8 doctors weighed in:

Can frenectomy cause scarring? My 5-year-old daughter needs a labial frenectomy, but I am worried that it will cause scarring in the gap between her teeth. Should we wait until she’s older and gets braces?

8 doctors weighed in
Dr. S. Jay Bowman
Dentistry - Orthodontics
2 doctors agree

In brief: No and wait

A properly accomplished and conservative frenectomy will preserve the dental papillary gingival tissues without damage.
Prophylactic removal of the frenum at 5 typically does not result in spontaneous closure of the space. I recommend waiting until the space is to be closed to have the procedure. Then close it and hold it as the tissue is healing.

In brief: No and wait

A properly accomplished and conservative frenectomy will preserve the dental papillary gingival tissues without damage.
Prophylactic removal of the frenum at 5 typically does not result in spontaneous closure of the space. I recommend waiting until the space is to be closed to have the procedure. Then close it and hold it as the tissue is healing.
Dr. S. Jay Bowman
Dr. S. Jay Bowman
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1 comment
Dr. S. Jay Bowman
I prefer to have a frenectomy include the the tiny bundles of fibers between the 2 front teeth back to the incisive papilla. It is those fibers that cause the space to re-open, not the muscle under the lip. If space is closed first, those fibers cannot be addressed when procedure is done. Close the space immediately after.
Dr. Arnold Malerman
Dentistry - Orthodontics
1 doctor agrees

In brief: Please wait

I instruct my students to wait until the permanent teeth are ideally positioned before doing surgery.
Often as permanent teeth erupt they leave the frenum behind, eliminating the need for surgery. Sometimes the frenum requires surgery, but if done at wrong time can be a hinderance to properly positioning teeth, or can pop them apart again after they have been straightened. Ck w an orthodontist.

In brief: Please wait

I instruct my students to wait until the permanent teeth are ideally positioned before doing surgery.
Often as permanent teeth erupt they leave the frenum behind, eliminating the need for surgery. Sometimes the frenum requires surgery, but if done at wrong time can be a hinderance to properly positioning teeth, or can pop them apart again after they have been straightened. Ck w an orthodontist.
Dr. Arnold Malerman
Dr. Arnold Malerman
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Dr. Kenneth Grossman
Dentistry - Endodontics
1 doctor agrees

In brief: No scarring

This is a very minor surgical procedure .
It is accomplished in just a few minutes and heals by 1 wk usually. It can be done at any time or age. The one benefit of doing it now is that the central incisors will erupt without the variable of the muscle pull giving the orthodontist a true starting position. The disadvantage may be psychological on some 5 yr olds.

In brief: No scarring

This is a very minor surgical procedure .
It is accomplished in just a few minutes and heals by 1 wk usually. It can be done at any time or age. The one benefit of doing it now is that the central incisors will erupt without the variable of the muscle pull giving the orthodontist a true starting position. The disadvantage may be psychological on some 5 yr olds.
Dr. Kenneth Grossman
Dr. Kenneth Grossman
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3 comments
Dr. David Schleimer
It is a minor surgical procedure, albeit one that on occasion causes scarring. As an orthodontist (not GP or endo), I have to deal with the long term correction of median diastemas. It is rare to have scarring be an issue, but in my opinion it is best to close the dental spacing and then, only if needed, resect. Very often the tissue will atrophy and not be a problem, and thereby save the patient the surgery. Respectfully, I feel if you do not treat them yourself, your opinion is purely academic. I truly have no problem with you voicing your opinion, and obviously I have no compunction about providing a different opinion.
Dr. Kenneth Grossman
I value your opinion but I have done many la frenectomies in my career, and my opinion is not just academic. That being said, I agree w you! not debate who has done more , you or or I.
Dr. Samuel Barr
Dentistry
1 doctor agrees

In brief: The

The answer may depend on how high between the teeth the labial frenum is, and how thick it is.
A thick labial frenum can have muscle fibers in them. If this type of frenum runs up high between the upper front two teeth, then this muscle can indeed cause an orthodontic problem, and there is an argument for early removal. However, you are correct that removal can sometimes cause scarring. This scarring can then cause difficulty in keeping the two front teeth together once orthodontic treatment is completed. This scarring is usually not, however, a cosmetic concern. I would recommend that you have your child seen by the dentist you anticipate providing the orthodontic treatment. This is the dentist that would be best able to evaluate the condition and decide if the procedure done now would make his/her job easier down the road. And if the orthodontist's job is easier, then your child is better off!

In brief: The

The answer may depend on how high between the teeth the labial frenum is, and how thick it is.
A thick labial frenum can have muscle fibers in them. If this type of frenum runs up high between the upper front two teeth, then this muscle can indeed cause an orthodontic problem, and there is an argument for early removal. However, you are correct that removal can sometimes cause scarring. This scarring can then cause difficulty in keeping the two front teeth together once orthodontic treatment is completed. This scarring is usually not, however, a cosmetic concern. I would recommend that you have your child seen by the dentist you anticipate providing the orthodontic treatment. This is the dentist that would be best able to evaluate the condition and decide if the procedure done now would make his/her job easier down the road. And if the orthodontist's job is easier, then your child is better off!
Dr. Samuel Barr
Dr. Samuel Barr
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Dr. David Schleimer
Dentistry - Orthodontics

In brief: Wait

5 years of age is too early for the type of orthodontic intervention you may be contemplating.
Scarring does occur occasionally, and for that reason in my own practice i almost never have a frenectomy done until the space is closed. Then if scarring takes place it will not prevent closure of the gap.

In brief: Wait

5 years of age is too early for the type of orthodontic intervention you may be contemplating.
Scarring does occur occasionally, and for that reason in my own practice i almost never have a frenectomy done until the space is closed. Then if scarring takes place it will not prevent closure of the gap.
Dr. David Schleimer
Dr. David Schleimer
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2 comments
Dr. S. Jay Bowman
I prefer to have a frenectomy include the the tiny bundles of fibers between the 2 front teeth back to the incisive papilla. It is those fibers that cause the space to re-open, not the muscle under the lip. If space is closed first, those fibers cannot be addressed when procedure is done. Close the space immediately after.
Dr. David Schleimer
Dr. Bowman, what if by closure, atrophy ensues and negates the need for procedure? Is that not a good thing? I do understand your point, but I am unsure that I have seen it in my own practice. I like closing first. Generally all connective tissue fibers will atrophy if not enough space is allowed for them to exist. Just my 2 cents...
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