Laser frenectomy by board-certified periodontist Dr. Chanook David Ahn. Minimally invasive tongue tie and lip tie release for infants, children, and adults. Located in the South Coast Metro area, serving Costa Mesa, Irvine, Newport Beach, Santa Ana, and Tustin.
A frenectomy is a minor surgical procedure that removes or releases a frenulum, which is a small fold of tissue that connects the lips, tongue, or cheeks to the jawbone. When a frenulum is too short, thick, or tight, it can restrict the normal movement of the tongue or lips and lead to functional problems including difficulty breastfeeding, speech impairment, gum recession, and gaps between teeth. A frenectomy releases this restrictive tissue to restore full range of motion and eliminate the problems it causes.
There are several frenula in the mouth, but two are most commonly involved in clinical problems. The lingual frenulum connects the underside of the tongue to the floor of the mouth. When this frenulum is too short or tight, the condition is called ankyloglossia, commonly known as tongue tie. The labial frenulum connects the inside of the upper lip to the gum tissue above the upper front teeth. When this frenulum is too thick or attaches too low on the gum, it is referred to as a lip tie. Both conditions can be corrected with a frenectomy.
A third frenulum, the buccal frenulum, connects the inner cheek to the gum tissue near the premolars. While less commonly problematic, a tight buccal frenulum can contribute to food trapping, difficulty with oral hygiene, and localized gum recession. Dr. Ahn evaluates all frenal attachments during periodontal examinations and recommends treatment when a frenulum is contributing to functional or periodontal problems.
Tongue tie, or ankyloglossia, occurs when the lingual frenulum is abnormally short, thick, or tight, restricting the tongue's ability to move freely. The condition affects an estimated 4 to 11 percent of newborns, with males affected approximately twice as often as females. Tongue tie ranges in severity from mild restriction to near-complete fusion of the tongue to the floor of the mouth, and its clinical impact depends on the degree of restriction and the demands placed on tongue function.
Several classification systems exist for tongue tie. The Kotlow classification measures the length of free tongue from the tip to the point of frenal insertion, grading severity from Class I (mild, 12 to 16 millimeters of free tongue) to Class IV (complete, less than 3 millimeters of free tongue). The Coryllos classification categorizes tongue ties by the location of frenal attachment, from Type 1 (attached at the tongue tip) to Type 4 (a posterior or submucosal tie that is not always visible on casual examination but significantly restricts tongue elevation). Dr. Ahn evaluates tongue tie by assessing both the anatomical attachment and, more importantly, the functional limitation it creates.
A lip tie occurs when the upper labial frenulum, the band of tissue connecting the inside of the upper lip to the gum tissue above the upper front teeth, is abnormally thick, tight, or attaches too close to the teeth. Like tongue tie, lip tie varies in severity from mild to severe and can cause functional and dental problems at every age.
In infants, an upper lip tie can prevent the upper lip from flanging outward during breastfeeding, which is necessary for a proper seal around the areola. This can result in an inefficient latch, air swallowing (leading to excessive gas and fussiness), and the same breastfeeding challenges associated with tongue tie. Many infants with breastfeeding difficulties have both a tongue tie and a lip tie, and both may need to be addressed for breastfeeding to improve.
In children and adolescents, a thick or low-attaching upper labial frenulum is one of the most common causes of a diastema, which is a gap between the upper front teeth. Orthodontists often refer patients for a labial frenectomy before or during orthodontic treatment to allow the gap to close and prevent it from reopening after braces are removed. The ideal timing for a labial frenectomy in children is typically after the permanent upper canine teeth have erupted, around age 11 to 12, because the natural eruption of canines can sometimes close the gap without intervention.
In adults, a prominent labial frenulum can interfere with the fit and retention of upper dentures by creating a notch in the denture border. It can also contribute to gum recession on the facial surface of the upper front teeth by pulling the gum tissue away from the tooth when the lip moves. A frenectomy in these cases improves both denture stability and periodontal health.
A frenectomy is recommended when a restrictive frenulum is causing or contributing to a functional, developmental, or periodontal problem. Not every person with a short or tight frenulum requires treatment. The decision is based on whether the frenulum is causing symptoms or complications, not simply on its appearance.
Infants are evaluated for frenectomy when breastfeeding difficulties cannot be resolved with lactation support alone. A tongue tie or lip tie evaluation should be part of any comprehensive breastfeeding assessment when an infant has difficulty latching, feeds for extended periods without adequate weight gain, or when the mother experiences persistent nipple pain despite correct positioning. Early intervention can preserve the breastfeeding relationship and support healthy infant development.
