Frenectomy before braces or Invisalign?

Frenum and whether to address it during orthodontic treatment
Frenectomy before braces or Invisalign?
April 16, 2023

What is a frenum?

Frenectomy before braces or Invisalign? Let us first explain what a frenectomy is for. The frenum is the thick band of tissue that lies between the top front teeth and attaches from the gums to the upper lip. For most people, this attachment occurs above the teeth and is only seen if you stretch the upper lip out. However, occasionally this tissue grows down further and can lead to some changes in the teeth. Most notably, a low frenum can cause the front two teeth to grow in with a space between them that cannot close without help from braces or Invisalign

What is a frenectomy?

A frenectomy is when a dentist, orthodontist, or periodontist removes or clips the thick band of tissue that is between the upper front teeth. This can also be done on the frenum that attaches to the lower lip, although this is less common. 

When should I get a frenectomy, if necessary?

Generally, performing a frenectomy before orthodontic treatment is not necessary because braces or Invisalign will still be needed to close the space between the front teeth. Once the space is closed, we may decide the procedure isn’t necessary if it seems the frenum is no longer interfering with the position of the teeth. If it is determined that the frenectomy is necessary, it’s better to have the teeth in their final position because if scar tissue forms after the procedure, that can prevent the space from closing during treatment. 

How do we maintain space closure?

To be safe, a permanent retainer is often recommended after a diastema (space between the top front teeth) is closed and/or a frenectomy is performed. Even though the clear retainers do a great job at holding teeth in place, gaps between the top front teeth are notorious for wanting to creep back open during the day when you’re only wearing your retainer at night. A permanent retainer is a little metal wire behind the teeth that will ensure that space stays closed at all times. 

Do you have any more questions about frenectomies or your teeth? Let us know in the comments below! You can also reach out via phone/text at 704-782-5146, send us a message on TikTok or Instagram @bestorthonc, or reach out via our website here.

Dr. Best