A frenum is a thin attachment made of mucosa and connective tissues. It holds movable organs in place and keeps them functional. It can be of varying sizes like other parts of the human body. Diastema, or gaps between teeth, has been connected to its abnormalities, but those gaps can occur naturally.
In dentistry, frenum refers to lingual, labial, and buccal frena. They hold the tongue and the jaws in place and help us chew or speak without interference.
Frenum, or Frenulum?
Frenum and Frenulum are used synonymously in dentistry. Some, however, would like to call a small frenum a frenulum.
Frena is the plural of frenum. Similarly, frenula is the plural of frenulum.
Types of frena found in our mouth
There are three types of frena in our mouth: Lingual, Labial, and Buccal.
The lingual frenum is found under your tongue. It is the thin line of connective tissues that connects the bottom of your tongue to the floor of your mouth. It is also known as a submucosal band, midline mucosal fold, string, cord, or mast among professionals within the dental industry. 99.% of healthy children have a visible lingual frenum.
The labial frenum contributes to the movement of the tongue. However, how it limits that movement and when it needs to be surgically altered is still unknown.
There are two labial frenums in our mouths. They are Superior Labial Frenum and Inferior Labial Frenum.
1. Superior labial frenum
It is the small muscular band that works between the upper lip and the upper gum. It is also called the maxillary labial frenulum or lip frenulum.
2. Inferior labial frenum
Inferior labial frenum exists between the lower lip and the lower gum.
There are four buccal frena in our mouth. They connect the gums to the cheeks and contribute to keeping the jaws functional while talking or eating something.
How many frena or frenula are there in our mouth?
There are a total of seven frena or frenula in our mouth. They are:
- Lingual frenum: 1
- Labial frena: 2
- Buccal frena: 4
Can someone have two lingual frena?
Having more than one lingual frenum under your tongue is rare. But it is not impossible. It may be an irregularity among other human anatomical irregularities.
The Journal of Medical Case Reports featured a case in 2020 where a 10-year-old girl was found to have two frena connecting her tongue to the floor of her mouth.
What are the components of a frenum?
A frenum is composed of the following two components:
- Mucosa. It is the thin, moist tissues that line the inner part of your mouth. It contains mucus glands that produce saliva. In addition, it contains critical components of your immune system. Besides, it helps prevent germs from entering your body.
- Connective tissues. The tissues have a significant amount of elastic fibers in them. They consist of a protein called elastin and are yellow. Elastin provides connective tissues with strong extensibility so that they can be extended in all directions.
What is the function of a frenum?
- Both superior and inferior labial frena provide stability to the upper and lower lip, respectively.
- The lingual frenum helps secure the tongue in place.
- Buccal frena keep the jaws connected to the cheeks.
- Anatomically, they all contribute to your facial structure.
- They also help you talk and eat normally.
- A frenal abnormality may result in various issues, including gaps between teeth and dental diseases.
The disadvantages of having a frenum abnormality
First of all, an abnormal labial frenum can cause a midline diastem between your front teeth. However, it can be behind some other conditions such as the following:
- Brushing your teeth may be a real problem for you. The frenum will not allow you to place the brush at the proper level to brush your teeth comfortably.
- The frenum tissues may come off the back of your teeth while chewing or speaking resulting in gum recession.
- Frenum abnormality may form pockets of food, causing bacterial infection in the mouth.
- An abnormal frenum may interfere with your speech. Children may face difficulty articulating certain sounds around the age of three.
According to research, 57% of patients having a short frenulum displayed speech disorders.
An abnormal frenulum can also contribute to the following:
- Sleep disorder
- Jaw pain
- Shoulder pain
- Neck pain
- Misaligned teeth.
How do dentists treat frenal abnormalities?
Dental surgeons may use one of the following three specific techniques to remove a frenal attachment from your mouth:
- A simple surgical removal technique
- The Z-plasty technique. It does not require frenum removal.
- The localized vestibuloplasty technique. It involves the modification of the frenum, including its position.
The surgical removal of the frenum is called a frenectomy. It is usually a painless process and heals within a week. Your dentist may use local anesthesia to numb the frenum before removing it.
According to research published in Angle Orthodontist in the UK in 2022, three-quarters of orthodontists would consider frenectomy as a part of orthodontic treatment.
Should you surgically correct a frenum condition because you have gaps between teeth?
Having gaps between teeth is an oral condition called diastema. While diastema may be a normal dental condition, which you should not be afraid of, it has been connected to frenum abnormalities.
You should not correct your frenum surgically because of diastema. Diastema can be a product of also the following conditions or habits:
- Excessive thumb sucking
- Tongue thrusting
- Having additional teeth alongside your permanent teeth
- Cystic lesions
- Bone disorder
- Existence of a midline bony cleft
How to fix a frenum injury
Frenum injuries can happen when someone falls against a hard object with their mouth open. They generally happen to young children, especially those between 1 and 4 years old, and can concern parents. This is what you can do to control the situation:
- Flush the wound clean with ice-cold saline. If you do not have a saline solution at home, you can make some quickly. Boil a cup of water for about 15 minutes, cool it down, and add half a teaspoon of salt to it. Dissolve the salt, and your saline solution is ready to be used.
- Flush the wound thrice a day with an antiseptic mouthwash.
The wound will heal by itself in most cases. However, if it is deep, you may seek medical assistance. Medical treatment may include the following:
- Stitching. You may need interrupted stitching. It is a kind of stitching where individual stitches are disconnected. It is a standard stitching technique used to close wounds.
- Use of adhesives. Cyanoacrylates act fast and help reduce inflammation.
Can a frenum grow back?
A surgically removed frenum will not grow back. If your frenum is damaged because of interference or injury, hard tissues may form. As a result, your tongue may lose a part of its capacity to extend in all directions as required. That may affect how you speak or chew. There is a chance that the frenum will tear again.
Frenum: Facts to remember
- A frenum can be large or small and still be normal.
- A frenum may not be abnormal if you have gaps between your front teeth. The gaps between teeth may not be connected to your oral frena.
- Any abnormality in the frena may occur at irregular intervals.
- The number of frenal surgery has fallen in recent years. Dentists understand frena better now than before.
- If your frenum gets injured, it will heal without stitches.
- Frenectomy, or surgical removal of the frenum, does not hurt.
- The removal of a part of the frenum may improve your smile.
- Leonard B. Kaban, Maria J. Troulis. Pediatric Oral and Maxillofacial Surgery. 2004.
- National Cancer Institute. Accessed: 1 October 2022.
- Lingual frenulum: classification and speech interference. The International Journal of Orofacial Myology. Accessed: 1 October 2022.
- Policy on Management of the Frenulum in Pediatric Patients. The American Academy of Pediatric Dentistry. Accessed: 1 October 2022.
- John HyunBaek Ahna, Tim Newton, Catherine Campbella. Labial frenectomy: Current clinical practice of orthodontists in the United Kingdom. Angle Orthodontist. Accessed: 1 October 2022.
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