My perception (and this could be wrong) is that most ped. dentists don’t have adequate experience with using lasers, and are probably afraid to work on babies. Two ped. dentists that I spoke with in my area (Oregon) recommended waiting. If there was a dentist in our area, even within a few hours, that was experienced with doing lingual and labial frenum revision using lasers I wouldn’t hesitate to have the procedure done immediately. The closest dentists that Dr. Kotlow recommended to me were in LA and Salt Lake City.

        It bugs me that few dentists are as proactive about this as Dr. Kotlow. Since this happened to us, I have talked with several mothers who had nursing issues due to tongue and labial ties, and there don’t seem to be any pediatric dentists around here who acknowledge the issue and are willing to help fix it.

        • I had my second son a week ago and was Becoming sore a couple days after his birth. I had nursing pain for four months with my first and now see that he and our second son have upper lip ties. We have an appointment for tomorrow at a dentist who is highly recommended and uses a laser. I was just curious what you found out/ did as I see Tom didn’t reply to your questions. I am torn about him being in any pain. 🙁

          • Hi Karrie – sorry – I just saw your comment. How did it go at the dentist? I would love to know. If we had had a dentist in our area that has extensive experience with handling lingual and labial tie corrections on infants using a laser, I would have corrected my daughter’s labial frenum tie (upper lip) as early as possible. The midwife clipped her tongue tie at 1 day old (with scissors, no blood and not so much as a peep from baby), and it helped with breastfeeding, but I think her labial tie, which is severe, also impeded her latch. Now that her teeth are in (with a huge gap), we have to be very careful to brush her front teeth well because material and plaque seem to gather there very easily.

            From what I understand, the use of lasers to fix these issues is very quick and results in very little pain. I think it’s not more commonly recommended because most pediatric dentists don’t have the experience in using lasers. I honestly don’t get what the downside is, and why “the books” don’t advise correction early on, especially when labial and lingual ties can impair breastfeeding (I’ve heard this from so many moms). Anyway – I hope it all worked out for you and your son.

            • The procedure went well. My husband held him because I was a post-partum mess basically. 🙂 there was no bleeding and he cried more from being held still with his lip up. He nursed right after which made me feel better. The jury is still out on how much it helped my nursing pain, but I am hopeful!

            • I forgot tom mention that we saw one of the two dentists with a master certification in pediatric laser dentistry. I went to him because that’s who most people recommended, I didn’t realize that he was THE dentist to see around here. Apparently people from all over the country come to him for this procedure. Lucky for us he was about an hour away. Dr. Margolis in Buffalo Grove:

        • Amanda – there is a n ENT at the Oregon Clinic who does lingual and labial frenotomies with a laser to correct poor nursing latch. His name is Bobak Ghaheri, MD – he just did the procedure for my 5 week old and we saw immediate, striking improvement.

  15. I am 21 and I just had a Frenectomy done yesterday. I had a very large gap before braces and after I got my braces off about six years ago I was supposed to have the procedure done but didn’t follow through for financial reasons. the frenum caused my teeth to shift because that tissue is so strong and I have had numerous retainers that i had to wear constantly because my teeth would shift almost immediately after taking the retainer out. Finally i got a permanent lingual retainer but the tension causes them to pop off. In addition to that its hard to clean and floss around a permanent retainer. I am now a dental assistant and as a professional courtesy the work was done after all these years I had no swelling and very minimal pain and it looks and feels so much better already! If I did not have it done I would have had recession in the near future. I recommend seeing a periodontist for the work since they are gum specialist. My daughter will eventually have to have the very same procedure done but I definitely don’t see a need until after braces because it doesn’t bother her. I am an advocate of frenectomies because it is not just esthetic.

  16. My 3 1/2 year old son has tissue attached from his upper lip to the middle of his teeth. He was diagnosed with speech delay. I almost feel like maybe the excess skin on his upper lip may be prohibiting him to pronounce words clearly almost like he is clenching his teeth or his jaw won’t open. Please can some one give me insight if this might be effecting his speech, has this happened to any one else, and was there success.Please any information would be helpful as my son is frustrated and thinks its easier to point, and Imfrustrated because I don’t want him to be behind were people won’t pay him attention because they can’t understand him
    Thanks in advance

  17. Hi! I have been contemplating on getting this procedure done on my 6 year old daughter and today we got the appt scheduled. She had a humongous gap in between her two front baby teeth and the space is still there, even after they have fell out. Her frenulum hasn’t given her any problems but she slipped and fell on the gym floor at her school and ripped it a little. I was born with and have always had a nice sized gap in my mouth and that is something that I don’t want her to have to deal with when she gets older. Also, I understand the “wait and see approach” but why would you want to wait and risk the complications that come along with having a gap?? Also, this procedure is less painful and less cheaper than just merely throwing braces on a child. I wouldn’t want to have to burden my child with the process of wearing braces for all of those years. I probably should have mentioned the fact that her grandfather has a gap in between his teeth also, that is almost as wide as a popsicle stick so that is one of the major reasons I see fit to start working on the problem now, than later.

  18. Hi Tom,

    I have taken my 9 yr. old son to see a Periodontist about this frenectomy procedure and he is taking the “wait & see ” approach as well. My son has his 2 front permanent teeth in but still has one baby tooth on the right side and permanent on the left coming in. He suggests we wait until those permanent teeth come in fully to see if they somehow shift to close in the gap. I do think my son may need braces eventually so I was wondering if it would be best to wait until after braces to see if they help the gap.

    Any thoughts? By the way your sight is very helpful.

  19. I have just had my 5month old done as was having trouble feeding, He was sucking in air and always spilling up until the next feed, after the procedure no more spilling!! he can now latch as he should. HOWEVER…. If I ever knew about this lip tie issue eariler (than 5months) I would DEFFENATLY RECOMMEND getting baby done as soon as possible ie: days old or a couple of weeks old…the longer you leave it the more they feel and the harder it is for the lazer to cut! my boy waz the oldest our dentist had done this on and had a hard time with the lazer cutting and also soooo much harder holding baby down, whereas younger babys he had through were easier and quicker to do and no screaming or pain after it. So if i could do it all over again i would do it asap…not wait…. I guess time will tell wether it stops him having gappy teeth like his dad. but the spilling/latching is a uge improvment.

