Laser Frenectomy vs Traditional Frenectomy: What Parents Should Know

When a parent is told their child has a tongue-tie or lip-tie, the immediate question is usually not whether to treat it, but how. Two very different techniques exist for performing a frenectomy—the procedure that releases a restrictive frenum—and the differences between them matter more than most parents realize. One uses a soft-tissue laser; the other uses a scalpel and sutures. Both accomplish the same anatomical goal, but the experience for your child, the recovery, and even the likelihood of certain complications can look quite different depending on which approach is used.

As a Yale-trained, board-certified periodontist who performs frenectomies on patients ranging from newborns to adults, I want to give parents a clear, honest comparison so you can ask the right questions and feel confident in the decision you make for your child.

What Is a Frenum—and When Does It Need Treatment?

A frenum (also called a frenulum) is a small fold of tissue that connects one structure in the mouth to another. Everyone has several of them. The two that cause the most problems are the lingual frenum, which connects the underside of the tongue to the floor of the mouth, and the labial frenum, which connects the upper lip to the gum above the front teeth.

When a frenum is too short, too thick, or too tight, it can restrict movement. A restrictive lingual frenum—commonly called a tongue-tie (ankyloglossia)—can interfere with breastfeeding in infants, and with speech, eating, and oral hygiene in older children. A restrictive labial frenum, or lip-tie, can prevent the upper lip from flanging properly during nursing and, in some children, contribute to a gap between the upper front teeth.

Not every frenum that looks prominent needs treatment. The key question is always whether it is causing a functional problem—difficulty nursing, a speech impediment, trouble clearing food from the teeth, or restricted tongue range of motion. A frenum that sits low or looks thick but causes no symptoms is often best left alone. When treatment is warranted, the procedure to release it is called a frenectomy, and this is where the choice between laser and traditional techniques comes in.

How a Laser Frenectomy Works

A laser frenectomy uses a concentrated beam of light energy—most commonly a diode laser or a CO2 laser—to vaporize the restrictive tissue. There is no blade, no cutting in the traditional sense, and in most cases no sutures. The laser simultaneously removes tissue and cauterizes blood vessels and nerve endings as it works, which means three practical things for the patient: significantly less bleeding, less post-operative pain, and a reduced risk of infection because the laser sterilizes the tissue as it passes through.

For infants, the entire procedure typically takes under two minutes. A topical anesthetic gel is applied to the tissue, the laser releases the frenum in a matter of seconds, and the baby can usually nurse immediately afterward. For older children and adults, a small amount of injectable local anesthetic may be used for comfort, but the procedure itself remains remarkably quick—usually five to ten minutes from start to finish.

Because there are no sutures, there is nothing to dissolve or remove later. The treatment site forms a white or yellowish healing patch (a fibrin clot) that resolves over the next one to two weeks. Parents are typically given a set of stretching exercises to perform on the healing site several times a day to prevent the tissue from reattaching as it heals.

How a Traditional Frenectomy Works

A traditional frenectomy uses a scalpel or surgical scissors to cut the frenum. The tissue is excised, the wound edges are sutured closed, and the area heals by primary intention—meaning the stitched edges grow together. This technique requires injectable local anesthesia in virtually all cases, including for young children, and for very young or anxious patients, sedation may be recommended.

The procedure itself takes somewhat longer than a laser approach, typically 15 to 30 minutes including anesthesia and suture placement. Bleeding during surgery is controlled with gauze pressure and, in some cases, electrocautery, but there is meaningfully more blood than with a laser approach. The sutures are usually absorbable, dissolving on their own over one to two weeks, though occasionally a follow-up visit is needed to remove them.

Recovery from a traditional frenectomy is generally longer and involves more discomfort. The sutured wound can be tender for several days, and swelling around the surgical site is common. Pain management typically involves over-the-counter medications, sometimes supplemented with a short course of prescription pain relief for older children or adults.

Side-by-Side Comparison

Here is how the two techniques compare across the factors that matter most to parents and patients:

When Each Technique Is Appropriate

For the majority of infant, child, and adult frenectomies, a laser approach is my preferred technique and the one I recommend most often. The combination of less bleeding, faster healing, minimal anesthesia requirements, and a simpler recovery makes it the better experience for patients—especially for infants and young children who cannot understand what is happening and for whom every minute of reduced procedure time matters.

