Tiny Texans Pediatric Dentistry

Frequently Asked Questions (FAQs): Frenectomies

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Finding the right pediatric dentist for your child is a big decision. We realize you will probably have a lot of questions to ask before you can decide which dentist is right for your family. At Tiny Texans Pediatric Dentistry, Dr. Christina and her entire team appreciate questions—and we look forward to providing you with answers.

There are some questions we tend to hear over and over, so we have compiled some of those here for your convenience. If you have a question that is not listed here, we invite you to give us a call. We look forward to discussing the dental needs of your little ones. 


Some hospitals will check newborns at birth for signs of a lip or tongue tie, others will not. The first symptom of a lip or tongue tie is usually difficult or abnormal pain with breastfeeding.

For older children, challenges with speech, eating and swallowing can be signs that there is a restrictive tongue frenum.  Sometimes you can see a large gap between the child’s two front teeth if the lip frenum attachment is too low, thick or tight. If you suspect your child may have a restrictive tie, it is best to schedule an evaluation with a training doctor immediately.


Dr. Christina Ramirez uses a soft tissue diode laser for Frenectomies. For newborns and infants, the patient is swaddled and has safety goggles placed to protect their eyes from any possible laser exposure. A small amount of topical anesthetic is placed along the tissue to be released before the laser is used. The procedure takes a few minutes for each area and the baby is returned to mom immediately after to breastfeed. Most mothers are able to feel a difference in the baby’s latch immediately.

For older children, patient cooperation is a huge factor and nitrous oxide or an oral sedative like versed may be used to help with the experience. Because the tissue is usually thicker at this age, a local anesthetic such as lidocaine is used to insure patient comfort during the Frenectomy.


The tissue that attaches any organ to nearby tissue to prevent it from flopping around is called frenum, or frenulum. There are several frenums in the mouth, the most prominent usually being the frenum under the tongue and upper lip. When the frenum attachment is too tight or short, it can restrict the movement of the tongue or lip. In young children, this can cause normal things like breastfeeding, talking, or swallowing to become more challenging.  A Frenectomy is the corrective procedure that releases the tension on the frenum allowing better movement of the tongue or lip. At Tiny Texans Pediatric Dentistry, Dr. Christina Ramirez uses a soft tissue laser to complete Frenectomies on newborns (from days old to 6 months) and children. The earlier the tie is released, the sooner the child can learn to use their lip and tongue correctly.  Lasers are believed to have better healing and less bleeding than using a scalpel or scissors.

Each child heals differently, but you can expect some soreness around the Frenectomy area for 3-7 days. We find that over the counter medications like ibuprofen (children over 6 months only) and acetaminophen work well for soreness and should be used as needed for pain. Arnica tablets and Rescue Remedy are also more holistic options to assist with the healing process. There is sometimes some slight swelling or bleeding  around the treat area that will revolve within first 24-48 hours. Stretches will be reviewed with you before your child’s Frenectomy is completed to assist with proper healing and minimize reattachment. These stretches will be done about 4-6 times a day for about 2 weeks. A follow up appointment will be scheduled with Dr. Christina Ramirez the week after the Frenectomy to make sure the site is healing correctly.

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