  20. Hi, I’m in the UK. About 6 months ago my now 8 and half yr old son was referred to university hospital in London for Labial Frenum surgery by his dentist. The hospital refused to do it, said it was either a dental chair operation (which the dentist wasn’t happy to do), or to leave it until he’s at least 10. Over the last 6 months the gap between is adult teeth has closed up, probably being pushed by the adult teeth erupting either side of the front 2. The canines haven’t come through yet. We returned to the dentist again recently for a check up and there was a different dentist who again insisted this operation needed doing, that his daughter has the labial frenum attachment and he will be getting hers done as soon as her adult teeth appear. He said the gap may close up as the teeth move around as others come through, but that the two front teeth will open up again unless the skin between them is cut. Seems to me that the waiting approach is only going to lead to having to wear a brace in future. However, of course I don’t want my son to suffer unnecessary trauma. I just don’t know what to do, I’m going on the strongly felt views of two different dentists, but find myself up against the head consultant at the hospital who doesn’t agree. We have our second appointment next week and I don’t know whether to insist on them doing it, or to go private and have laser surgery, or just leave well alone…! …Thanks.

  21. Hello,

    Our little girl is only three weeks old and her labia frenum is attached behind her gum line, making breast feeding uncomfortable and less effective than it should be. Is this a situation that means we should get surgery? I am receiving conflicting information from doctors, dentists and breast feeding specialists.

    Thanks for any info!

  22. My 8 year old has had extra tissue above his front teeth and below his bottom teeth. At age 3, I was advised that should be removed. At age 8, the new dentist recommends that he have a frenectomy on both. He will need to numb both gums. The top left tooth took about 6 month to begin to come in after his baby tooth fell out. It is almost fully in and is coming in at an angle. Is it harmful for the extra tissue to pull on the gums? The dentist wants in done soon but wanted an extra appointment to numb him and do the procedure. It looks like he will need braces.

  23. My 8 year old has had extra tissue above his front teeth and below his bottom teeth. At age 3, I was advised that should be removed. At age 8, the new dentist recommends that he have a frenectomy on both. He will need to numb both gums. The top left tooth took about 6 month to begin to come in after his baby tooth fell out. It is almost fully in and is coming in at an angle. Is it harmful for the extra tissue to pull on the gums? The dentist wants in done soon but wanted an extra appointment to numb him and do the procedure. It looks like he will need braces.

  24. My 8 year old has had extra tissue above his front teeth and below his bottom teeth. At age 3, I was advised that should be removed. At age 8, the new dentist recommends that he have a frenectomy on both. He will need to numb both gums. The top left tooth took about 6 month to begin to come in after his baby tooth fell out. It is almost fully in and is coming in at an angle. Is it harmful for the extra tissue to pull on the gums? The dentist wants in done soon but wanted an extra appointment to numb him and do the procedure. It looks like he will need braces.

  25. Just wanted to say thank you so much for your website. Simply doing an online search turns up so much information, much of it not specific or helpful in any way, and this site is a godsend. Thank you.
    My son is 15 months and has a thick upper labial frenulum and quite a significant gap between his front teeth, and his pediatrician did say that it would likely need to be snipped at some point, but did not give specifics. He had no problems latching during breastfeeding, it doesn’t seem to cause him pain, and he is beginning to be pretty verbal without any apparent problems. I feel so much better now about waiting to have surgery – not that anyone has pressured us yet, but I also feel confident that I can address anyone’s concerns about his appearance by saying that we will wait to see if the gap closes with his permanent teeth, and explain why the surgery is not necessary at this point. Thanks for all your very good information and advice for everyone who has written in; I wanted you to know how much this means to me as a parent! 🙂

  26. Tom,

    Why have my comments been removed?

    I provided an invaluable resource for patients wanting to get some more information about this subject, and my comments were all removed. Is this really in the best of your patients’ kids? Dr Kotlow and others have been performing this procedure for decades and have tons of knowledge. You are fresh out of school with a great opportunity ahead of you. I invite you to read his articles and rethink what you have been passing out here on your blog

    – Dr Mc (another dentist with many years of experience)

    • Hi Brian – I apologize for that. Many people leave comments here and many are well-intentioned. I do get over 100 spam comments every day, and since yours had a link to your website as well as an extra link in them, they appeared to be spam. Many dentists spam this blog to gain backlinks to their website, so I apologize that your well-intentioned comments were deleted.

      You can re-post them. All I ask is that you link to some specific material that would help the previous commenter’s question – simply linking to a long list of academic articles that many patients could find hard to understand may not be too helpful to them.

      Also, what do you think that I need to “rethink” in this post? I did write it back in dental school, and I know things are different in the “real world” then in academia, but I think you can agree that many practitioners do prematurely recommend frenectomies. I will be writing an article very soon on lingual frenectomies – the current one deals mainly with labial frenectomies. Have a great day – Thanks for your follow-up comment!

    • It’s the same in the UK. I went back to a London leading dental hospital & was assured by the consultant that they don’t like to do frenectomies until the child is 11 or 12. My son’s dentist insisted that he should have it done but the consultant said not until his adult teeth have come & then it would normally be done in liaison with an orthodontist. I could see that they would be reluctant to put a young child through that, especially as a first experience at the dentists.

  27. My daughter is almost 8. She had a gap between her baby front teeth. Both front teeth have fallen out now. At my daughter’s last dental visit for a cleaning the dentist said she will need a frenumectomy or else the permanent teeth will also have between them. I have been researching this and I find that many suggest waiting until the permanent teeth come in to see if they will have no gap on their own. I read that there is a chance that will be no gap when the permanent teeth come in, but also a chance that there will be. If she does end up with a gap between her permanent teeth she will need the frenumectomy and braces. My 14 year old son has braces…so expensive! Is it best to take the chance and not have the frenumectomy done now, and wait and see? What harmful effect could happen if I have the frenumectomy done now even if she didn’t need it for her permanent teeth to have no gap?

    • Hi Terry – In school we were taught to not perform a frenectomy (for the sole purpose of correcting a gap between the two front teeth) until the permanent canines have come in.. If the frenectomy is done now, it is possible that scar tissue will form and will end up being the cause of the gap.

      It would be a good idea to share with your dentist the quotes from the pediatric dentistry textbooks that I included in the article above and have a conversation with your child’s dentist to determine if a frenectomy is really needed.

      I hope that helps, Terry. Let me know if you have any other questions.

      • Tom,

        You are correct about the scar tissue. BUT only if you use stainless steel. Using a laser produces no scar tissue. So there is no reason not to do it sooner, especially if that tissue is low.
        I was taught the same thing in school. However, the education on lasers was not present then, and it’s a much different ballgame.

        Brian McMurtry, DDS

        • Thank you both for your comments and input. I am still stuck and unsure. I see both points and possibilities. If it’s not going to be necessary than I don’t want to put my daughter through the procedure or take the chance of scar tissue. I don’t know if her dentist would be using a laser or not. On the other hand, if she is going to need the procedure in the future to correct a gap with her permanent teeth than I’d rather do the procedure now as a preventative. I really do not want her to have to need braces. Her baby teeth had a pretty good size gap. People would think she had lost a front tooth when she hadn’t yet. There is no way to know the future though, so what ever I decide will be taking a chance. I will speak with her dentist about the procedure. I am also going to bring her to another local dentist for their opinion as well. Thank you again!

