October 29, 2025, 10:05 a.m.
The Hospitalist Team
What is the difference between frenotomy and frenectomy?
If your child has a tongue tie or lip tie, you may hear the terms frenotomy and frenectomy. Both are procedures to release a frenum, the small fold of tissue in the mouth that can sometimes restrict movement. While the names sound similar, the procedures differ in scope and when they are recommended.
What is a frenum?
A frenum is a band of tissue that helps guide movement in the mouth, such as under the tongue (lingual frenum) or between the upper lip and gums (labial frenum). When the frenum is unusually short, thick, or tight, it can interfere with feeding, speech, and oral hygiene.
Frenotomy vs. frenectomy
- Frenotomy is a quick release of the tight tissue. It’s often performed on newborns or infants who have feeding challenges, and recovery is fast.
- Frenectomy is a more comprehensive procedure that removes or reshapes the frenum, often using surgical tools or a laser. It is typically performed on older children or when the frenum is thick, has reattached, or is affecting speech or dental development.
Which one does my child need?
The decision depends on your child’s age, symptoms, and the severity of the restriction. Infants with breastfeeding problems often benefit from a frenotomy. Older children who have speech delays, gum sensitivity, or orthodontic concerns may need a frenectomy. A pediatric dentist can evaluate both the anatomy of the frenum and how it functions to guide the choice.
Comfort and recovery
Both procedures are generally well tolerated. Infants recover quickly, while older children may need local anesthesia. Lasers are often used in frenectomies to reduce bleeding and speed healing.
When to schedule an evaluation
It’s worth seeing a pediatric dentist if your child:
- Has trouble breastfeeding, bottle-feeding, or speaking
- Has a visible thick or tight band of tissue under the tongue or lip
- Experiences discomfort while brushing or eating
- Has been referred by a pediatrician, lactation consultant, or orthodontist
Addressing tongue ties or lip ties early can make feeding, speech, and oral care easier. Whether a frenotomy or frenectomy is the right choice, both procedures are safe and effective ways to improve function and comfort for children.
