A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower). It connects the gum tissue and the inner aspect of the lip or tongue. If the attachment of a frenum is high or very tight, it can cause increased gum tissue recession, complicate orthodontic care, and even affect speech and eating in some cases.
A lack of attached gum tissue in conjunction with a high frenum can cause or worsen gingival recession. Additionally, an excessively large frenum can prevent the teeth from coming together properly as they develop or during corrective tooth movement, resulting in a gap between the front teeth. If the frenum is too large to allow the teeth to come together or prevents the healthy attachment of gum tissue to the teeth, the frenum is surgically released to correct this issue with a frenectomy. A frenectomy is simply the surgical removal of a frenum.
When orthodontic treatment is planned or initiated, the removal of an abnormal frenum, with or without a gum tissue graft, can increase stability and improve success of the final orthodontic result. If the frenum affects speech or eating, a frenectomy done at a young age may limit or eliminate any lasting complications.