Short frenulum

A short frenulum of the lip (upper or lower) is not a disease, but an anatomical and topographic feature of the structure of the vestibule of the oral cavity, which is classified as a structural abnormality of the soft tissues of the oral cavity.

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Causes short frenulum

The causes of a short lip frenulum are rooted in disorders of the formation of the oral mucosa and congenital anatomical anomaly of the vestibule of the oral cavity. As in cases with the structure of the skeletal structures of the facial part of the skull, the etiology of the disorder in the formation of muscle and mucous tissues is determined by endogenous (hereditary) and various external risk factors during the first two months of intrauterine development (when the embryo's facial skeleton and oral cavity are formed).

The frenulum of the lips (frenulum labii) is located in the vestibule of the oral cavity (vestibulum oris), which is bounded on all sides by the cheeks, teeth and the mucous membrane of the alveolar part of the gums of both jaws. The vestibule is covered by a mucous membrane consisting of multilayered squamous epithelium.

The frenulum of both lips is a thin triangular strand (bridge) of mucous tissue, located vertically - between the middle of each of the lips and the middle of the corresponding gum, or more precisely, the alveolar process of the jaw. The frenulum is an elastic "constructive" element of the vestibule of the oral cavity and serves as a limiter of the mobility of the lips.

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Pathogenesis

In most cases, the pathogenesis of the defect is associated with the fact that the connection of the frenulum with the gum is located below the base of the gingival papilla between the two front incisors (i.e. too close to the teeth). In addition, there are anatomical varieties of the frenulum itself: distortion of shape, thickening and compaction of the mucous tissue, shortening of the ridge (the free side of the bridge).

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Symptoms short frenulum

Obvious symptoms of a short frenulum of the upper lip: the upper lip is not very mobile and cannot completely cover the upper row of teeth, difficulty closing the lips (which is why the mouth remains slightly open).

The position of one of the lips when smiling may be specific, with the inability to open both rows of teeth.

The first signs that a baby has a short frenulum of the upper or lower lip are manifested by significant difficulties with sucking. A nursing mother should pay attention to how the baby takes the breast, how quickly he gets tired of sucking, how quickly he gets hungry again, whether he gains enough weight. Usually, this defect is detected by neonatologists immediately after the birth of the child, they inform the mother and, in her presence, eliminate the defect by cutting the frenulum.

Complications and consequences

Quite often, a short frenulum under the upper lip causes or increases a diastema - a gap between the upper central incisors, as well as gaps between all the teeth of the upper jaw - trema of the teeth. At the same time, the teeth become more sensitive due to a violation of the adhesion of the alveolar tissue to the roots of the teeth; teeth are much more easily affected by caries. And problems with diction are expressed in difficulties with pronouncing labial and labiodental consonants (b, r, m, v, f).

In addition to the formation of a gap between the lower front teeth, the most common consequences and complications of a short frenulum of the lower lip are the formation of an incorrect bite in a child after the appearance of milk teeth - with a frontal protrusion of the lower row of teeth.

When the frenulum of the lower lip is short in adults, there is a gradual reduction in the volume of soft tissues near the teeth of the lower row (gingival recession), which is accompanied by exposure of the necks of the lower front teeth. Often, depressions (gingival pockets) are formed between the gum and the tooth, which become a prerequisite for the development of periodontitis.

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Diagnostics short frenulum

Diagnosis of a short frenulum of the lip (upper or lower) is carried out during a visual examination of the oral cavity, during which the dentist, orthodontist or speech therapist clearly sees at what distance from the base of the gingival papilla between the two front incisors (upper or lower dental row) the place of fusion of the strand with the gum is located. The norm is considered to be a distance of 5-8 mm.

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Treatment short frenulum

The only method by which short labial frenulum is treated is surgical.

This operation is called frenulotomy or frenectomy. Frenulotomy involves cutting the short frenulum of the lip with scissors or excising part of the tissue with a scalpel (with suturing). The intervention requires local anesthesia, is accompanied by minor bleeding, and pain and swelling are observed after the operation. The scar at the site of the cut or excision usually dissolves.

A frenectomy is a medical procedure performed with a laser under minimal sedation with anesthetic applied to the mucous membrane. Bleeding with this method is practically absent; pain, swelling and scar tissue formation are individual in nature, but in any case, everything heals in a shorter time than with frenulotomy.

Experts emphasize that the short frenulum under the upper lip of a child can be trimmed either immediately after birth or at the age of six to eight years - when the milk front incisors are replaced by permanent ones. Before this, the frenulum is not trimmed so as not to disrupt the formation of the maxillary arch and not to provoke the development of malocclusion.

If a child has a short frenulum of the lower lip, frenulotomy can be performed during the milk bite (but not earlier than three years of age), however, doctors advise waiting until the permanent incisors erupt.