Frenectomy or Not?

Updated on April 30, 2009
J.D. asks from Celina, TX
38 answers

Please help me Mommas! My 10 year old son's orthodontist has recommended a frenectomy. (this is the tissue that connects the lip to the gums. The ortho has said if we don't do the frenectomy his two front teeth could separate again after the braces come off. When we originally started orthodontics it didn't seem like a big deal. My son had to have some baby teeth removed before the expander went in. What a nightmare! Two hours into the extraction he still wasn't numb after several shots, topical numbing and nitrous gas he squeezed my thumbs and said just tell her(the dentist) to pull them mom! He never got numb and felt every tooth (4) come out! My husband had the same issue as a teen when he had to have teeth pulled (6) for his braces. He felt each one come out! I'm completely distraught over what to do! I don't want his teeth to move again. We have already spent $2500 so far and the frenectomy is another $1000. I can't bear to put him through this again but we already have so much invested. I have googled this as well only to be more confused. Please help guide us! Thanks!

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R.W.

answers from Dallas on

Not. Please get a second or even third opinion. We were to have a frenectomy and finally decided against it. Instead, we had a mini permenant retainer put on his front teeth on the back of the teeth. it works beautifully and when he's much older, he can choose to have the retainer removed. Even if his teeth shift a little, slightly spaced teeth can be a distinguishable and fun characteristic.

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S.M.

answers from Dallas on

I am no expert. Nor have I ever been to an orthodontist, but my brother has. The first one he went to, they told him he would have to have his wisdom teeth and this tonsils??? taken out before they could do anything with his teeth. My mom decided to take him for a second opinion and that ortho told them the other was crazy. I would say, if it doesn't sound right, get a second opinion! That's horrible about feeling his teeth getting pulled! I had the same problem when I had my wisdom teeth removed. It brings a whole new meaning to "It's like pulling teeth." Horrible! Good luck!

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R.R.

answers from Dallas on

One ortho recommended it for my 11 year old before she got braces. But, we went with another ortho who didn't say anything about it (price and we moved). After about 5 months of the braces (when her huge gap had closed)it started bleeding from that area. It fell out by itself. Odd, I know, but it broke up and slowly came off.

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T.F.

answers from Dallas on

I have never had the extensive work as your son but I do have a mouth that takes a LONG time to get numb and before anything can be done, they have to shoot me again. It is awful....a lot of dentist's do not understand that YES YOU CAN feel it.

With me, they use novacaine and marcaine together.

Another thing, I cut my foot badly and at the hospital I felt EVERY stitch. The Dr. working on me asked me if my mouth was hard to deaden....Of course I said yes and he said it is related to the rest of the body as well. Just a little FYI there.

Finally, as a child, I had a space between my 2 front teeth. I did not wear bracesat the time but a dentist wanted to do this procedure on me. After 2 other opinions, I did not have the prodedure because we were told that it would make my lip go higher hence giving me a very "gummy" smile. I modeled as a child and even occasionally now and the info we got was very important to us because it dealt with my overall look.

I am so glad my parents did not get the prcedure for me. When I was 25, I opted to get braces on my own. By that time, the space between my teeth had pretty much closed on its own. I wore braces for 2 yrs and I still have had no change.

On a personal note, I would not do it. However, he is your child and it is your decision to make. If you do, at least get another opinion.

Best wishes.

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J.S.

answers from Dallas on

They usually don't have a back wire for the top front teeth. It's probably better to do the surgery, so it won't mess up the work the braces has done. It sounds like you had a lousy dentist. Go to an oral surgeon to get this done. They can put your son under, so he won't feel a thing.

I had my wisdom teeth out that way, and I had a great experience. I've heard others who were not put under who had bad experiences. Yuck! I would want to be put under.

1 mom found this helpful

M.C.

answers from Dallas on

Hi...

I believe Frenectomy is important for social reasons especially in order to become a good kisser when it's time for that kind of intimacy... If it's not done now, he'll probably seek out someone in the future...

The younger you are the faster you heal from any kind of lesions...

It's important and if your MD's are recommending it... then I would do it...

