After a Frenectomy: Post-Op Instructions

A frenum is a vertical band of soft tissue between the upper and lower front teeth, connecting the inner aspect of the lip to the gum tissue around the teeth. There is also a frenum between the tongue and the gum tissue.

If a high frenal pull is observed, or the frenum is large, the consequences can include difficulty feeding (for babies), gum recession, gaps between the front teeth (diastemas), difficulty brushing teeth, speech problems, and uneven gum levels. In these cases a frenectomy can be performed to remove the soft tissue attachment.

Post-op instructions

1. Avoid sharp, spicy and acidic foods and drinks for the first 72 hours.
2. Discomfort is usually mild and can be managed with an over-the-counter medication such as children’s Tylenol. Follow the dosage instructions on the package.
3. Some oozing and very light bleeding from the site is normal for a couple of days after the procedure. It should stay mild.
4. A white soft scab will appear for the first 7 to 10 days while the site heals. This is not an infection. It is a covering over the healing tissue, and it is normal.
5. Infection is unlikely, but you are welcome to rinse gently with warm salt water (table salt in warm or room temperature water) over the surgical site.
6. For the first 24 hours, cold drinks, ice, freezies or popsicles can be applied gently to the site to help keep swelling down.
7. Brush normally, but be careful not to disturb the soft tissue while it heals.
8. By 7 to 10 days the tissue should be healed or mostly healed. If you have questions at any point, call us or come in for a follow-up so we can make sure everything is on track.

Keeping the site from reattaching

This is the part that decides whether the procedure holds.

The mouth heals fast. Left alone, the two edges of the release will knit back together, and the frenum can end up tight again. Gently separating those edges a few times a day keeps the site open while it heals.

How to do it

1. Wash your hands well and put on a clean glove.
2. Lift the lip up and away from the gum so you can see the site clearly. For a tongue frenectomy, lift the tongue up toward the roof of the mouth instead.
3. Sweep your finger along the site, side to side, staying in the groove of the release. The aim is to separate the edges, not to scrub. Do not try to remove the white patch.
4. Hold the lift for a few seconds, then release.
5. Repeat as directed below.

How often and for how long

• Start the day after the procedure.
• Three to four times a day.
• Continue for three weeks.

What is normal

• Some resistance, and some discomfort, especially in the first few days.
• A small amount of pink in the saliva during the first few days.
• The white patch staying in place. That is healing tissue, not something to clear away.

Doing the stretches shortly after a dose of pain medication makes the first few days much easier. For a child, being quick and matter-of-fact about it works better than a long build-up.