As I was on my way to the dentist with my 12 year to see if a frenectomy was necessary (top front two teeth have big gap), I was trying to explain to my 3 year old (both girls) what they were going to be doing to "Sissy". When I lifted her lip, I realized SHE was the one with the potential for a frenectomy! The dentist confirmed this. Turns out, the 12 year old might not need one, but my three year old will (when she is the appropriate age).
Anyway, she also has a lisp that I am not yet certain is developmental or due to some sort of "structural" problem. Can frenectomies be done in young children? Please explain why or why not. Also, what is your knowledge of an "overgrown frenum" being at least a contributing factor to a lisp?
Dear Gabrielle,
Frenae (plural of frenum) are bands of muscle or tissue attaching the lips, cheeks, and tongue to the bone in the mouth. Because no significant functional problems are encountered when a frenectomy is completed, there appears to be a minimal role in the function of the tongue or muscles of facial expression.
For the upper front frenum, a should actually be postponed until the permanent lateral incisors and permanent canines erupt (permanent canines usually erupt about 11-13 years old). This recommendation is based on the fact that when the laterals and canines erupt, they will generally close the early diastema (space) between the permanent central incisors. If the diastema is not closed by normal eruption of the upper anterior permanent teeth, a frenectomy may be helpful, although orthodontics may also be necessary. The exception to postponing the frenectomy would be evidence on a radiograph of a notching in the bone between the central incisors. This radiographic evidence dictates the need for early excision of the frenum.
In my experience and reading, an upper frenum does not seem to affect speech patterns. On the other hand, the frenum which attaches the tongue to the lower arch may interfere with speech. Generally, this will become apparent as the child begins to form words and phrases. If a notching of the tongue is noted when the tongue is protruded, it is generally recommended to have the frenum excised when the child starts developing speech patterns. Speech therapy may also be required.
A consultation with a speech therapist may help to determine the cause of your daughter's lisp. Good luck and thanks for the good question.
