Short frenum of the lip
Last reviewed: 23.04.2024
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A short frenum of the lip (upper or lower) is not a disease, but an anatomical and topographic feature of the oral cavity, which is attributed to structural abnormalities of the soft tissues of the oral cavity.
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Causes of the short frenulum of the lip
The causes of a short frenum of the lips lie in the disorders of the formation of the oral mucosa and the congenital anatomical anomaly of the anterior cavity of the mouth. As in cases with the structure of skeletal structures of the facial part of the skull, the etiology of disruption of the formation of muscle and mucous tissues predetermine endogenous (hereditary) and various external risk factors during the first two months of intrauterine development (when the facial skeleton and oral cavity form in the embryo).
Bridle lips (frenulum labii) are located on the threshold of the oral cavity (vestibulum oris), which is bounded on all sides by the cheeks, teeth and mucous membrane of the alveolar part of the gums of both jaws. Coverage of the vestibule is a mucous membrane consisting of a multilayered planar epithelium.
Bridles of both lips are thin triangular strands (lintels) from the mucous tissue, located vertically - between the middle of each of the lips and the middle of the corresponding gum, more precisely, the alveolar process of the jaw. Bridles are an elastic "constructive" element of the vestibule of the oral cavity and serve as limiters for the mobility of the lips.
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Pathogenesis
In most cases, the pathogenesis of the defect is due to the fact that the connection of the frenum to the gum is below the base of the gingival papilla between the two anterior incisors (i.e., too close to the teeth). In addition, there are anatomical varieties of the bridle itself: distortion of shape, thickening and thickening of the mucous tissue, shortening of the crest (free side of the lintel).
Symptoms of the short frenulum of the lip
Explicit symptoms of a short frenulum of the upper lip: the upper lip is inactive and completely unable to cover the upper row of teeth, difficulty in closing the lips (why the mouth remains ajar).
Specific can be the position of one of the lips with a smile, with the inability to open both dental rows.
The first signs that the infant has a short bridle of the upper or lower lip, are manifested as significant difficulties in sucking. The nursing mother should pay attention to how the baby takes the breast, how quickly it becomes tired of sucking, how quickly it becomes hungry again, whether it is enough to gain weight. Usually this defect is detected by neonatologists immediately after the birth of the child, the mother is notified and in her presence the defect is eliminated by cutting the bridle.
Complications and consequences
Quite often a short bridle under the upper lip causes or increases the diastema - the gap between the upper central incisors, as well as the crevices between all teeth of the jawbone - teeth trembles. In this case, the teeth become more sensitive due to a violation of the adherence of the alveoli tissue to the root of the teeth; much easier teeth affects caries. And problems with diction are expressed in difficulties with pronouncing of labial and labial-dental consonant sounds (b, p, m, c, f).
In addition to the formation of a gap between the lower anterior teeth, the most common consequences and complications with a short frenulum of the lower lip are the formation of a malocclusion in the child after the appearance of milk teeth - with the frontal extension of the lower dentition.
When the short frenum of the lower lip in adults, there is a gradual reduction in the volume of soft tissue near the teeth of the lower row (recession of the gum), which is accompanied by the bare necks of the lower anterior teeth. Often, between the gum and the tooth are formed grooves (gingival pockets), which become a prerequisite for the development of periodontitis.
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Diagnostics of the short frenulum of the lip
Diagnosis of the short frenum of the lip (upper or lower) is performed by visual inspection of the oral cavity, during which the dentist, orthodontist or speech therapist clearly see at what distance from the base of the gingival papilla between the two anterior incisors (the upper or lower dentition) is the fusion site strand with a gum. A distance of 5-8 mm is considered the norm.
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Treatment of the short frenulum of the lip
The only method by which the short frenum of the lip is treated is surgical.
This operation is called frenulotomy or frenectomy. Frenulotomy consists in cutting a short frenum of a lip with scissors or in excision of a part of a tissue with a scalpel (with application of a seam). Intervention requires local anesthesia, accompanied by a slight bleeding, after the operation, pain and swelling are noted. The scar at the place of pruning or excision, as a rule, resolves.
A frenectomy is a medical procedure performed with a laser with minimal sedation with an anesthetic applied to the mucosa. Bleeding with this method is practically absent; pain, swelling and scar tissue formation are of an individual nature, but in any case, everything heals in a shorter period than with frenulotomy.
Experts emphasize that a short frenum under the upper lip of a child can be cut either immediately after birth, or at the age of six or eight - when the dairy front incisors are replaced by permanent ones. Prior to this, the pruning of the bridle is not done in order not to disrupt the formation of the maxillary arch and not to provoke the development of an incorrect bite.
If the child has a short frenum of the lower lip, frenulotomy can be performed with a bite (but not earlier than three years), but doctors advise waiting for the eruption of permanent incisors.