Do I need to trim a short frenulum of the upper lip in children and why
The elastic folds of the oral mucosa connecting the lips to the jaw are called bridles. There are two such jumpers - the lower and the upper. The third bridle is under the tongue, connecting it to the bottom of the oral cavity.
Normally, the folds of the oral mucosa do not interfere with speaking and chewing food. But there are a number of pathologies associated with their structure, which are accompanied by discomfort and can lead to impaired diction and occlusion. With the abnormal structure of the frenulum of the upper lip in a child or adult, it is trimmed.
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Is it necessary to trim a short bridle of the upper lip to the child
The bridle is considered defective if it is too short, wide, dense, improperly located or consists of two folds instead of one. Low fastening of the frenum to the lower or upper lip provokes the following complications:
-
Photo: a short bridle of the upper lip in a child
violation of the sucking reflex in infants;
- decay of deciduous teeth;
- speech defects and pathologies of the development of speech organs;
- discomfort while chewing food;
- the formation of gingival pockets in which plaque accumulates;
- exposure of tooth roots;
- increased sensitivity of enamel;
- increased risk of developing periodontal diseases: periodontal disease, periodontitis, gingivitis;
- tooth mobility;
- a change in the position of the dentition.
Too short and tight bridle is fraught with such problems:
- the formation of interdental diastema (gap);
- the inability to widen your lips and smile fully;
- speech impairment, distortion of pronunciation of sounds;
- malocclusion: due to the constant tension of the interdental papilla, the front teeth protrude strongly forward.
Why and when is a bridle trimmed
The doctor makes the decision that the child needs to cut the bridle only if there is evidence and only if conservative therapy is impossible or did not bring any result. The presence of even one sign indicating the abnormal structure of the elastic bridge between the lip and jaw is a sufficient reason to consult a doctor.
Photo: diastema between central incisors
Signs, in the presence of which you need to trim the bridle:
- The jumper is too small and the thickness is too large.
- Impossible full breastfeeding.
- Periodontitis begins to develop.
- An unaesthetic gap formed between the teeth - a diastema.
- Speech develops with obvious defects.
- The kid feels pain under his upper lip.
Why do children cut the bridle of the upper lip
Correction of the elastic bridge between the upper lip and jaw avoids the development of periodontal diseases. In most cases, anomalies in its structure lead to the development of gingivitis, periodontitis and hyperesthesia - increased sensitivity of enamel. Such pathologies are manifested due to the accumulation of plaque in the gingival pockets and are fraught with early tooth loss.
Why do children undercut the bridle of the lower lip
The pathological development of the folds of the oral mucosa located under the lower lip promotes the development of caries on milk teeth and the formation of gingival pockets, which can lead to the manifestation of inflammatory diseases. In addition, with such a defect, the area under the lip often hurts.
To correct the elastic bridge between the lower lip and jaw, in most cases, laser plastic is used.
At what age is better to trim the bridle
If signs are found that indicate non-standard development of the frenum, you should contact an orthodontist, speech therapist, neonatologist or periodontist. Surgeons and dentists are not involved in identifying indications for this operation, but they may advise you to consult your doctor.
The operation does not threaten the health of the child, so you should not put it off for the best period. In addition, if the defect is not eliminated by adolescence, a pathological change in occlusion may begin.
Plastic surgery of the folds of the mucous membrane of the oral cavity can be prescribed by a neonatologist if its defect prevents the full breastfeeding of the newborn. In this case, pruning is carried out at the age of 3-6 months. The nerve endings in such small children do not yet have sensitivity, so they are not hurt during surgery. After the procedure, neither the gums nor the lips hurt the babies.
If you do not trim the frenum in infancy, you will have to wait until the baby is 4 years old. The optimal age for the operation is 5–6 years.
To determine the most suitable period for trimming the bridle, the time of teething should be taken into account: by the time of the operation, the central incisors should be fully erupted, and the lateral ones should begin to erupt. Too early pruning is fraught with complications: there is a high probability of the jumper returning to its original position and damage during the operation of the anlage of the molars.
Ways to cut a short frenulum of the upper lip
Correction of the frenulum of the upper lip is carried out in two ways - by partial removal or by dissection and subsequent stitching to grow together in the anatomically correct position.
A pathologically formed bridle is prone to spontaneous rupture during falls and chewing of solid food. Therefore, if it is suspected of abnormal development, you should consult a doctor for diagnosis and surgical treatment.
The choice of a method for eliminating a pathology depends on its severity and type. Correction is carried out by surgery or using laser surgery. Each method has its advantages and indications for use.
Surgery
Surgical correction of the frenum is carried out using a scalpel under local infiltration anesthesia. Typically, dentists use Ultracain D-C-forte, containing epinephrine, for anesthesia, due to which the procedure is completely painless - only slight pressure is felt on the operating area. Before the procedure, it is necessary to pass a general analysis of urine and blood, to do coagulography and fluorography.
To change the width, length or position of the jumper between the upper lip and the jaw, the doctor performs its excision. Normally, slight bleeding may occur during surgery. Manipulation takes less than 30 minutes.
Within a few days after the procedure, a slight swelling of the soft tissues in the region of the upper lip is possible, bleeding and soreness may persist. Normally, complete wound healing takes 10–11 days. During this period, you must adhere to a diet, eat liquid foods of neutral temperature, perform antiseptic rinses and apply for speedy healing.
Depending on the type of defect of the frenulum, various types of surgical plastics are used:
- Frenuloplasty. It is carried out with a narrow fold of the oral mucosa, if you need a correction of its position and method of attachment.
- Phrenectomy.It is produced with a pathologically wide jumper, which is fraught with the accumulation of a large amount of plaque, which provokes the development of dental diseases of an inflammatory nature. In addition, the method of complete excision of the folds of the oral mucosa is used when it is damaged as a result of a fall.
- Frenotomy It is carried out if the fold is too narrow and is not attached to the edge of the alveolar process.
Photo: frenuloplasty
Laser plastic
The advantages of the laser method of frenulum plasty include bloodless operations, anesthesia with a cooling gel, the absence of postoperative edema and sutures, and quick healing. The patient is not hurt during or after the operation.
The disadvantage of laser frenum plastic surgery is its narrow focus - most anomalies can be corrected only with the help of classical surgery.
The duration of the procedure is only 3-5 minutes. The doctor with the help of the device directs a laser beam to the operated area of tissue, under the influence of which it dissolves. The edges of the resulting wound are disinfected and sealed. Neither during the operation, nor after it, the area under the upper lip does not hurt.
Abnormal development of the frenulum of the upper lip in adults
The bridle of the upper lip needs to be cut not only for children, but also for some adults. For example, before installing removable orthodontic structures, such an operation allows for reliable fixation of the prosthesis.
Usually, abnormalities in the structure of the elastic bridge between the upper lip and jaw occur in adults due to the carelessness of dentists and parents. But it is not worth worrying about a pathology that was not identified in time, since plastic bridle can be performed even in old age. Methods to eliminate the defect do not depend on the age of the patient.
