Frenuloplasty of the Upper Lip Frenulum in Children

The upper and lower lip frenula in children, also called the labial frenulum, allow the lips to lift and tilt, maintain proper muscle tone, and enable chewing and sucking. The upper lip frenulum is a triangular fold of mucous membrane that connects the inner surface of the upper lip to the gingiva of the upper jaw (more precisely, to the outer surface of the alveolar process). It is visible in a mirror when lifting the lip — this “frenulum” grows into the gum above the upper teeth and divides the upper vestibule of the mouth into right and left parts.

The upper lip frenulum can vary in shape, thickness, and attachment point to the gum. If it attaches about 4–6 mm above the interdental papilla (i.e., above the upper teeth), this is considered normal attachment to the mucosa or gingiva. However, if it connects to the interdental papilla itself (so-called papillary attachment) or even penetrates it (penetrating attachment), this is a developmental defect, more precisely, an abnormal frenulum attachment. Another condition affecting the upper lip frenulum is congenital hypertrophy, meaning excessive thickening caused by connective tissue overgrowth. Visually, a hypertrophied upper lip frenulum appears broad and fan-shaped. A much rarer abnormality is the underdevelopment or complete absence of the upper lip frenulum.

Upper lip frenulum release in children is a surgical intervention required to correct an excessively short, thick, or improperly attached frenulum.

An improperly formed frenulum can cause:

• difficulties with breastfeeding or bottle feeding (inefficient sucking)
• speech disorders in older children
• diastema (wide gap between the front teeth)
• increased risk of dental caries and gum inflammation
• cosmetic defects.

Various methods are used for upper lip frenuloplasty in children, depending on age, health condition, and individual characteristics. The most common methods are:

• Laser Frenuloplasty — a modern, painless method where the frenulum is cut with a laser beam under local anaesthesia. Advantages include no blood loss, rapid healing, and minimal risk of infection or complications.
• Electrocautery — the frenulum is cauterised using electric current under local anaesthesia. This method also provides haemostasis (bleeding control), but requires a longer recovery period and may cause some pain.
• Surgical Operation — the classic method where the frenulum is cut with scissors or a scalpel under general or local anaesthesia. This is used in complex cases of excessively thick or abnormally attached frenulum. Disadvantages include bleeding, sutures, scarring, and the risk of infection.

Upper lip frenuloplasty in children is a relatively simple and safe procedure that usually takes no more than 15 minutes.

After upper lip frenulum release, the following recommendations should be followed:

• treat the wound with antiseptics and apply healing-promoting ointments;
• avoid hot, acidic, spicy, and hard foods for several days;
• perform special exercises to stretch the frenulum and prevent tissue adhesion;
• visit the specialist for follow-up to monitor healing and assess results.

Upper lip frenulum release in children is a simple and completely safe procedure, usually without complications. Possible complications include post-procedure pain, fever, wound inflammation, severe bleeding, and scar formation (especially if the recommended exercises are not performed). Is this procedure suitable for every young patient? Not entirely. It should not be performed on infants with respiratory infections or blood clotting disorders. Schedule an appointment with one of our doctors. We understand how important your child’s health is, and we will do everything to help!