        • Hello I recently took my 1 year old son to our local pediatric dentist (she came highly recommended) looked at my son’s mouth and then told me she was going to schedule a Frenectomy. She didn’t explain much all she said was I have 2 options for the procedure I could have her do it there with lasers or I could take him to the hospital and they would put him to sleep and do it with stitches. She said that if she used the lasers there would be steps I would have to take 3 times everyday for the next 2 weeks after. She said she would better explain when we come back for the procedure. I was confused i took him to hus doctor to get his opinion and he said it looks like my son’s will be hard to fix. So I researched and found this article and now I’m starting to wonder about doing it at all. I’m not sure what to do now. What is your opinion?

      • Thank you both for your comments and input. I am still stuck and unsure. I see both points and possibilities. If it’s not going to be necessary than I don’t want to put my daughter through the procedure or take the chance of scar tissue. I don’t know if her dentist would be using a laser or not. On the other hand, if she is going to need the procedure in the future to correct a gap with her permanent teeth than I’d rather do the procedure now as a preventative. I really do not want her to have to need braces. Her baby teeth had a pretty good size gap. People would think she had lost a front tooth when she hadn’t yet. There is no way to know the future though, so what ever I decide will be taking a chance. I will speak with her dentist about the procedure. I am also going to bring her to another local dentist for their opinion as well. Thank you again!

  28. Hello, My daughter turned 4 in October we have check ups every 6 months with her dentist. The last two visits (6 mos ago and 1 year ago) he mentioned this procedure to try and avoid a gap in the future. I felt odd trying to change something that is characteristic, a family trait, and to me does not detract from her beauty.

    Well, today we had a visit again and we have been refered out to a surgeon. Since her visit 6 months ago her eating has somewhat changed and she will frequently say her “gap hurts.” In the last 2 days she has stopped eating a sandwich, an apple, and one of her favorite foods, corn on the cob. Sometimes she will eat part of her dinner, complain, and leave the rest of her food. I have also noticed that the muscle between the teeth seems to have gotten larger and more pronounced, widening the gap.

    Now that I have been reading online and am aware of the age recommendations as well as the possibility of the scar tissue causing a permanent gap i am again unsure. Our appointment is next week.

    If anyone has feedback or input please let me know. Especially if you have a child that has had the procedure done, how did it go and what has the outcome been?

    Is there anywhere that I can view statistics on outcomes of this procedure?

    Thank you !!

    • Corissa,

      At age 4, there is no advantage to performing a frenectomy early vs waiting. However, trauma (which is what it sounds like here) is good indication to have it looked at, and if recommended, have the procedure performed.

      FIND A LASER DENTIST, though. As Dr. Tom and I have stated, the old-school way of doing this procedure (scalpel) will cause scarring which can be problematic for ortho concerns down the road. Using a laser to do the procedure is very safe, offers quick healing, and discomfort afterwards is very minimal (usually only requires a dose or two of tylenol or ibuprofen).

      I’m getting ready to post some before and afters on my website soon, showing how non-invasive this procedure is.

      I hope your daughter’s appointment went well, if she had the procedure done. If not, look for a laser dentist who can do it for you.

      Dr. Brian

      • Thank you very much Brian. This is exactly what I have decided to do. I actually cancelled the visit for more time to consider and research.

        For now her eating habits have improved and she has not complained for some time.

        Unfortunately, with the insurance we have the doctors are limited and as of yet I have not located one that uses lasers.

        Thank you all for the information presented here. I will continue to look for a doctor in California that accepts Medi-cal AND uses laser treatment waiting until the situation again presents itself as more of a necessity.

        • Corissa, Good Luck!

          I don’t know anyone in CA using lasers and accepting Medi-cal. I would suggest calling the local dental society and getting a list of dentists accepting it.

          Then goto laserdentistry (dot) com and plug in your zip code to find a nearby laser dentist. Bounce that off your medical list (or call them)

          Dr Brian

  29. Our daughter, age 8m/o, was scheduled for a labial frenectomy in Taiwan. Out dentist suggested that she should scheduled this procedure as early as possible. But my uncle, who is a dentist from US, told us to cancel this. After reading your information along with other information online, and after having a conversation with an orthodontist, we have decided not to do the frenectomy and instead wait to see how her permanent teeth come in.
    Thank you for taking time to have this site! I appreciate the information

  30. Hi Tom, wow thank you for all of your time in replying to all of these questions!

    We have an eight year old who has been seen by a school dentist and told he should have his labial frenulum cut to reduce his gap between his front teeth.

    I have read your comments that we wait until the adult canines come in, and not cut due to the potential for scar tissue. However, what are your thoughts on laser? Does this result in no scaring? Has it been around long enough to measure the scaring?

    Or regardless of scaring is the thought that the canines will do all the work squashing the front teeth together?

    Hmm, would we be wise to see someone for a personal assessment? If so with whom – a periodontist or an orthodontist? ;)) thanks!!

    • Most of the literature supports waiting, because it is dated from the 70s or earlier. That is what we were trained on.

      HOWEVER, LASER CHANGES EVERYTHING. And the literature is starting to be more forthcoming in regards to this procedure with laser.

      Laser does not produce the kind of scarring that a scalpel will. So now can be an excellent time to have it done, based on what you are posting.

      A general dentist who uses laser should be able to perform this procedure without the need for a specialist. Ask if they do this procedure with laser though. You want someone with experience.

      Dr McMurtry, CharlotteLaserDentist

  31. I had a very large (genetic) gap between my front teeth growing up with the extra skin hanging down between the two front teeth. I believe I was about 8-10 yrs old when I had it removed. I do remember it being very uncomfortable afterwards. Otherwise, my teeth were straight and there was no need for braces. Around 16/17 yrs old my dentist put two small dots of some sort of cement on the top outside edges of those two front teeth and I wore a rubber band around them to pull the space together. (the cement was to keep the rubber band in place) Once the space was together, he put a butterfly clip on the back side of my teeth. I was told it could stay forever. However, at 20 yrs old, I was accidently elobowed in the mouth which broke the small wire and the dentist removed it. Now at the age of 47, I have a very very small, hairline, space. It has never grown any further apart even though there is room in my mouth for it to expand.
    My daughter had the space and the extra skin, and now her 2 daughters have it also. One of her daughters is only 2 1/2 and her extra skin hangs down to the bottom of her baby teeth.
    Genetics are genetics.. and if your going to have a space between your teeth there is nothing you can do about it at a young age. My personal opinion.. how mine was done worked great for me mentally and physically. I was never picked on about it and by the time I had the rubberband, everyone had braces. So it was no big deal for me.

