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A frenum or frenulum is a small fold of tissue which supports or restrains the motion of the part to which it is attached. The lingual frenum is a fold of tissue beneath the tongue and a labial frenum is a fold of tissue between the lip and the gum. Frenum is a normal part of the anatomy. If there is a variation in the anatomy of the frenum causing restriction in the movement of the lip or tongue and altering the desired function and development, surgical intervention may be indicated to release the restraint. For example, if a lingual frenum is too short, or attached inappropriately, it can restrict the movement of the tongue. This is commonly known as tongue-tie or ankyloglossia. In the upper lip, a thick or tightly attached frenum is known as a lip tie and it may be a contributing factor to restricted movement of the upper lip.
The tongue performs a wide range of movements that culminate in several functions. The symptoms of tongue tie can vary from mild to severe and may have multi-system impacts within the body. Literature has shown that untreated tongue tie may affect and contribute to problems in the following areas of development throughout life if left untreated:
Neonates and Infants
Children
Adults
At the time of writing there has not been a high-efficacy study investigating the functional consequences of an upper lip tie.
Clinical experience and case studies indicate that upper lip tie may:
Whilst the incidence and functional impact of upper lip tie remains relatively under-researched, it would be reasonable to assume a cautious approach in treatment and decision-making in infants, basing the approach on thorough individualised functional assessment. Labial frenectomy in the older child/teenager may be recommended and beneficial for dental/orthodontic reasons.