To begin a frenum, in the mouth, is a naturally occurring muscle and predominant tissue attachment seen between the two front teeth (either upper or lower). It connects the inner aspect of the lip with the gum. There is also what we call a lingual frenum and it attaches the tongue to the floor of the mouth and to the gum tissue just behind the lower two front teeth. Finally there is what we refer to as the buccal frena, which attach the cheeks to the gums.
Maxillary (upper): The upper frenum is the piece of skin seen that runs between the upper two front teeth and the lip. In certain cases this frenum becomes a problem of being too low in its attachment and/or too thick. If left alone, it can cause or help lead to, separation of the two front teeth. It may also help in causing gum recession in this area as well. If this frenum becomes a problem it must be removed or repositioned. This is also done many times prior to or after orthodontic tooth movement.
The lingual (tongue) frenum if abnormally present is the piece of skin attaching the tip of the tongue to the gum behind the lower front teeth. This is often referred to as “Tongue-Tie.” If present this needs to be removed as well in order for the tongue to have proper movement and in some cases for proper speech to develop. In yet other situations myofacial therapists will need this muscle released in order to get proper movement and again speech patterns.
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In either case Dr. Pick uses the carbon dioxide laser to remove frenum attachments. The laser is fabulous for this as with the laser there is no bleeding during and/or after the procedure, no suturing needed, minimal to absent swelling and scarring, almost no chance for recurrence and a decreased to complete absence of pain post-surgically! In addition due to the use of the laser surgical time is dramatically reduced. Because of these superb laser advantages over traditional scalpel surgery, the laser becomes a wonderful surgical instrument when used in children and young adults! Dr. Pick helped pioneer the use of lasers in dental surgery and his team at Northwestern in 1983 were the first ever in the world to do the carbon dioxide Laser Frenectomy technique and publish on it. Dr. Pick co-wrote the first textbook on the subject Lasers In Dentistry.