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B.G.

answers from Dallas on

Just a comment from a Mom of 8,
A 10 year old boy still has a lot of growing to do, so his teeth are going to move any way. Boys don't reach their peak size until 16-18. Girls usually mature younger. I would definitely get a second opinion. I think 10 is too young to have braces anyway, boy or girl.
Just my opinion.........
Good luck and check with a different orthodontist.
Dr. Jay Ghosh in Allen is excellent.
B. G. (mother of 8, grandmother of 4)

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G.H.

answers from Dallas on

Hi Jane,

I haven't read all of your responses, so I hope I'm not repeating info you already have. Here's our situation: My now 5 year old son had a frenectomy at 3 1/2. In our case, it was pretty significant, and I didn't want it to affect his speech. After talking to others who were in my boat, our doctor and our dentist (who said he could do it in office), I opted to go to an ENT. We used Dr. Bauer at ENT for Children in Coppell. (I've heard good things about Dr. Murray as well.) They were able to put him under IV sedation in an outpatient surgery center. The surgery took no time at all, and the worst part of it was the pain immediately after the surgery. They gave him a little extra pain med before we left and he was fine on Motrin after that. Surgery was such a big decision for something that didn't seem like a big deal, but I would totally do it again for the benefits he now has. Hope all goes well!

G.

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R.H.

answers from Dallas on

*hugs* to your son, poor thing! i've had a lot of dental work done & i can imagine how horrible it must feel to not get good anesthesia. having said that, i can say some doctors have been better than others at patiently getting me numb - stopping if i feel something and only proceeding after numbness is regained. this takes time, yes, but it also takes skill. i've also been told that with my physiology, sometimes numbness in certain areas of my mouth takes luck too.
my suggestion would be to not go back to the same dentist that had trouble getting the baby teeth out - anxiety can be a factor for your son in terms of his pain as well as a factor in the dentist's work. maybe even going straight to an oral surgeon could save some money in the long run. and shop around - dentists should be able to tell you what they ordinarily charge for a frenectomy -- a few phone calls couldn't hurt!
HTH!

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C.G.

answers from Dallas on

Dear Jane,

My son has had braces and when it was time to take the braces off the teeth did seperate as we suspected it would. We did the surgery with a specialist and it was not a big deal. We didn't have numbing issues like you did. Since your child doesn't take the numbing medication well, maybe it would be in his best interest to be in a light sleep where he won't feel anything. Talk to the surgeon and discuss this option. Good luck and its worth the surgery as the teeth will then stay in place with his retainer.
C.

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B.B.

answers from Dallas on

$1000 seems high. Dr. Dula was only going to charge us $400, though we opted not to do that for our daughter. He gave us 50/50 odds that she would have a gap, though she didn't start out with one so we avoided the whole issue. My son ended up giving himself one when he got hit under his football helmet on the chin in practice one day. The mouthpiece protected his teeth but cut that tiny piece of skin! A second opinion is absolutely necessary. Good luck!

D.D.

answers from Dallas on

It is a very simple procedure done with a local anesthetic. He will have maybe one stitch to close. Our daughter had it done about 6 years ago. However, if you are uncomfortable with your current oral surgeon, then by all means search out a new one with whom you are more comfortable.

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S.T.

answers from Dallas on

My dentist has realized that my nerves in my face are not in the correct position. I need to get what he calls mini shots to make my face numb enough for the dentist to do work on my. The Frenectomy doctor should be able to do a good job of numbing the area. Don't go to a normal dentist. There are doctors who specialize in the surgery who also use plastic surgery techniques to make the scar minimal

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S.S.

answers from Wichita Falls on

They can bond a wire to the back of the teeth to keep them from moving. If your orthodontist didn't suggest it, I'd look for a second opinion.

S.

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M.S.

answers from Dallas on

Hi J.,

You have a lot of advice already. Let me add that my husband had braces put on 3 times as a teenager and the space between his front teeth came back every time. There are no other issues with his teeth - no crowding of the back teeth, no crooked teeth. The space is small and seems to have no impact on his dental health. And, of course, I think he is incredibly handsome.

