A frenectomy is a minor dental surgery that removes or loosens a frenum, one of the small bands of tissue inside your mouth that connect your lips, cheeks, or tongue to your gums. The procedure typically takes less than 30 minutes and costs between $200 and $2,000 depending on complexity, location, and whether anesthesia is needed. Most people encounter the term when a dentist identifies a frenum that’s too tight, too thick, or attached in a spot that causes functional problems like difficulty breastfeeding, a persistent gap between the front teeth, or restricted tongue movement.
The Two Main Types
The most common frenectomies target one of two areas. A lingual frenectomy addresses the tissue under the tongue. When this band is unusually short or tight, it restricts how far the tongue can move. You may have heard this called “tongue-tie,” or ankyloglossia in clinical terms. A normal “free tongue” measurement from the base attachment to the tip is greater than 16 mm. Severity is graded on a four-class scale: mild cases measure 12 to 16 mm of free tongue, moderate cases 8 to 11 mm, severe cases 3 to 7 mm, and complete tongue-tie is less than 3 mm.
A labial frenectomy targets the tissue connecting the upper lip to the gum above the front teeth. When this frenum is unusually thick, stiff, or fan-shaped, or when it inserts too close to the gum line between the teeth, it can hold the two front teeth apart and create a visible gap called a diastema. It can also pull on the gum tissue and contribute to recession, making it harder to keep the area clean.
Why It’s Done in Infants and Children
In babies, tongue-tie is one of the most common reasons for a lingual frenectomy. A restricted tongue can prevent an infant from latching properly during breastfeeding. Instead of keeping the tongue over the lower gum while sucking, the baby may chew on the nipple, which causes pain for the mother and prevents the baby from getting enough milk. Left unaddressed, this can lead to poor nutrition and failure to thrive.
As children grow, an untreated tongue-tie can interfere with speech. Certain sounds become difficult to produce, particularly “t,” “d,” “z,” “s,” “th,” “n,” and “l.” Signs that a child may have a problematic lingual frenum include difficulty lifting the tongue to the upper teeth, trouble sticking the tongue past the lower front teeth, or a tongue that looks heart-shaped or notched when stuck out. Even everyday activities like licking an ice cream cone, licking the lips, or playing a wind instrument can become frustrating.
Reasons Adults Get a Frenectomy
Adults seek frenectomies for several distinct reasons. Some have lived with mild tongue-tie their whole lives and pursue the procedure to improve speech clarity or comfort while eating. Others need a labial frenectomy before or after orthodontic treatment. Research published in The Angle Orthodontist found that orthodontic relapse of a front-tooth gap was twice as great in patients with an abnormal frenum compared to those with a normal attachment. Removing the frenum reduces the chance that teeth drift apart again after braces.
A growing area of interest is the connection between tongue-tie and obstructive sleep apnea. Reduced tongue mobility is independently associated with a higher risk and greater severity of sleep apnea. When the tongue can’t rest in its optimal position on the roof of the mouth, it’s more likely to collapse backward and block the airway during sleep. Studies suggest that a frenectomy combined with targeted oral exercises can improve snoring and sleep apnea symptoms, though speech therapy and oropharyngeal exercises are typically recommended before and after surgery for best results.
A frenectomy is also indicated when a frenum pulls on gum tissue enough to cause recession, or when it creates a shallow pocket of gum that traps bacteria and makes oral hygiene difficult.
Laser vs. Scalpel
Frenectomies are performed with either a traditional scalpel or a dental laser. Both work, but a meta-analysis comparing the two found consistent advantages with laser treatment. Laser frenectomies eliminated bleeding during the procedure in 100% of cases studied, while every scalpel group experienced some post-operative bleeding. Laser procedures were also faster on average and required no stitches, whereas scalpel procedures needed sutures in most cases.
Pain and comfort differences were notable. Patients in the laser group reported significantly less pain on both day one and day seven after surgery. They also experienced less discomfort while chewing and speaking at both time points. For these reasons, many dental providers now prefer laser for frenectomies, though the scalpel approach remains widely used and effective.
What Recovery Looks Like
After a frenectomy, the surgical site forms a white or yellowish soft scab within the first day. This is normal wound healing, not infection. The white patch shrinks gradually over the following days as new tissue grows underneath.
The most important part of recovery is performing stretches to prevent the tissue from reattaching. Reattachment is a real concern: in one survey of healthcare professionals, a repeat procedure was considered, requested, or performed in 32% of infant cases. Consistent stretching is what prevents this.
For a lip-tie release, the stretch involves pulling the upper lip up as high as possible (high enough to cover the nostrils if you can), pressing gently but firmly against the wound to keep the diamond-shaped opening stretched. This is done three times a day for three weeks. Slight bleeding during stretching is normal and not a cause for concern.
For a tongue-tie release, the approach depends on whether stitches were placed. If sutures were used, stretching starts on day four. If no sutures were placed, stretching begins the morning after treatment. The basic stretch involves lifting the tongue from the center to open the diamond-shaped wound fully, repeated three times daily for three weeks. Older children and adults add exercises like sticking the tongue out to a point, sweeping it left and right, pushing it into each cheek like a gumball for ten seconds, suctioning it to the roof of the mouth, and holding each position.
Risks and Complications
Frenectomies are low-risk procedures overall. Infection is rare, occurring in roughly 2% of cases in one large survey. When it does happen, it presents as an abscess or localized mouth infection. Minor post-operative bleeding is the most common issue, particularly with scalpel procedures, and it resolves on its own.
One complication worth knowing about is misdiagnosis. In the same survey of healthcare professionals, 43% of infants referred for complications after a frenectomy were found to have an underlying neuromuscular issue, and 27% had received inadequate breastfeeding support. In other words, the tongue-tie wasn’t always the actual problem. This is why a thorough evaluation matters before the procedure, especially in infants with feeding difficulties. A lactation consultant or speech-language pathologist can help determine whether the frenum is truly the source of the issue or whether other factors are at play.
How Dentists Decide You Need One
For labial frenectomies, one common diagnostic tool is the blanch test. Your dentist pulls the lip outward and watches whether the tissue between the front teeth turns white (blanches), indicating that the frenum’s fibers run all the way through to the palate. A positive blanch test, combined with a persistent tooth gap, is a standard indication for the procedure. The American Academy of Pediatric Dentistry recommends frenectomy in these cases to reduce the risk of teeth separating again after orthodontic treatment.
For tongue-tie, the evaluation looks at range of motion. A healthy tongue should protrude past the lips without the tip clefting, sweep the upper and lower lips easily, and not blanch or pull on the tissue behind the lower front teeth when retracted. If the tongue can’t do these things and the restriction is causing functional problems with feeding, speech, or sleep, a frenectomy becomes a reasonable option.