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Lingual Frenulectomy

A Lingual Frenulectomy (also called tongue-tie release or frenotomy) is a straightforward surgical procedure to divide an abnormally short, tight, or thick lingual frenulum — the band of tissue connecting the underside of the tongue to the floor of the mouth. When this band restricts the tongue’s normal range of movement, the condition is known as ankyloglossia, or tongue-tie.

The procedure can be performed in infants, children, and adults, depending on the clinical presentation and degree of functional impairment.

What is Tongue-Tie?

Tongue-tie occurs when the lingual frenulum is unusually short or tight, limiting the tongue’s ability to move freely. It ranges in severity from mild to complete. The impact depends on the degree of restriction and the patient’s age and functional needs.

Why is Lingual Frenulectomy Performed?

1. Breastfeeding Difficulties in Infants

  • A restricted tongue can prevent an infant from achieving an effective latch during breastfeeding, leading to poor feeding, inadequate weight gain, and maternal nipple pain or damage.
  • Early release of the frenulum can significantly improve feeding outcomes.

2. Speech Difficulties

  • In older children, tongue-tie may contribute to difficulty producing certain sounds — particularly “t”, “d”, “n”, “l”, “r”, and “s” — and may affect overall speech clarity.
  • A frenulectomy may be recommended alongside or following speech therapy assessment.

3. Oral Hygiene and Dental Problems

  • A tight frenulum can restrict the tongue’s ability to sweep food from the teeth, and may contribute to gum recessionat the lower front teeth.

4. Mechanical Restriction

  • Older children and adults may experience difficulty with eating (e.g. licking an ice cream, playing a wind instrument, or kissing) due to restricted tongue mobility.

What Happens During the Operation?

  1. In infants, the procedure can often be performed without general anaesthesia, using topical or local anaesthesia, and takes only a few minutes.
  2. In older children and adults, the procedure is performed under general anaesthesia with careful division or excision of the frenulum.
  3. Typical duration: 10–20 minutes.

Expected Recovery

  • Recovery is generally quick and well tolerated.
  • Mild discomfort and slight swelling under the tongue are expected and settle within a few days.
  • In infants, breastfeeding can usually be resumed immediately after the procedure.
  • In older patients, a short course of simple analgesia is usually sufficient.
  • Tongue exercises may be recommended post-operatively to maintain the improved range of movement and prevent re-attachment of the frenulum.