What the fren is a frenectomy? It doesn’t sound too friendly. In the ‘80s style dinner party game ‘Dictionary’ (later the board game ‘Balderdash’) a definite definition winner would be:

“A portmanteau of the word ‘friend’ (one with whom there is a bond of mutual affection) with the suffix ‘ectomy’  –  meaning to remove. A more sonorous synonym of the word ‘unfriended’: an original term referring to the severing of communications via the social media platform Facebook.”

A frenectomy is most certainly a severing  –  of the frenum. It is also known as the frenulum  –  a familiar term more associated with an intersecting band of tissue of the male anatomy.

For ease of purpose, the frena under discussion will be referred to as frenum rather than frenulum because the resultant confusion could be a Carry On best where a pendulum is introduced and hilarity ensues.

A frenectomy is indeed involves communications, being that it’s related to the mouth.

A frenectomy is an (apparently) simple procedure performed by a general dentist or oral surgeon to remove any one of the three connective frena of the mouth.

The lingual frenum is what attaches the base of the tongue to the floor of the mouth. As its name suggests, it’s related to speech. It ascribes the fluidity of the tongue in its gathering and organisation of patterns of movement necessary for word formation.

The tongue does all this while anchored to the floor. The difference the lingual frenum makes in terms of fine and precise articulation is the difference between watching Gene Kelly and Peter Garrett dance. Both are equally mesmeric as clear expressions of emotion and idea and definitely some find one more difficult to understand than the other.

‘Lingual frenum’ does sound like a ballet term in a pink pancake tutu, so it’s not a stretch to consider it a choreographer of the tongue.

The lingual frenum is the largest of the frena.

There is also the maxillary labial, as well as the mandibular frenum. Both connect the lip to the gum: the former the top; the latter the lower.

When any of these soft tissue stabilisers are too short, too long, too wide, too anything, they can cause speech problems, gaps in the teeth, and even gum issues.

How would you know if a frenectomy makes the short-list for someone? (Asking for an unsevered friend.) Leaning more towards a pass-the-bucket list than a bucket one is one person’s experience of the associated risks.

Their story admits to being never one to regularly see a doctor, and that probably extends to the dentist as well. They are 50-years-old with their share of issues (poor hearing and arthritic knees) and consider themselves mostly well.

It’s a perspective that seems a little restricted given that part of their narrative is the one of millions of Americans finding the only relief for chronic pain in opioids.

Anyway.

It was an unrelenting and encompassing tongue pain that throbbed and burned pain into eating and speaking that finally lead them to an oral surgeon.

The diagnosis was tongue-tie, or ankyloglossia  –  entertainingly ironic for someone with agonising fasciculations, struggling with pronunciation. It was a condition the patient had always had and never noticed because it had been asymptomatic until that point.

Typically, the lingual frenum separates before birth, sanctioning the tongue free-range movement. Tongue-tie has it short-tethered along the bottom of the tongue. Why this happens is largely unknown; although there are tongue-tie cases with certain genetic components.

In the original telling of this tale, the cock-eyed use of frenulum showed its ugly head: a risk foreseen and warned against here; even prior to having revealed this revealing reveal. Which strongly suggests psychotic powers may be involved.

So … this surgical removal of the frenulum was undertaken to relieve the tension on the tongue that was making someone’s life utter misery.

Allegedly, to an oral surgeon it’s “just a snip” in terms of process and complexity.

What it entailed was a long needle into the floor of the mouth, excruciating pain, an adult crying, a seemingly prolonged and unnerving sound of slicing, and then there were the sutures.

The routine follow-up care consisted of antibiotics, salt water rinses and narcotics for when the numbness wore off. Over days, came overbearing side effects from rounds of medications in order to treat the returned pain.

The surgeon’s colleague suggested an undissolved stitch as a usual suspect; its removal did nothing to remove the agony.

Eventually, the culprit was identified as neuropathy: nerve damage pain.

Neuropathic pain varies in source and mechanics, which is why successful treatment runs the gamut from precision medical intervention to pilates, paleo, meditation, mindfulness and mung beans.

Nerves do heal, and the pain disappears. However for some  –  the storyteller included  –  the outcome is a life-changing journey of chronic pain in addition to an un-remedied original condition.

A 2-for-1 from the menu you were never going to eat from.

And simply a cautionary tale. Applicable to any surgery or procedure that carries risks because they’re real.

Worldwide, between 3.5 and 5 per cent of the population give a tongue-tie first squawk on this planet. Were every one of those cases to have their ankyloglossia corrected, 4% would reattach.

Frenectomies correct tongue-ties, lip-ties and gum ties. They can be done by laser or surgery. It’s a procedure that ideally, should be performed a year before permanent teeth arrive; sometime between the ages of 5 and 7 to prevent any unnatural movement in the teeth, like an upper front gap from the maxillary labial frenum. 

For adults facing a frenectomy, take a friend. Tell them you’re getting lip service.

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