For RESEARCHERS

As with any surgical procedure, the immediate post-operative management and ongoing rehabilitation is paramount to achieving optimal clinical outcomes.

The tongue and lip have excellent blood supply and therefore heal extremely well usually over a 7 – 14 day period.  There is minimal discomfort after the frenectomy procedure. Analgesics or antibiotics are usually not required after frenectomy.

Following a frenectomy, the operative site will normally appear as a raw ulcer. This is normal. There may be slight oozing of blood, but generally this stops within an hour. During this time, compression over the wound with a gauze square may be used to address this.

For babies, it is encouraged to use breastmilk’s anti-infective and analgesic properties. Frozen breastmilk, boiled water ice chips, or drops of breastmilk to the frenectomy site as tolerated for the first 24hours following the procedure may minimise discomfort and swelling. Frequent breastfeeding is encouraged for all infants following the procedure. Cool fluids, cold food or ice chips to suck may assist to alleviate pain and swelling in children and adults. There is usually no need for analgesics, anti-inflammatory or antibiotic medications to be prescribed after routine surgery.   

Lip and tongue exercises and gentle massage are recommended to help prevent reattachment. A team management approach with rehabilitation professionals assists in designing a personalised rehabilitation program taking into account the individuals’ functional deficits.  Some people may experience tenderness or muscle fatigue in the tongue as they begin to use their tongue in a new way.  In infants, this fatigue may result in unsettled behavior, which passes within a few days and is usually alleviated with short, frequent feeding or usual settling measures. 

Some babies may take a number of weeks to ‘re-learn’ how to use their tongue and lip.  Help from an IBCLC lactation consultant, and/or speech pathologist is recommended to aid rehabilitation.  Even solely bottle fed babies require rehabilitation post procedure to optimize function.  Regular follow up appointments in the weeks after frenectomy with both speech pathology and lactation consultancy are important to achieve the best outcome for the infant.  Additional support offered by working with a physiotherapist, osteopath or chiropractor will help alleviate the compensations that the infant has made throughout their body in response to the abnormal pressures that the restriction/s have caused throughout attempts at normal function.  In some cases, the infant may need input from a dietitian and from an occupational therapist to address nutritional and functional issues around eating, as well as input from a general practitioner or paediatrician.

In older children and adults, the rehabilitation process may be much longer and involve more team members.  These individuals need to have rehabilitation that reflects their functional deficits and structural changes (e.g. eating problems, speech problems, saliva management, dental/orthodontic problems, airway problems etc).  Team members might include dietitians, occupational therapists, physiotherapists, speech pathologists, orofacial myologists, paediatric dentists, dentists, orthodontists, medical doctors, medical surgeons (e.g. ENT Surgeons, maxillary facial surgeons etc) and general practitioners/family physicians, chiropractor/osteopath as needed.