A second opinion can give you a lot of comfort and help you make the best decision. I have a wonderful dentist in Arlington (Green Oaks and Pioneer Parkway). He does cosmetic work. He is very thorough, very respectful, and very professional. I am not into orthodontic work yet, but you could probably call his office and see if they could give you a consultation. His name is Dr. Thomas Whinery. Phone number ###-###-####

Good luck!
Peace and Joy,
M.

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L.W.

answers from Dallas on

get a second opinion.

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S.J.

answers from Dallas on

This runs in my family too. My sister, my brother, my cousins & my kids will have to have it too. Our dentist has already told me b/c it is so prominent. I can't speak about the previous numbing shots your son had, but I remember this being a very simple procedure. You'll have to have it done or he is right, the front teeth will never come together permanently. Speak with your dentist about your concerns & try NOT to be overly concerned in front of your son. Good luck.

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E.J.

answers from Dallas on

Hi! I am an orthodontist and if there is a space between the two front teeth prior to treatment and the frenum is low, I always recommend a frenectomy be done. However, this doesn't guarantee the space from slightly reopening. This procedure just greatly reduces the chances. For my patients I will suggest the frenectomy be done and then bond a small wire behind their upper two front teeth to make sure that space will stay closed. Hope this helps!

E.C.

answers from Dallas on

My son had the same problem, and just had this procedure done. He got the numbing shots, and laughing gas. (They worked wonders for him.)

It was a quick procedure - about 10 minutes. And, yes, it kept his front teeth from seperating again. And his would seperate FAST without the procedure.

Afterward, he was in a lot of pain. His lip was swollen, and it hurt to eat, talk, and laugh for about three days.

I didn't want him to have the procedure done; but I am glad we went ahead and did it. You don't want to waste all the money you spent to make his teeth look good!!

By the way - I read some of the other responses, and I will tell you they TRIED to put a wire on the back of my son's front teeth. It popped off within a day because his teeth parted so quickly! Maybe you could try this and see if it would work for your son before have the procedure done...

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C.E.

answers from Dallas on

I am slow to numb as well, but not to that extent. I would look into having an oral surgeon perform the procedure rather than the dentist. They can give him an intravenous anesthesia and can monitor him more closely. My son had his wisdom teeth extracted at the oral surgeons office and was totally knocked out during the procedure. Of course, you can expect some discomfort for a day or two, but it will be worth it in the end.

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S.R.

answers from Dallas on

I have no idea about the procedure itself, but I had a very bad experience with the dentist (two root canals done with no pain meds) when I was a teenager and I don't like going at all now. I can tell you that your dentist can prescribe a pill that you take an hour before your appointment and in most cases they don't even remember ever going to the dentist. In my case, my fears are so deeply rooted that I can remember details about the visit and some conversations that people had, but the procedures themselves aren't that clear. I had no pain and don't mind going to the dentist as long as I can take the pill called Halcion. Maybe this helps you in the area of knowing your child won't be in pain if you do have this procedure done.

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L.A.

answers from Dallas on

Hi, I had this procedure done 35 years ago when I was 12....I remember it being a little unpleasant at the time...but the orthodontist told my Mom that if that did not come out that the braces on my front teeth would do no good as the skin acted like a rubber band and between my teeth and they would separate again. I am so glad they went ahead and did it...my teeth are now perfect and I never had a separation problem....and I am sure they have way perfected the prodecure now....they literally burned out the skin between the teeth up to the where the lip attaches with what look like a ball point pin connected to a wire that was very hot on the end...I do remember the smell of burning skin vividly...but the recoup time was minimal...they packed between my lips and gums with some kind of material and I had to wash that out regularly to discourage infection...but I do not remember it being a bad experience....hope this helps....

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H.J.

answers from Dallas on

We are going to Baylor College of Dentistry. Yes, they are students but supervised by very good teachers. One of my son is a patient in pediatric orthodontic department and he loves it there. They also have a perio department where they do their surgery. I had a gum tissue graph a few years ago and I save a LOT of money! The phone number for the perio department is ###-###-####. Don't hesitate to email me if you want more info [email protected]____.com
Good luck!

