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I have had several questions recently about frenectomies. When they are needed and when it should be done. I wanted to review a few basics about heavy frenum attachments and the timing of a frenectomy.

A frenectomy is the removal of the muscle attachment- usually between the front teeth. The one we see the most is between the upper front teeth.

A heavy frenum can contribute to a midline space, but may also contribute to gingival recession in some cases. A frenectomy is usually not needed until the space has been closed. In younger children a frenectomy is not indicated and should not be done until all of the permanent teeth have erupted. Often a space in an 8-year-old will close as teeth erupt. Doing a frenectomy in a younger patient could make it more difficult to close the space due to the scar tissue that may form. There are exceptions, of course where a very heavy frenum is painful or creating recession.

In patients with braces the frenectomy may be done after the space is closed- but it should be done prior to the removal of the braces.

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