The Indications, Timing, and Surgical Techniques for Performing Elective lingual and Labial Frenulectomies for Infants and Children

This article discusses the significance of anatomical variations of Maxillary and Mandibular frenula found in children, indications for surgical intervention vs deferment and no treatment, and the anesthetic and surgical techniques in contemporary use for their management. Ankyloglossia, or tongue-tie is a common phenomenon observed as early as birth which can become problematic for infants experiencing feeding difficulties when breast or bottle feeding. Secondarily, it has potential to impact on later speech development and the ability to verbalize certain sounds. While some children can overcome the anatomical defect, others require surgical intervention to free the anterior third of the tongue. Depending on the severity of the defect and anterior and superior nature of the attachment to the anterior alveolar ridge, ankyloglossia has potential to adversely affect periodontal health associated with lower incisors, both primary and permanent. The article describes various indications and variability of surgical approach for a given circumstance. Maxillary frenulums are probably the least understood and pose the most confusion for clinicians in the determination of actual need and timing for surgical intervention.