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D.C.

answers from Austin on

Hi Jane,
What a horrendous experience you and your son have had. I wouldn't wish that on anybody!

Re: your question, I don't have any experience in this. BUT, I can tell you that I would ALWAYS seek out a 2nd or even 3rd opinion if I was questioning what a doctor told me.

I hope everything works out for you!
D.

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K.H.

answers from Dallas on

Hi there....my daughter had the same issue. And because my sister had the same issue and chose not to do the frenectomy and her teeth have gapped again, I chose to do the procedure. I have a very finicky young lady and she did just fine. Yes, there was a bit of pain and swelling but it went away in 24 hours with ice and advil.

We also had our pediatric dentist to do it, and it basically cost me a copay. She was so much less expensive and my daughter had a great experience. If your pediatric dentist doesn't do it, I can recommend mine, because my friend paid the price you are talking about and her daughter faired no better than my daughter. We have been seeing our dentist for 7 years and trust her completely.

It's funny in my family, I have had the tongue clipped when I got my braces, my youngest daughter had her tongue clipped as an infant (at my request) and my sister's baby also had to have her tongue clipped as she couldn't nurse well.
Everyone did just fine and is no worse for the wear.

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M.C.

answers from Dallas on

I had a similar situation when I was an adolescent: one ortho said I needed the frenectomy, and a second said I did not. We went with the second. My parents spent $1500 (in the 80's), I spent two years in braces, more with a retainer, and the space between my two front teeth did, indeed, come back permanently. That being said, it doesn't bother me at all--if it's good enough for Madonna and Lauren Hutton, it's good enough for me! LOL! However, if I had it to do over again, knowing what I do now--I'd actually just not do the braces at all. I didn't have any other issues, besides the space. If your son has crowding or other issues, the braces may still be necessary. So here's, basically, what you should consider: you need the frenectomy if you want the space to go away permanently. If you're okay with the space, then don't bother. For the past 20 years I've had dentists trying to give me invisalign, bonding material, etc to get rid of a "cosmetic issue" which I don't think is an issue. So take this into consideration, and do what you think is right!

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J.T.

answers from Dallas on

This may or may not make you feel any better, but the orthodontist told my parents the same thing. I had a HUGE space between my front teeth and he said that surgery was the only way to correct it. My parents opted not to do it and my teeth look just fine. They didn't separate again and I'm almost 36 now, got my braces off when I was 16. I'm glad I didn't have to have the surgery.

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L.P.

answers from Amarillo on

First let me say I do not get numb either unless they do a nerve block, And before yo look this up and hear the horror stories yes I had facial numbing for about 4 months after but all went back to normal. I have a 4 yo that they actually had to sedate to extract a broken tooth. Ask the doctor about using nocktec before the appointment and then numbing with a local this is how we did my daughters. If the skin is thick and goes to the bottom of the gum line then it will pull and cause the seperation. HAve you asked your pedi about it? may be worth the visit and he/she may have some alternate recommendations for either the surgery or the numbing process. Good Luck

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E.C.

answers from Dallas on

Get a second opinion. Then if he does need the frenectomy, do it under IV sedation. My son's dentist told me that he needed major jaw reconstructive surgery because his back teeth didn't touch when he closed his mouth. Nobody had ever told me of this problem before and I was in shock. I took him for his consultation at the orthodontist and they used a device to spread his palet and he didn't need any surgery. So I would get a second opinion before going any further.

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J.D.

answers from Dallas on

Not sure who your ortho is, but I would get a second opinion. Our kids go to Dr. Richard McFarland and they are 2nd generation patients, (Dad, Aunt and Uncle used him in the 80's). His main office is in Flower Mound and a smaller office is in The Colony. The office number is ###-###-####.
Good luck!
Jen D.-Frisco

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L.P.

answers from Dallas on

My daughter had the same thing - there was a gap in between her two front teeth. When she was a child, her dentist told me that braces could not correct this problem and she would need the same procedure your ortho is telling you to have. Her teeth were otherwise straight so we opted to not have the surgery. As a teenager, the gap started bothering her. I took her to an orthodontist and she wore braces for 8 months. She just got them off and the gap is closed. She is going to be wearing a regular retainter, but having one bonded to the back of her teeth is an option if the gap starts opening up again. I would seek a second opinion. My ortho is Dr Dyer in Grapevine and they are great!