  32. Hello Tom,
    first i should thank u for such a neat and concise explanation about the doubts we have. today my sister called to say she fixed frenectomy for her 6 yr old daughter. when i was looking for some latest developments in the net, i came across ur site, which is very helpful and my special appreciation for not puttting any cheap flickering ads which irritates and disturbs u while reading the actual stuff.

    anyway i passed the information to her and also asked her to browse ur site, thanks once again and will let u know what she decides!

    Dr Usha

  33. Tom, please allow me to disagree with the suggested age for a labial frenectomy. The diastema between the two central anterior teeth is easily noticed and any experienced dentist will tell you if it is abnormally wide. A simple test is to pull on the frenum and to see whether it pulls (blanches) the tissue just palatally to the gap. If that happens, you know that the frenum is a band of connective tissue between the two teeth. And as soon as the two laterals erupt, you can see if there is enough space for them to be “straight”. If that is not the case then an early frenectomy is required. And you need to close the gap immediately (it takes maybe as long as two days). This allows the laterals to erupt easier and in better position. You do need to tie the two teeth in position in some way for some time, but certainly not longer than a few months. If you delay closing the gap you end up with reparative connective tissue between the two front teeth and all you have achieved is cutting the frenum off. One’s own experience as dentist should tell you whether major orthodontics is on the way and in that case the procedure should be postponed. A frenectomy can be a preventive measure. I hope this gives some more perspective to the views regarding the procedure.

  34. Hi,

    Both of my children just had a frenectomy, they are 6 and 7. Our dentist had told us that they needed to have it done so that their gaps would close up. After reading your conclusion on this matter, I wish that I had waited until they were about 11. I sure hope that there will not be issues with the gaps closing up due to scar tissue now.

    • Tina,

      IF the procedure was done with laser, then there is no cause for alarm. If it was done with scalpel, that may be a different story.

      The thought process is that if done early, the residual scar will push the teeth back apart after ortho is completed. That is why you usually wait IF done with scalpel. Scalpel = scar. Laser does not = scar, which is why it can be done early without fear of scar and actually allow the teeth to come together.

      URLs seem to get flagged here, so if you google search my name and charlotte laser dentist, you will quickly find my site. If you goto the smile gallery and go most of the way down, you will see a child’s picture where we performed this procedure and the space closed on its own in a matter of a month (according to the parent). My picture was at 7 weeks postop but the gap was closed.

      Hope this puts your fears at ease

      Dr. McMurtry

  35. My seven year old son’s dentist told us yesterday that he needs to have a frenectomy because it is causing his gum to recede from his teeth and is creating a problem with him properly cleaning his teeth. They do the procedure by laser and offer things to make the child more comfortable (I can’t remember exactly what). The dentist said that most children that have it done in the morning even go back to school afterwards but that ice cream is a great reward for a job well done. I was definitely going to wait until he was older due to the concern about scar tissue, but the laser seems to take that problem away. We have also been told that he will need braces later because of the gaps between all of his straight teeth. I grew up self conscious about a slit between my front teeth (that was eventually fixed in high school with a binder that has managed to stay in tack all these years) and I never needed braces. With that in mind, I think I am going to opt for the procedure now in hopes that his bigger adult teeth will fill in all the spaces and braces might not be needed later. Thank you to everyone involved on this site for your comments and experiences! It definitely has been helpful to me!!!

  36. Thanks for your article.
    Our dentist suggested my 12 year old daughter to have a frenectom to avoid more gaps between her front teeth.Just like every mother,I started gathering more data upon his advise.Your article and comments helped me so much but frankly speaking I am still afraid of doing this surgery for my daughter, thinking that maybe I can do it in future by laser.The gaps between the front teeth is not that much considerable.The main question in my mind:Is it really necessary to do it now? What will happen if I do it later?

  37. My 8 year old daughter has a moderate gap between her 2 front teeth(front incisiors). She lost her baby tooth (lateral incisor) located next to the 2 front incisors one year ago (when she was 7), but that permanent tooth (lateral incisor) has not come in yet…her dentist recommends a frenectomy in hopes of those 2 front teeth closing the gap and that one lateral incisor tooth being able to come in. What do you think?
    Thank you.

  38. My 6 year old daughter just lost both her upper teeth:) . Ourvdentist told me to make sure to make an appt , the moment that happens if we want to avoid a big gap between her teeth.
    My father has a huge gap between his teeth,
    Am I the worse mother for not wating my child to have that? But surgery? I hate the idea , she is just so young, with 0 pain , no speech problems .
    do I have the option to wait , am I damaging her chances of having beautiful teeth.
    Can i tell my dentist to back off.


  39. My 8 year daughter has a pronoused space between her 2 front teeth. The dentist said that her teeth will never close until she has a frenectomy. The periodontists says wait until she gets her braces.
    My daughter is self conscience about this space.
    My question is
    If her teeth will never close until this procedure is preformed, why not do it now? Maybe by having this procedure done, it could give natural a chance to correct this?
    Thank you

    • Colleen, you are correct, having the procedure now CAN allow the teeth to migrate together on their own.

      HOWEVER, the procedure must be done with a LASER. If you go the traditional method (read, scissors or scalpel), it will create a scar that can ultimately cause the two front teeth to separate after ortho is completed. By using a laser you don’t get that kind of scarring and it will allow for natural migration. Ortho might still be needed to close some space, but it really depends on how wide the space is to begin with.

      In summary, laser = treat now, stainless steel = treat later

      if you goto

      www dot charlottelaserdentist dot com and goto Patient Gallery, scroll most of the way down and you will see a good example of a laser frenectomy procedure allowing a space to close naturally on its own.

  40. My daughter fell one day after she turned one year old and shoved a bottle up under her lip ripping her frenum. We of course panicked and took her to the ER where we learned what most parents learn there was nothing that could be done. We consulted with our doctor weeks later and were told that it would heal but most likely not reattach. We found out as my daughter’s teeth were coming in that this ended up NOT being the case. It did reattach and did just the opposite of what all articles and people have said. He grew back in between her front teeth and to the under side of her mouth. She has recently lost her front teeth and one has started to come back in. We have consulted with a dentist and he feels that surgery will need to be done but there is conflicting information on when this should take place. There is no way her adult teeth will grow in properly with this skin attached between them so why would we want to wait for her adult teeth to fully grow in? If this procedure is done before her second top tooth comes in won’t the chance of a gap remaining be decreased? Is there a type of procedure that is better than another when dealing with this and will there be any complications or after affects to the roof of her mouth this it attaches clear in there? I am very worried about waiting to have this fixed. Any advice would be extremely appreciated. Thanks.

    • Jamie,

      Please read my comment above for Colleen’s question.

