Definition of Frenum Pull
A frenum (or frenulum) is a small fold of tissue that supports or limits the movement of a mobile organ within the body. In the mouth, the primary role of oral frenula is to coordinate the movements of the lips and tongue with the growth of the mouth's bones during development. The frenula that typically raise concerns are located under the tongue, at the front of the upper lip, and at the front of the lower lip.
Causes of Frenum Irritations
Irritations or ulcers associated with frenula can occur when the tissue interacts with an appliance such as an aligner, or is injured by actions like brushing with a toothbrush. Some frenula are naturally larger, or may attach at unusual locations. For instance, a "tongue-tied" individual has a notably short and thick lingual frenum that connects the underside of the tongue to the mouth's floor. Severe issues with frenula may require a minor procedure to snip or cut the frenum.
Solutions for Frenum Pull
Detecting frenum issues can be challenging, as aligners might initially feel comfortable but cause irritation and ulceration as the patient talks and moves. Unfortunately, these dynamic movements aren’t captured during impressions. Clear photographs can aid in identifying these issues. Although rare, gingival frenum pulls usually occur in areas around the maxillary premolars and midline. If frenum pull is problematic, consider trimming the aligner in the affected areas to prevent further irritation.