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C.M.

answers from Dallas on

Hi Jane,
Our daughter had to have a frenectomy for the very same reason. She was 9 years old at that time. It turned out to be a very quick and painless procedure (though she was EXTREMELY nervous!). We used Dr. Sunie Marchbanks in McKinney. She & her staff helped our daughter through the process. They were very kind and professional. It's been 3 years since having her frenectomy and she just completed her final phase of braces. They came off in March and she is sporting a beautiful smile - without a gap!
Best of luck!
C.

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J.H.

answers from Amarillo on

Research it or get a second opinion, If his bite would still be fine, and he just had a little gap I see no problem. Sometimes after their wisdom teeth come in the gap closes, or makes the teeth get really close. You even see modles with little gaps in their front teeth.

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K.J.

answers from Dallas on

This is going to be a vague answer, but it might ring a bell with someone reading this or the doctor. My sister had the same piece of thick skin between her 2 front teeth. Instead of opting to get it cut, the doctor put a permanent retainer behind her 2 front teeth. When I say retainer, I mean a single wire that is connected to the back of each tooth that holds the 2 teeth together. The cool thing is that it is a jagged look , so she can floss--the wire goes up and down. Can you picture that? Anyway, whenever I tell anyone about this, they have never heard of such a thing! By the way, she had the same thing, as far as the numbing medication not working when she had cavities filled, etc. An epidural didn't work when she had a baby, too! Yikes.
K.

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K.B.

answers from Dallas on

I am so sorry your little guy has had such a horrible experience! I had the frenectomy done years ago before I had my braces. My tissue was separating my two front teeth and I had the "gap" caused by this. I remember having the procedure done, and had no problems or severe pain. At the time, I had to go back to have the stitches removed (which was no biggie)but I don't know if they still do it that way or if they now use the dissolving stitches. I no longer have the gap and am very glad I had this done. I would certainly be sure the dr. who does this is aware of your son's problem with anesthesia so that won't happen again. Best of luck with whatever you decide!

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T.W.

answers from Dallas on

i was about your son's age when i had this, or something similiar done. what i remember is they had to remove the muscle between my two front teeth. it was too big and created a large gap. i remember it was uncomfortable and was painful to take the stitches out, i had an unsimpathetic nurse, but that is all i recall. the mouth heals quickly so i dont think i was in pain for too long. i hope this helps!

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S.R.

answers from Dallas on

I have no idea... but, I would get a second opinion just to have another professional's opinion. This might help in your decision making. Also, if surgery is needed could you not try and have this so he can be sedated in a hospital setting to give him more comfort ? Good luck.

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H.M.

answers from Dallas on

I haven't read all the responses but I am going to respond as a dental professional. We do a lot of these procedures but with a laser. I am not sure what technique your particular office was planning on using but the laser makes it easier in terms of cauterizing the tissue to help with blood clotting and even healing time is quicker. I see a lot of patients, including myself, that does have a bonded retainer that goes on the tongue side of the teeth. This helps tremendously but it does make it harder to keep clean because you have to use floss threaders to be able to floss. On the other hand, some patients that only wear the removeable type retainer tend to forget to wear them and their teeth move because of it. I have seen a few patients that do have the bonded retainer and there teeth have moved some anyways. The frenum is a muscle and it can definitely cause teeth to move. I wouldn't be so fearful of this procedure but I can understand the fact that if he wasn't numb, then it would be a very bad procedure no matter what is being done in the mouth. We have had some patients that have difficulty getting numb but you use a different type of anesthetic or see if they can IV sedate him. There are usually ways around this to help get the patient comfortable to do a dental procedure. Hope this helps and good luck!

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