March 15, 2022

Pediatric Frenums and Why You Should Be Looking at Them

As a dental professionals, we strive to incorporate good oral health routines for our patients and loved ones to prevent decay and other problems. Unfortunately, there are instances where dental anatomy puts patients at higher risk to having oral health problems. This article will discuss pediatric frenums (specifically lip ties) what to look for, how to address it, and dental treatment that can help.

What is a frenum?

A frenum is a soft tissue attachment that has muscle fibers which attach the lips, cheek, and tongue to soft tissues in the mouth. Frenums also provide more stability. They are classified on a scale of 1-4. The level of attachment helps dental professionals determine if the patient will be at risk for developmental delays such as the ability to latch during breast feeding or from a bottle, proper spoon feeding, or speech development. The attachment level will also affect the course of patient specific treatment.

If there is a frenum present but it is not affecting any developmental characteristics, it is still important to partake in routine dental check-ups and examine the area at home weekly if not daily especially in regard to enamel health.

Nancy, RDH’s Experience

Even dental professionals and their kiddos aren’t immune from dental issues. Nancy, registered dental hygienist, recently noticed her little one had white spot lesions on her newly erupted teeth. Nancy began taking photos regularly to monitor the progression. In just 3 weeks time, what started as white spot lesions quickly advanced to dental caries.

Although Nancy’s daughter did not have any developmental delays, due to her frenum attachment positioning the oral cavity was not naturally able to clear the milk and food particles properly throughout the day which led to the breakdown of her enamel.


The most common treatment for frenum issues is a frenectomy. A frenectomy is the dental procedure “that removes the connective tissue (called the frenum) at either the top or the bottom of the mouth, specifically under the tongue or the upper gums.” After healing, the higher frenum attachment allows patients to brush and perform other dental hygiene procedures with more ease and efficiency.

In conclusion, it is important to frequently perform “lip flips” at home to keep an eye out for any possible decay. If you are concerned that your little one is experiencing delays, we encourage you to make an appointment with your dental provider. Early intervention is important to prevent further delays or more extensive treatment.

Photo Credit: https://www.semanticscholar.org/paper…

Resources: https://www.broadsmilespdo.com/services/frenectomy-procedure/#:~:text=Tongue%20Tie%20Revisions-,Frenectomy%20refers%20to%20the%20procedure%20that%20removes%20the%20connective%20tissue,%2C%20eating%2C%20or%20orthodontic%20problems.