There are two frenum (also called frenulum)in your mouth. The lingual frenulum is the part of the mouth that connects the base of the tongue to the floor of the mouth. The labial frenum are at the front of the mouth. They are between the lip and the gum, both at the upper lip and lower lip. The purpose of frenum is to give the lips and tongue more support and stability in the mouth. Although they are uncommon to talk about, these frenum can cause some challenges if they are abnormal.

Absent Frenum

There are those with an absence of frenum. It can be connected to various developmental and genetic conditions. One example is Ehlers-Danlos Syndrome. Other inherited genetic conditions that can lead to unusual formation of the labial frenum are

  • Infantile hypertonic pyloric stenosis
  • Holoprosencephaly
  • Ellis-van Creveld Syndrome
  • Oro-facial-digital syndrome

Abnormal Frenum

Generally speaking, if a frenulum is growing abnormally, it can cause cascading issues within the mouth. They can also be damaged such as in accidents or injuries involving the mouth from sports, etc. It could also be damaged in oral surgery if the surgeon is not precise.

The frenum is loose tissue in the mouth and can sometimes have a tear. It could be caused while eating, kissing, or by oral appliances. These may bleed a lot. However, they usually heal on their own and are not a cause for concern. The mouth is one of the fastest healing parts of the body.

Some common conditions associated with problems with the frenum include:

  • Developmental abnormalities in the mouth
  • Difficulty and discomfort swallowing
  • Speech challenges
  • Disruption of the development of the upper two front teeth causing a gap
  • Mouth breathing
  • Snoring
  • Jaw abnormalities and pain, including TMJ
  • Pulling the gum away from the teeth
  • Lip tie
  • Difficulty nursing
  • Pain and difficulty with oral hygiene
  • Increased tooth decay and periodontal disease

Lingual Frenulum

The lingual frenulum can sometimes be too tight. When this happens, it makes it difficult for the tongue to move in the mouth. This can impact speech. In a baby, it may make it difficult for them to nurse efficiently.

Tongue Tie

If the lingual frenulum is very short or very thick it may lead to tongue tie. In addition to the speech and possible nursing challenges, a tongue tie can also have longer lasting impacts on oral health. After a meal, a person natural cleans the teeth with the tongue. With a tongue tie, the patient may be unable to do this, leaving particles behind on the teeth which can lead to tooth decay.

Tongue tie can lead to mouth breathing which can dry out the mouth. Without enough saliva, a patient does not rinse out the bacteria and food particles in the mouth. This can lead to more tooth decay, periodontal disease, and bad breath.

Tongue tie can also impact tongue posture which can lead to many other challenges as we discussed in our previous post.

Labial Frenum

If the labial frenum are abnormal, it can impact the way the teeth grow and come in. It can affect dental health if they pull the gum away from the teeth. In severe cases it can expose the tooth roots, like periodontal disease, and can be extremely painful.

Lip Tie

The labial frenum can also be so tight or so short that it causes lip tie. The frenulum changes as a baby’s mouth develops. Diagnosing lip tie in babies is therefore controversial. There are several signs that may indicate a baby has a lip tie.

  • Slow weight gain
  • Difficulty latching to breast feed
  • Long feedings
  • Clicking sounds while feeding
  • Milk spilling from mouth while feeding
  • Reflux
  • Irritability
  • Painful breasts for the mother after feeding


A frenectomy is a surgery that is designed to reverse the affect of any of these abnormalities. It typically involves reducing a frenulum that is too long or too tight. This is usually only recommended if the frenum tear frequently or if they are impacting the normal use and development of the mouth. The are common for children who have speech difficulty or difficulty breastfeeding.

A frenectomy is a short procedure. It is performed in an oral surgeon’s office, not the hospital. Local anesthesia is typically used. If the surgery is more extensive or if the patient is very young, a general anesthesia in a hospital is used.  The surgeon will use either a scalpel or electro or laser surgery and the wound is closed with stitches. Aftercare will involve some pain medication, cleaning the area, and rest for the tongue. The recovery is generally only a few days.

Smiley Piercing

For those familiar with various piercing of body parts, the labial frenulum is one area that some choose to pierce. This is piercing that can only be seen when you smile, which is why it is called a smiley piercing. This is a challenging piercing, though, because the tissue is so small and thin. Most people are unable to have this. Those that due are at high risk for it to be torn out and injuring the frenulum.

Overall, if you suspect you or your child has a problem with their frenum, you should talk to your dentist. At Danville Family Dentistry we will help you be sure your frenum are working properly and all your oral health. Contact us today!

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Disclaimer: The information included in this article is for educational purposes only. It should not be used as a substitute for professional medical advice, diagnosis or treatment.