Children may be referred for a frenectomy by a speech-language pathologist when tongue tie is identified as a contributing factor to speech difficulties, or by an orthodontist when a labial frenulum is preventing gap closure or is expected to cause orthodontic relapse after treatment. Pediatric dentists also identify frenal problems during routine dental examinations.
In adult patients, frenectomies are most commonly performed by periodontists as part of comprehensive periodontal care. A tight lingual frenulum that pulls on the gum tissue of the lower front teeth can cause localized gum recession that worsens over time. Releasing the frenulum removes the mechanical tension on the tissue and is often performed in conjunction with gum grafting to restore lost tissue. Adults may also seek frenectomy for speech improvement, orthodontic relapse prevention, improved denture fit, or resolution of lifelong functional limitations.
As a periodontist, I see firsthand how a tight frenulum can damage gum tissue over years of constant pulling. Many patients come to me with gum recession on their lower front teeth that is directly caused by a restrictive lingual frenulum. Releasing the frenulum is a critical first step before gum grafting, because without addressing the root cause, the recession is likely to recur. I also perform frenectomies for orthodontic patients, infants with breastfeeding difficulties, and adults who want to improve speech or oral function. The laser frenectomy is one of the quickest and most rewarding procedures I perform because patients experience immediate improvement in tongue or lip mobility.
Frenectomies can be performed using traditional surgical instruments (scalpel or scissors) or with a dental laser. Dr. Ahn performs laser frenectomies at The Loft Dental Studio because the laser offers significant advantages in precision, comfort, and healing for patients of all ages.
The laser vaporizes the restrictive frenal tissue with precision, sealing blood vessels and nerve endings as it works. This results in a virtually bloodless procedure with reduced post-operative pain and faster healing. For infants, the reduced bleeding and faster procedure time mean less stress for both the baby and the parents. For adults, the laser approach means a quicker return to normal eating and speaking.
Every frenectomy begins with a thorough examination. Dr. Ahn evaluates the location, thickness, and attachment point of the frenulum, assesses the degree of functional restriction it causes, and discusses the patient's symptoms and treatment goals. For infants, this includes observing feeding behavior and assessing latch quality when possible. For adults, Dr. Ahn evaluates the relationship between the frenulum and any gum recession, spacing, or periodontal concerns.
For infants, a topical numbing gel is applied to the frenulum before the procedure. The quick nature of the laser release often means no injection is necessary. For older children and adults, local anesthesia is administered with a small injection to completely numb the area. The injection itself is preceded by topical numbing gel to minimize discomfort. Sedation options including nitrous oxide are available for anxious patients.
The laser frenectomy itself takes approximately 10 to 15 minutes. Dr. Ahn uses the dental laser to precisely vaporize the restrictive frenal tissue, releasing the tongue or lip from its restricted position. The laser energy simultaneously cauterizes the tissue, resulting in minimal to no bleeding. Patients and parents often comment on how quickly and simply the procedure is completed. Immediately after the release, there is a noticeable improvement in range of motion. Infants with tongue tie often show improved tongue elevation within seconds, and many are able to breastfeed with a better latch immediately after the procedure.
Dr. Ahn provides detailed post-operative instructions tailored to the patient's age. The most important component of aftercare is stretching exercises to prevent the released tissue from reattaching during healing. For infants, parents are taught to gently sweep under the tongue and under the upper lip several times daily. For older children and adults, specific tongue exercises are prescribed to maintain the new range of motion and strengthen tongue muscles that may have been underused due to the restriction.
Recovery from a laser frenectomy is remarkably quick compared to most oral surgical procedures. The laser's ability to cauterize and sterilize tissue as it works means less inflammation, less bleeding, and faster healing than traditional surgical techniques.
Dr. Ahn schedules a follow-up appointment, typically one to two weeks after the procedure, to assess healing, check for any reattachment, and ensure that stretching exercises are being performed correctly. Additional follow-up may be scheduled as needed based on the patient's progress.
Why a Periodontist for Your Frenectomy: As a periodontist, Dr. Ahn has specialized training in the soft tissue anatomy of the mouth. This expertise allows him to perform precise frenectomies that release restrictive tissue while preserving surrounding structures and promoting optimal healing. His understanding of how frenal attachments affect gum health makes him uniquely qualified to address the periodontal implications of tongue ties and lip ties in patients of all ages.
