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Diseases of the frenulum of the upper lip and tongue: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Congenital abnormal position of the frenulum of the upper lip
Shortening of the frenulum of the upper lip is usually combined with the formation of a diastema between the permanent central incisors.
The excessively developed (wide) frenulum of the upper lip reaches the space between these teeth; sometimes it touches the equally excessively developed incisive papilla (papilla incisiva).
If the frenulum is very short or is attached to the edge of the alveolar process, it can pull the gingival papillae, resulting in the formation of a pathological gingival pocket. Food debris accumulates in it, causing chronic gingivitis and bad breath.
Treatment
Treatment consists of either lengthening the short frenulum by moving opposing symmetrical triangular flaps according to A. A. Limberg, or cutting off the frenulum from the gum. In the latter case, the incision is made at the level of the frenulum attachment to the gingival margin. 2-3 interrupted sutures with thin catgut are applied to the cut frenulum, and the gum wound is covered with a strip of iodoform gauze for 2-3 days. After 3-5 days, the wound epithelializes.
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Anomalies of attachment and length of the frenulum of the tongue
If the frenulum is shortened and is attached not only to the base of the lower surface of the tongue, but also to its anterior part (up to the tip of the tongue), there is a limitation of the tongue's mobility and difficulty in pronouncing some dental-gingival sounds.
Treatment
Treatment can be performed by moving the counter triangular flaps of the mucous membrane, as in the case of shortening the frenulum of the upper lip. However, if the shortening of the frenulum is significant and the tongue is as if soldered to the floor of the oral cavity, moving the counter triangular flaps of the mucous membrane may not give the desired result. In such cases, it is better to use the transverse dissection method with subsequent mobilization of the edges and suturing the resulting diamond-shaped wound on the border of the floor of the oral cavity with the lower surface of the tongue.
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