A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower). It connects the inner aspect of the lip with the gum. A lack of attached gingiva, in conjunction with a high (closer to the biting surface) frenum attachment, which exaggerates the pull on the gum margin, can result in recession. Additionally, an excessively large frenum can prevent the teeth from coming together resulting in a gap between the front teeth. If pulling is seen or the frenum is too large to allow the teeth to come together, the frenum is surgically released from the gum with a frenectomy. A frenectomy is simply the surgical removal of a frenum with either a blade or a laser.
This is can be especially important with orthodontic treatment, either before or after. The removal of an abnormal frenum, with or without a gingival graft, can increase stability and improve success of the final orthodontic result. Often, an abnormally strong frenum can pull teeth apart, causing gaps to reappear after orthodontics is completed. This means the patient may need to go back into braces to pull the teeth back together. If the orthodontist suspects this may be a problem, they will usually refer the patient to a periodontist to remove the frenum just before or after the braces are removed.