      Laser, by far, is the better way to treat this. By using laser, there is no need to wait and can allow these teeth to migrate naturally on their own a:)

      goto Dr. Kotlow’s website. He has written a number of articles about these conditions, and their may even be an underlying tongue tie as well

      goto www dot kiddsteeth dot com (there are 2 d in the address). Goto the articles page, and the 2nd article is a fact sheet he has put together. there are a number of good articles on his site.

      Laser usage is NOT something taught in school (although we are starting to hear some schools using them a little bit). To an extent it’s outside the box thinking, but there is literature out there to support various procedures with phenomenal results that goes against traditional mindset. I am able to do fillings (and big ones) without having to numb patients up, gum surgeries without having to flap back all the gum tissue, bleach gums, reshape gums, and so much more in a more clean, esthetic, quicker healing way.

  41. Our dentist recommended my 9 year old son get a maxillary labial frenectomy. After reading the information on your site we are cancelling our appointment. He still has his primary canines, so I feel they are recommending this procedure way too early.

    They also recommended we have his baby teeth on the bottom pulled as the permanent teeth were coming in behind them. We did our own research on this topic as well, and decided to let the baby teeth come out on their own. Now that the baby teeth have come out, and his permanent teeth have come in his bottom teeth are perfectly straight. At first they were very crooked, but have worked themselves out.

    Thank you for your information about these matters. I really don’t want my son to be subjected to any unnecessary procedures, and the information on your site helped clarify that we definitely don’t need to have this frenectomy done now.

  42. Hi Tom,

    Greetings from a fellow Virginian! What a great conversation. You have put my mind to ease because as many others have posted, I also worry about performing a frenectomy too early. I have a specific question that I don’t see answered thus far. My son is 4 and also has a large gap. His labial membrane is very thick and connects from underneath his lip down to the base of his gum line and around to the back of his gum line. There is literally a thick raised glob of tissue that wraps around his gum line. Will this tissue thin as he gets older? The membrane is so thick that it creates a physical barrier and I wonder if permanent teeth even stand a chance to push it out of the way. And if a frenectomy is required later in life, do they laser off tissue on the gum line too?

    And a less important question if I may, his front two baby teeth are significantly longer than the rest. Is this an indication that his permanent teeth could be this way too. My precious boy is too sweet to go through life with buck teeth. So I was wondering if you had insight on this too.

    I truly appreciate your time. Truly!

    • Hi Michele – The tissue can change as he gets older, if not, a frenectomy can easily be performed at an older age when he is better able to cope with the surgery. I know with the prior surgery technique of cutting, they can easily take away the tissue at the gum line. I would imagine that lasers could do the same, but I don’t have any experience with using a laser for a full frenectomy.

      As far as whether or not the permanent teeth will look like the baby teeth, it really varies. Sometimes they do and sometimes they don’t. The teeth can easily be contoured though if you are not satisfied with the shape following orthodontic treatment. I hope that helps!

    • Michele,

      Could it thin out? Anything is possible, but in my experience, if it is that far down as you describe, that kind of pathologic gap will persist into the adult teeth.My suggestion would be to find a laser dentist to evaluate him. As long as there are no speech, trauma, or decay issues, then waiting until the adult front teeth come in to treat is an often recommended stance. Waiting until after ortho is only for scalpel/scissors treatment as that kind of scar can affect movement, but not laser. With laser, it is preferred to treat earlier to help ortho close the gap.

      These comments are all based on assumption and not construed as patient advice until seen in person.

      As far as how the adult teeth will be shaped, I agree with Dr. Draper. We won’t know until they come in.

      Dr. Larry Kotlow has some great info on his website in the articles section. Kiddsteeth dot com

      Dr. McMurtry
      Charlotte, NC

  43. Hi,

    My daughter is 8 years old, and over the past several months has had a fixed retainer in the top of her mouth to fix her under bite that she was born with, and to give her more room (we have very small mouths). She was also born missing her top two lateral incisors, both baby and adult (genetic), so the next step has been braces on just the top four teeth, her two central adult teeth, and her two baby canines, I think to pull the top two center teeth together. We have yet to decide what will be done with the missing teeth. Anyway, recently, the dentist told me that she needs to have an upper lip frenectomy, and it seems her’s comes down pretty low. I’m reading different information on the subject though, and am really not in support of doing anything that’s unnecessary. She has no pain, and eats/smiles find, so I’m assuming this is just because he is afraid he won’t be able to close the space between her teeth. Can you tell me what your take on this is? Were not even really to the point where we know the space won’t close, as she just got the braces on recently, but he already wants to proceed. I appreciate any help you can lend.


  44. I was told today at a Dentist appt. that both my daughters need a frenectomy. They are 6 and 8 years old. I had a frenectomy about 10 years ago when I was an adult. Neither daughter has any pain or trouble talking. Their dentist made it sound like it is common to do this now. I found your site as I am sitting here researching this topic and am glad I found you.

  45. My 2 1/2 year old has a very visible lip tie. I believe this is why she quit breastfeeding at 3 months old. I continued to exclusively pump until she was 1 but at the time I had no idea why she basically went on a breastfeeding strike. At her first dental check up, her dentist took a look and said that she does have a lip tie but that at her age it would be hard to tell if she will out grow the tie or if later she will need a frenectomy. Since she is not bothered by it (and we are past the breastfeeding stage) he suggested that we just keep an eye on it as she grows and we’ll reevaluate after her adult dentition comes in. At nearly 3, she speaks quite clearly so I am confident in the dentist’s suggestion of monitoring her lip tie over time.

  46. Our dentist recommended a Frenectomy on my child. She is eight years old. Both her upper front teeth has completely turned sideways. He said she cant get braces because not all of her permanent teeth came out.

  47. The fact that the two central teeth have rotated is a sign that there is not enough space for the two teeth. The second incisors (and I do not know if they are visible as yet, though 8 years for a girl, is probably already somewhat late and may be an indication that they also don’t have space into which to erupt without rotating or moving out of the arch, usually into the palate) are the real indicators of a problem on hand. It is so easy to judge the available space once the baby second incisors have shed. If it can be seen that there is not enough space, but if the dentist is sure that the frenum is keeping the two central incisors apart and that if they are approximated via frenectomy and a small orthodontic appliance, then a frenectomy is warranted at that age. If there is going to be too little space for the permanent teeth to erupt nicely in the arch, you should live with the crooked teeth till about the age of eleven and then have the frenectomy done and complete orthodontic evaluation and treatment in one go. You then only treat in one phase! Much easier for the patient. Kind regards from South Africa.

