Treating Frenulum-Muscle Connections

Frenulum is the name of the tissue folds where lips, tongue and cheeks are connected to the gums. Every healthy human being has frenulum (tongue, lip, cheek connectors). They are classified regarding their level of adherence.

1. Mucosal: The connection that ends at the point where the tongue, lips and cheeks connect to the gums.

2. Gingival: The connection that is formed on the inner side of the gum lining.

3. Papillary: The connection that extends to the gums between teeth.

4. Papilla Penetration: The connection that goes through teeth and extends to the palate tissue.

When muscular connection is at a normal level there is no problem regarding teeth appearance and gum health, whereas when the muscular connection is amplified and near the gum limits, problems that cause teeth and gum diseases arise.

Teeth and gum diseases do not always root from a person’s feeble mouth maintenance or eating habits. Sometimes, these problems stem from physiology. The muscular connections, dubbed frenulum, are of great importance on this aspect.

 

ONE REASON BEHIND TEETH AND GUM DISEASES IS THE ANOMALOUS FRENULUM CONNECTIONS.

Teeth and gum diseases are not always caused by faulty mouth maintenance or eating habits. Gum withdrawal, spaced teeth and cavities that form despite a person’s extreme care are sometimes the aftermath of the anomalous connections of the tongue, cheek and lip muscles (Frenulum).

Every person has frenulum (tongue, lip, cheek connectors). Though, the classification of these connectors with respect to how they connect to the gums should provide a better understanding concerning what particular level of connection causes what level of problems.

1) Normal connection (MUCOSAL)

2) GINGIVAL, the muscle connection that connects to the top lining of gums.

3) The connection with the gum papillary between teeth.

4) The connection that extends from between teeth to the palate tissue.

1. In degree one mucosal connection that does not extend to a gum corner, food residues are not trapped easily as they slide away.

2. The muscular connection that overlaps the gingival limit of gums causes a “Withdrawal syndrome”. If the muscle connection is long, this affects 1-2 teeth. If the connection is in the middle of the upper frontal teeth, this may even cause spaced frontal teeth. In connections at degrees 3 or 4, spaced teeth are inevitable.

This is why the muscular connection should be tugged with hands to check if there is a white (stasis) appearance.

WHEN TO INTERVENE MUSCLE CONNECTIONS?

1) In the event of spaces between upper frontal teeth being caused by connections of the second, third or fourth degrees.

2) in the event of the frenulum that are connected to the gums pulling these gums back as a result of the movement of lips and cheeks, trapping food residues at that area.

3) the frenulum positioned to promote the gum pulling and the occurrence of gum pockets.

4) In order to facilitate the orthodontic therapy. (As frenulum cause spaced teeth)

5) If there is a frenulum connected to the gum tissue where the implant was applied, even after the treatment, as frenulum cause particular problems in teeth, there will be problems with the artificial teeth as well, so it should be intervened.

WHERE ARE FRENULUM PROBLEMS FOUND LARGELY IN THE MOUTH?

The problems regarding frenulum generally occur in the middle of the frontal central teeth, between lower central teeth, between molar teeth and hardly on the lower jaws, behind the tongue and frontal teeth.

WHAT PROBLEMS DO THEY CAUSE WHEN FRENULUM ARE LOCATED BETWEEN THE TONGUE AND TEETH?

There will be difficulty especially with the letters S, R and P while speaking. Actually, when it is noticed by their teacher that a person cannot pronounce certain sounds as they start elementary school and the first intervention is performed accordingly, there will not be a permanent speech impediment. However, for those for whom this impediment goes untouched the tongue fails to develop properly and there will be a permanent speech impediment.

THIS IS WHY WHEN A CHILD CANNOT PRODUCE CERTAIN SOUNDS WHEN S/HE IS ABLE TO READ, THEIR TONGUE CONNECTORS MUST BE CHECKED!

FRENULUM= (Treating muscle connectors)

As classified earlier, if the muscle connectors restrict movement, they should be removed to reduce the blockage. With the advancements in today’s dentistry technology, especially the wide muscle connector between the first two frontal teeth may be split with laser or with a scalpel to alleviate such problems.

For the cutting procedure, (a) LASER is used. In general, DIOTE LASER is relied on with this procedure. This is the option preferred by the doctors and the patients who do not wish to deal with bleeding or stitches. With a narrow-range anesthesia at the frenulum area, the frenulum is adjusted to have the shape it should have had in the beginning. A kind of bandaging is performed with the tip of the diode laser that accelerates healing.

(b) a scalpel is used. This is a triangular alleviation on where the frenulum joins the tissue. This method requires stitches. The sutures are removed a week later.

RESOURCES:

• TOKER H. , ÖZDEMİR H. İnternational journal of dental hygiene

• Fedi P.F. Ana hatlarıyla periodontoloji

• Baylas H. Mukogingival sorunlar ve cerrahisi des notları (2008)