Whether for your infant, child, or yourself, Dr. Ahn can evaluate your tongue tie or lip tie and discuss treatment options. Quick, comfortable, and effective laser frenectomy in Costa Mesa.
Call (714) 549-7030The cost of a frenectomy varies depending on the complexity of the case and the patient's age. Laser frenectomy is generally an affordable procedure, and many patients are pleasantly surprised by the modest cost relative to the significant functional improvement it provides.
Many PPO dental insurance plans cover frenectomy procedures, particularly when performed for documented functional reasons such as breastfeeding difficulties, speech impairment, or periodontal health. Medical insurance may also provide coverage when the procedure is deemed medically necessary. Coverage and out-of-pocket costs vary by plan.
PPO Plans We Accept: Delta Dental, Cigna, MetLife, Guardian, Aetna, United Healthcare, and Blue Cross Blue Shield.
We offer financing through CareCredit, which provides low-interest and interest-free payment plans. FSA (Flexible Spending Account) and HSA (Health Savings Account) funds are also accepted, allowing you to pay with pre-tax dollars. For more details, visit our Insurance & Payment page.
A frenectomy can be performed at virtually any age, from newborn infants to adults. For infants with tongue tie or lip tie that is interfering with breastfeeding, the procedure can be performed within the first few weeks of life. Pediatric dentists and ENT specialists sometimes perform frenotomies (a simpler snip procedure) on newborns, while a more definitive laser frenectomy can be performed once the infant is a few weeks old. For children, frenectomies are commonly performed between ages 4 and 12 when speech concerns arise or before orthodontic treatment begins. Adults can have a frenectomy at any age, and it is frequently performed by periodontists like Dr. Ahn when a tight frenulum is contributing to gum recession or periodontal problems.
A laser frenectomy is one of the least painful procedures in dentistry. For infants, topical numbing gel is applied to the area, and the laser procedure takes only a few minutes. Most infants cry briefly during the procedure but calm quickly and can breastfeed immediately afterward. For older children and adults, local anesthesia completely numbs the area before the procedure begins, so no pain is felt during treatment. After the anesthesia wears off, most patients experience only mild soreness for one to three days, which is easily managed with over-the-counter pain medication such as ibuprofen or acetaminophen. The laser cauterizes as it cuts, meaning less tissue trauma and inflammation compared to traditional scalpel techniques.
The frenectomy procedure itself typically takes only 10 to 15 minutes from start to finish. For infants, the actual laser release may take less than five minutes. The total appointment time, including examination, anesthesia administration, the procedure, and post-operative instructions, is usually 30 to 45 minutes. Most patients are surprised by how quick and straightforward the procedure is. Because a laser frenectomy involves minimal bleeding and often requires no sutures, there is no extended time needed for wound closure.
Whether speech therapy is needed after a frenectomy depends on the child's age and how long the tongue tie has been affecting their speech patterns. For younger children (under age 4 or 5), speech often improves naturally after the tongue is released because they have not yet developed deeply ingrained compensatory speech habits. For older children and adults who have spent years compensating for restricted tongue movement, speech therapy may be recommended to retrain the tongue muscles and establish correct articulation patterns. Dr. Ahn works collaboratively with speech-language pathologists and can provide referrals when appropriate. In many cases, a short course of speech therapy (4 to 8 sessions) after a frenectomy produces significant improvement.
Many PPO dental insurance plans cover frenectomy procedures, particularly when the procedure is performed for functional reasons such as breastfeeding difficulties, speech impairment, or periodontal health. Medical insurance may also cover the procedure when it is deemed medically necessary. Coverage varies by plan and by insurer. The Loft Dental Studio accepts most major PPO dental insurance plans including Delta Dental, Cigna, MetLife, Guardian, Aetna, United Healthcare, and Blue Cross Blue Shield. Our administrative team verifies your benefits before treatment so you understand your out-of-pocket costs. Financing through CareCredit and FSA/HSA accounts are also accepted.
Reattachment of the frenulum after a frenectomy is uncommon but can occur, particularly if post-operative stretching exercises are not performed as directed. When the body heals from any soft tissue procedure, scar tissue forms at the wound site. If the edges of the released tissue are allowed to come back into contact during healing, they can reattach partially. This is why Dr. Ahn provides specific stretching exercises to perform after the procedure. For infants, parents are instructed to gently lift the tongue and upper lip several times daily during the healing period. For older children and adults, active tongue exercises are prescribed. Following these instructions consistently for the recommended two to four weeks significantly reduces the risk of reattachment.