  48. This is a great opportunity to talk about this procedure which is controversial still today. When you talk to family doctors, 90% of them will say there is nothing wrong and that the frenum does not cause breastfeeding issues. When you talk to ENT doctors, it’s the same. But when you talk to lactation consultants, they ALL do notice that it may interfere. Do all babies need revision ? Not at all ! But for those who do need and that are diagnosed to be associated with tight frenum (also referred to as tethered oral tissues), it is critical to perform the surgery in a timely manner. So who is right ? Education has a lot to do with this topic, like it was pointed out in a previous post. And yes more research is needed. But practical on-the-field data do show that frenectomy, when indicated, does aid in nipple pain, mastitis, latch, tongue sucking mouvements, mom’s supply, arch growth, airway, and most importantly the breastfeeding to continue. Myself a dentist, my colleagues and I do help with the mechanical aspect of the breastfeeding dyad. But an entire team is needed: IBCLC lactation consultants (who should definitely be your “quaterback”), osteopaths, chiropractors, myofunctional therapists, craniosacral therapists, family phycisians, dentists. You may not need all of them, but for sure you will need help from a competent lactation consultant who will then refer you as needed. They are the best ressource to assess breastfeeding difficulties. As far as technique, definitely have an incline towards laser frenectomy: hemostatic so bleeding is reduced to minimum and almost none, bacteriocidal so practically infection risk free, smoother scar, less sensitivity post-op, more precise, less chance of reattachment. For the parents who want to read more about the procedure, Dr Lawrence Kotlow has an extensive series of posts and articles on his website. Another invaluable ressource is the IATP International Affiliation of Tongue-Tie Professionals. So even though I appreciated the discussion with regards to the canines erupting at 11 , I do believe some babies require immediate attention. And this can only be achieved if everyone works hand in hand for the benefit of that little patient.

    Dr. Duc-Minh Lam-Do DMD, FAGD
    General Dentist (Quebec, CANADA)

  49. I am a general dentist, Accredited by the American Academy of Cosmetic Dentistry. I treat families, mostly adults, but for 30 years have been releasing tongue, lip and an occasional buccal (cheek) ties for mostly babies THAT CAN’T EAT!!! My experience started with LeLeche League moms desperate to discover why a baby could not latch, efficiently remove milk from a breast or bottle, chew up mom’s nipples, on and on and on. In almost EVERY CASE it was due to these restrictions, now being called a more inclusive term Tethered Oral Tissues (TOT). I released these restrictions, babies eat, moms ecstatic, happily refer their friends with new babies, this part of my practice just keeps growing. I don’t promote it because it grows by referral. I also see many kids that have been in speech for 2, 3, 4 years with little success, release their tethers and they are out of speech class in a short time! Very frustrating for the parents that no one recognized the restrictions.

    It did not take long to research why these are not diagnosed earlier by physicians. Ties used to be treated at birth, by doctors and midwives. When formula was invented and bottle feeding became the norm, physicians stopped being taught to evaluate the mouth. “If the boob doesn’t work, just give them this miracle juice from a bottle, it is just as good as breast milk”, pushed on them by formula company sales persons. Just check out medical school textbooks written over the decades , you will see the decline in attention given the mouth. We now know the short- and long-term affects on speech (can’t make good “R” and “L” sounds when your tongue can’t move!) facial growth, jaw growth, teeth position, airway development, (adults with restricted airways get sleep apnea! AAAAGH!) etc. etc etc.. when the mouth doesn’t use the proper muscles to eat from birth. “Sucking” from a bottle vs. “milking” from the breast. We need to get back to what nature intended.

    I agree to see websites by Kotlow, also see He has since died but made sure his website lives on. The Lactation Consultant industry, body work therapists like chiropractors and craniosacryl therapists among others help baby’s bodies adapt to the changes caused by these birth defect restrictions. Yes, these ARE birth defects, and they are very treatable. But practitoners MUST BE TAUGHT TO AT LEAST DIAGNOSE THESE RESTRICTIONS, and either learn to treat them or get practitioners on their team to refer to. They refer out eye disease, kidney disease, everything they don’t know how to treat. But they don’t know what they don’t know, so we need to keep working to educate them. Long, slow process. The best way is for satisfied families to discuss it with their family docs or pediatricians. Tell them how simple the treatment was, and how effective the treatment was. Grass roots efforts can go along way to convincing docs to learn a new way of thinking. The squeaky wheel gets the grease!

    So there, I ranted. Can you tell I’m passionate about this??

  50. In addition to the Kotlow webpages referred to above as a source of sound information by several of the posters re: the need for release of Tethered Oral Tissue (TOT), the earlier the better to avoid problems over a lifetime, Dr. Bobby Ghaheri, MD, ENT in the Portland, OR area, has a series of blogs that are another rich source of information re: the impact of a Tongue tie, one of several possible ties (Upper Lip ties and cheek ties are included in the umbrella term of TOTs) that impact eating, digesting, breathing, speaking, sleeping, posture, etc.

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  52. I think my 5 week old has a upper lip tie. Breastfeeding has been painful since day one. We live in Maryland and I am wondering if you can suggest a provider in my area who would be able to diagnose and treat my daughter.

    Thank you!

  53. I know this was written years ago but my 13 mo old has a labial tie between her front teeth with a little gap. When she smiles you can’t see her front teeth. If we wait and she might need the procedure later down the road does that mean up until then when she smiles you won’t see her front teeth? I haven’t read any comments on this so i was curious.

  54. My 18 m/o daughter had the same thing. I couldn’t touch her mouth and the skin was connected all the way between her top two front teeth. She acted as if it was very painful for her. The dentist told me she’s not supposed to have it cut until her adult teeth start coming in (around age 6) because the risk of scar tissue can leave a permanent gap between the teeth, but she already has speech delays, so I was concerned this could be affecting her ability to talk. We went to the pediatrician as a second opinion and she sent us to a pediatric ENT. He took a look and decided to do the procedure because it went so far down in between her teeth. She had it cut and stitched by him on April 12, 2015. LATER THAT DAY she was giving me cheesy smiles showing her teeth and she immediately started babbling more and trying to talk. Now she’s perfectly fine, and I have zero regrets about having the procedure done for her.

      • No problem! That was exactly the case, you works only see her bottom teeth because she wouldn’t move her to lip at all, and you had to pull her lip up to see her teeth and she screamed in pain every time I tried. She even lets me brush her teeth now! I highly recommend having a pediatric ear nose and throat doctor take a look. That’s the doctor that’ll do the procedure anyway, so they’ll definitely be able to tell you if your child needs to have it done.

        • Andrea, I’m glad an ENT would do this for your child. Most, however, don’t even know what to look for. Were they able to do this in-office, without the need to put her to sleep?

          • No, they had to put her to sleep for a few minutes. I was initially concerned about that, but the Pediatric ENT I found has lots of experience doing this procedure on young kids, and he walked me through the whole process, which did a lot to put my mind at ease. She was right back less than 15 minutes after she went back to the OR, it was really quick. When they brought her back to me, she was pissed off, but otherwise her old self, and she was acting like it never even happened by the time we got home.