That said, a traditional approach still has its place. There are specific clinical situations where a scalpel technique may be preferable or necessary:

• Very thick, fibrous frenums in older adolescents or adults where the tissue is dense enough that a laser may not release it completely in a single pass. A scalpel gives the surgeon more tactile control over tissue removal in these cases.
• Frenectomies combined with other surgical procedures, such as when a frenum release is performed alongside pediatric dental treatment that already requires general anesthesia, making the choice of instrument less impactful on the patient experience.
• Cases requiring tissue repositioning. When the frenum has created a recession defect on the gum tissue and the goal is not just to release the restriction but to reposition and suture the tissue into a new configuration, a scalpel approach with sutures gives more control over the final tissue architecture.
• Provider training and equipment. A laser frenectomy is only as good as the clinician performing it. If a provider does not have specific training and experience with soft-tissue lasers, a well-executed traditional frenectomy by an experienced surgeon is a better choice than a poorly executed laser procedure.

Why I Use a Laser for Most Frenectomies

In my practice at The Loft Dental Studio, the soft-tissue laser is my go-to instrument for frenectomies, and it has been for years. The reasons are practical rather than philosophical:

• Infant cooperation. A procedure that takes sixty seconds with a topical numbing gel is fundamentally different from one that takes twenty minutes with an injection. Babies tolerate the laser approach remarkably well, and most can nurse within minutes of the procedure—which is immediately reassuring for parents.
• Reduced bleeding. The cauterizing effect of the laser means the surgical field stays clean and visible throughout the procedure. There is less blood for the child to swallow, less bleeding for parents to manage at home, and a cleaner wound that is easier to perform stretches on during recovery.
• Faster parent-reported recovery. While individual experiences vary, the consistent feedback I hear from parents is that their child was back to normal faster after a laser frenectomy than they expected. Many infants are calm and feeding well within hours.
• Lower infection risk. The laser sterilizes as it cuts, creating a wound that is naturally more resistant to bacterial colonization. This is particularly relevant in the mouth of an infant or toddler, where keeping a surgical site clean is essentially impossible.

For the small percentage of cases where the anatomy or clinical situation calls for a traditional approach, I am equally comfortable performing a scalpel frenectomy with sutures. The decision is always based on what will produce the best result for the individual patient, not on a blanket preference. That is the advantage of seeing a specialist who is trained in both techniques and can choose the right tool for the specific situation. Our family dentistry team works closely with me to identify children who may benefit from evaluation.

What to Expect After a Frenectomy

Regardless of which technique is used, recovery from a frenectomy is generally straightforward. Here is what parents should expect:

• A white or yellow patch at the treatment site. This is normal healing tissue (a fibrin clot), not an infection. It typically appears within a day of the procedure and resolves over one to two weeks. Do not try to remove it.
• Mild fussiness in infants. Most babies are somewhat fussy for the first 24 to 48 hours. Infant acetaminophen (as directed by your pediatrician) is usually sufficient. Some babies are calm and feeding well within hours of the procedure.
• Stretching exercises are critical. The single most important thing parents can do after a frenectomy is perform the prescribed stretching exercises consistently, typically several times a day for about four weeks. These exercises prevent the healing tissue from reattaching in a way that recreates the restriction. Skipping stretches is the most common reason for a revision procedure.
• Feeding may change immediately—or gradually. Some infants latch better within the first nursing session after the procedure. Others take days or weeks to develop new muscle patterns, especially if they have been compensating for a restriction for months. Working with a lactation consultant before and after the procedure significantly improves outcomes.
• For older children and adults, soft foods for a few days and good oral hygiene are usually all that is needed. Avoid spicy, acidic, or very hot foods until the site has healed.

The Bottom Line for Parents

If your child has a tongue-tie or lip-tie that is causing functional problems—difficulty breastfeeding, speech issues, restricted tongue movement, or a gap between the front teeth—a frenectomy is a well-established, safe procedure that can make a meaningful difference. A laser approach offers less bleeding, faster healing, minimal anesthesia, and a simpler recovery for the majority of patients. A traditional approach remains appropriate for specific anatomical situations and is equally effective when performed by an experienced surgeon.

What matters most is not the instrument—it is the diagnosis. Not every prominent frenum needs treatment, and a proper evaluation by a specialist who sees these cases regularly is the best way to determine whether your child will benefit from a release. If you are considering a frenectomy for your child or have been referred by your pediatrician or lactation consultant, I am happy to evaluate the situation and give you an honest assessment of whether treatment is needed and which approach makes the most sense. Our pediatric dentistry page has more information about how we care for our youngest patients.