  55. Hi, my daughter, 8 and half years old, had a labial frenectomy (laser) in January 2015. At that time, her baby front teeth were still in. She had a lot of problems with her baby teeth (decay) probably due to the fact that she was premature (born at 31 weeks). Since I also had the frenulum problem and spaced front teeth and had surgical frenectomy at the age of 12 (which was quite a traumatic experience) our dentist suggested that the procedure be done as early as possible. All went well, but now, when her upper front permanent teeth are out (there is still a gap between them), I can see two horizontal lines in the very middle. They are not colored, but look like indentations or scars in the middle of the tooth. Could this be some sort of trauma due to the laser frenectomy while permanent teeth were still inside? I would like to hear your honest, impartial opinion. And what to do next? Thanks.

  56. My daughter is 9 years old and her orthodontist wants her to have a frenectonomy before she is fitted for her retainer. I have read all this info about how she should be at least 11 and have her permanent canines in. I am hesitate to have it done and would rather wait until her permanent teeth come in. Any suggestions, should we wait?

  57. My almost 3 year old has a severe speech delay along with a very tight labial frenum (attaches behind the 2 front teeth). It has always made tooth brushing a nightmare and I can’t help but think it contributes to his speech delay. I just keep hearing the same rhetoric from dentists that it doesn’t affect speech and it will remodel itself when the adult teeth come in. I could not care less about the aesthetic aspect of it, I just want to remove any and all barriers to speech for him. An ongoing speech delay is going to be a whole lot more traumatic for him than and 10 minute procedure in my opinion. I’m going to keep looking for a dentist with a laser that has some appreciation for my concerns instead if recting what they have been told.

    • I live in Albuquerque NM. My friend was actually just at her dentist’s office and brought it up with him. He has a laser and gas and feels completely comfortable doing the procedure on a 3 year old. I’m really hoping it works out. We already tried one oral surgeon but he doesn’t have gas (says it causes spontaneous abortions in female workers in dentist offices) and my son jerked away part way through the lido injection (he did so great up and was so cooperative up until then). The surgeon was clearly skeptical of doing the procedure to start with but agreed to try since myself and all 3 of his speech therapists think it’s worth doing.

  58. Kendra, where do you live? Based on that I can help you find a preferred doctor for you. OR google my name and call our office or submit a comment thru my website and we can get you a name.
    Dr Mc

  59. Hiya my 4 month old baby boy has what I think is a stage 4 upper lip tie. I’ve been to my dentist who said even though the frenulum is very thick and comes all the way down on his gum it isn’t really restrictive so she will refer me anyway when his baby teeth come in but doesn’t think they will do anything in childhood. However I am in the uk and I have found dr Levinkind who will look at it if I want to go privately. I beg to differ on the feeding issues I think this must be the reason why we are both struggling but even if it isn’t right I still would like it lasered anyway to prevent having the gap as its so thick right inbetween where his 2 front teeth will be I can’t see that gap closing by itself?

  60. I am so thankful for this article and all the stories shared here. My son is 7 and his new dentist recommended that an oral surgeon review and evaluate whether a frenectomy was “needed” for him, they said yes. I started my research and landed on this article. I have cancelled the appointment. I would rather wait and see what will happen (if it will correct itself) than have him go through a potentially painful ordeal that may not be necessary. So thank you everyone for your stories!! 🙂

  61. Anny I agree with you we are also waiting until it is absolutely neccesary my daughter will need braces anyway so after braces is what we are doing. If the teeth are pulled together then clipped I have read it is better to do that so teeth stay together. If you do before scar tissue keeps them from coming together. I think some dentists suggest it and try to make it urgent to get the money from the work being done. This upsets me. All information should be put on the table. They don’t tell you that it causes scarring that may cause them to never close.

    • Megan,

      The information you were given is only partially correct. If the procedure is done via old school methods (scissors or scalpel), then yes, you need to wait until closer to the end of ortho as this procedure using stainless steel will create a scar that can cause ortho troubles. HOWEVER, if you are using the latest technology to perform this procedure (read…laser), then scarring is not a problem. Laser is fast, pain-less, doesn’t require stitches, has faster healing, and doesn’t create the scarring that stainless steel does. If the procedure is warranted/recommended at an earlier age, it can actually help create space for the remaining teeth and orthodontist and may reduce treatment time. Performing this procedure with laser at any age can be appropriate based on what’s going on. If your doctor is using old-school techniques, then yeah, you need to wait.

      I don’t suggest this procedure, just to make a quick dollar. I recommend it when I think it will help my patients. I offer full disclosure with my patients. So make sure you have all the correct information, especially how the treatment will be done, before you decide what to do.

  62. The dentist that my four year child has been seeing keeps harping on me to get the labial frenectomy done. The pediatrician that she normally sees says that she has never recommended that for someone so young. The dentist advised me that a “pediatrician” is not a “dentist” and therefore I should not really be going by what she advises. At this point should I get a third opinion? If so with whom? Another dentist, the surgeon or another pediatrician?
    Thank You!

  63. It’s good to know that you should wait until the child is older than 12 to get a frenectomy. My daughter needs one, but I don’t want to have the procedure done until she gets braces. My husband and I usually put them on our kids when they are 13 or 14, so I will be sure to get it done then. Thanks for sharing!

  64. Today our dentist recommended that my daughter, who is 7, have a frenectomy. He did mention that they are rarely performed on children her age, but that she was one of those rare cases. I guess I’m skeptical by nature so I wanted to do a little research of my own. Her frenum attachment is causing her not to be able to brush her 2 front teeth (permanent) properly. She had excessive plaque build up on those 2 teeth only. I plan to call the oral surgeon that he recommended tomorrow and schedule the procedure.

  65. My 6 year old daughter has been recommend to have labial frenectomy. Her gap is huge between her teeth everyone thinks she already lost her front teeth, which she hasn’t. My family has a long history of gaps between the front top teeth. I did as a child and it corrected itself. Her dentist also said she has an extra adult tooth coming in the front and if I don’t either remove that tooth or so this frenectomy she will have a lot of issues. I’m super anxious about having this surgery I don’t trust dentists had too many bad experiences as a child and worked for a dental administrator and learned a lot about unnecessary procedures for profit. I will have to get a second opinion but for now I’m going to delay the appointment for this procedure. Thank you for this article it definitely helps hearing others with the same issues and concerns!

  66. Hi there, I just came across your post. I have been considering having this done for my 15 month old son. His libial frenulum comes down halfway over his front teeth. We find that’s to brush his teeth and he hates us brushing them as it is obviously painful for him. Is a frenectomy something we should consider at his age for the sake of clean teeth? He had his tongue tie fixed at 3 weeks old. Thanks

  67. Took my 9 yo to an orthodontist today as she has a very large gap between her front 2 teeth (she has 8 permanent teeth so far). She was told her frenulum goes all the way down and actually wraps underneath the other side. They recommend doing braces on the top front 4 teeth only to straighten and close the gap to where it is slightly open, then have the frenectomy, then finish closing the teeth with her braces after. Do I still need to wait until 12 yo or for this case go ahead and do the brace/frenectomy/brace option?

  68. When my now 8-year old was younger, we were told he may need a frenectomy but it should correct on it’s own. This week the dentist scheduled to have it done because he has his front adult teeth and it is causing them to pull apart. I didn’t question it at first but am now looking in to it and really don’t feel it is necessary, especially after reading about closing the gap before the procedure to avoid scar tissue obstructing the closure. By not having this procedure done right now, do I risk ruining the chance to fix the problem now or is it easily correctible in the future? I don’t want to make the wrong decision…

  69. Hi, I just notice a prominent gap between the front teeth of my 1 year old daughter. I understand why you are saying that we should get it done at 11-12 years.
    But what harm is there to get it done now….

  70. Hi,
    I am probably the exact opposite to most of these comments, I am now 34 and had a large gap in my front teeth and a large frenum all my life, no dentist would touch it until I was a teen however genetic in my family also played a part in which hf of my baby teeth are still here and my big teeth never came through. Ad the years went on the gap in my teeth became significant and started to push my teeth outwards onto an angle, this was extremely embarrassing I suffered into my 20’s and in my younger years people asking me if I had a tooth missing that’s how big it was. No dentist would considered removing this muscle earlier on and did not listen to family genetics and in turn caused a lot of embarrassing moments and dramatic loss of confidence until in my twenties I found someone to do it. Now I face the same thing for my son he is 5 and already has the gap and frenum that is prominent and he will I have no doubt suffer he same situation, I am hoping to find a dentist who will look into genetics and take this into strong account and hopefully perform this operation when he is around 10. I do not wish for him to go through the torment that comes along with a non straight gap with a large frenum creates.

  71. Hello. Just yesterday we went to an orthodont, my girl is turning 6 next week. I knew about her labial frenum since she was really small, her lip was always dry in the midle. So, the reason why we went to the orthodont was another one. She lost 3 of her teeth, and only 2 permanent showed up, taking all the space, so there is no place for the third one )) So the doc said is nothing we can do about it till she is 8. But she has problems with the oclusion, and he recomended us to wear a trainer, to keep her mouth close and teach her breathe trough her nose, as we have a problem with 2 degree adenoid (ENT doesnt recomend the surgery yet) And to be able to wear it, we need to cut the frenum. So, i am a bit indecided ))

  72. Discovered my almost 3 year old has this after she had day surgery by the dentist to remove her 2 front teeth because the cavities caused by this went all the way to the roots. I don’t know why she told me to ask the ent instead of fixing it. The ent says insurance isn’t likely to pay for it unless it’s causing speech or eating issues…missing her front teeth does that also. I’m worried her permanent teeth will be destroyed the same way and we had speech concerns before the surgery. Very frustrated.

  73. I recently took my 1 year old son to our local pediatric dentist for his first cleaning. She looked at his teeth and then told me she needed to schedule a frenectomy. She didn’t really explain much and just told me I have 2 options. She said she can perform it at the office using lasers and it will be quick and under 30 minutes with the recovery being nothing I would just have to rub the top of his gums 3 times a week for 2 weeks. She said the other option would be to put him to sleep and cut out the skin and stitch it up after. I didn’t really know what to say and she said that it needed to be done now so I told her I would just go with lasers to keep from putting him under. She set the date a month from now and I decided to do so research. I came across this article and now I’m wondering if this procedure is even necessary? I took him to his doctor to get his opinion and his doctor said my son’s looks like it would be difficult to fix and would take alot of work. He also said he doesn’t see how they will get him to be still long enough to fix it but it’s my decision. I confused on what to do. I want to know if there are any success stories of laser fixing the problem or will it just make it worse?

    • Jessica, if you look at the original date of this blog, it dates back to 2011. The textbooks cited in the blog cite literature from the 1970s, long before lasers were commonly used in dentistry. I have these same texts, and the dentistry I practice today is very different from when I graduated just 15 years ago.

      Under traditional methods (read – a long time ago), this procedure is done with scissors or a scalpel. In those instances one should often wait until the end of ortho because of scarring. Laser doesn’t create that scarring, so there is no contraindication to treating earlier.

      There are some great resources out there. To avoid the spam filter on here, I will avoid a direct link, but if you google any of the following, you can find some more information that is very up to date
      Bobby Ghaheri
      Larry Kotlow
      Brian McMurtry
      and use tongue tie or lip tie after it, you will be directed to their respective sites

  74. I just looked this up because my pediatric just told me my 1 year old needed this done. My husband dose not want it done right now. But the doctor told me her gum line would “raise up” and her “teeth could wind up falling out” reading this I think she’s just trying to make some money.

  75. my 8 year old daughter is scheduled to have this next week. after reading this I am not sure now. Both of my daughters have a space between their front teeth, so did I when I was young and I never had braces and no space now. My 8 year old does have skin in between her front teeth and that is why the dentist and orthodontist recommended this to be laser cut.

  76. My daughters is 7 and her dentist told me she needed the skin between her 2 front teeth cut because the gap has not closed and her adult teeth next to them have grown in sideways. from what I can see if pictures there is no skin attached to her lip its just part of her gum muscle I do believe. I have had people tell me not to do it because it leaves scaring. Her adult canine teeth have not come in yet. I have an apt on March 7th with the oral & maxillofacial surgeon. what should I do?

  77. Old article, live thread. All frenectomies, both baial “toungue ties” and maxillary should be doen WITHOUT A KNIFE. Doctors call them “scalpels”. We parents, call them knives. Don’t let your doctor use a knife for this procedure. Only have this procedure done with a Co2 specific (10,600 wavelength) soft tissue laser. The doctore will use a strong topical, our children don’t feel a thing, and the procedure is finished within one unit of doctor time. Your dentist should know how to code this for insurance reimbursement.

    DO NOT LET AN OMS, ORTHO OR PERIO TELL YOU the frenum can “grow back” when using the laser. This is rubbish, and a lie perpetrated because they didn’t invest the 45-65k in buying a Co2 laser.

    A frenectomy using a scalpel is child abuse, given a modern option.

    All the best. Our two (one max and one labial) went smooth and healed withith 48-ours with vitamin e gel to keep the area moist.

    Finally, ask 10 doctors a questions and you’ll get 15 opinions.


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