Frenectomy Protocol with Funny Face Myofunctional Therapy

What is a Frenectomy?

A frenectomy is a quick, minor procedure where a small piece of tissue called a 'frenulum' is released or removed using a CO2 Laser. This tissue connects the lips, cheeks, or tongue to the mouth. Sometimes, these frenulums can be too tight or restrictive, which can cause problems like difficulty moving the tongue, lip, or cheeks, and can affect things like speaking, eating, or breathing.

The goal of the procedure is to help free up movement, so that the muscles can work more comfortably and efficiently. After the frenectomy, we’ll also do some exercises to help strengthen and train the muscles, ensuring the best results and preventing the tissue from growing back too tight.

How am I being supported during this procedure?

• Ashley’s personal phone number to contact if you have questions or concerns 

• Personalized physical therapy care - no 2 treatment plans are the same!

• Education for client and family members

• Pain control, wound management options 

• Making appropriate referrals to best serve you!

• Immediate post - frenectomy care

The Prep:

• Assessment appointment first to get measurements, before photos, etc.

• Exercises minimum 2 weeks before the procedure to strengthen tongue muscles, improve tongue mobility, reduce healing recovery time and possibly reattachment, and for more severe ties of lip or tongue; address further myofunctional disorders. 

• Please do your exercises 3x/ day to ensure progress and proper prep

What should I expect after my frenectomy?

• Please contact the provider for details of the frenectomy procedure

• Exercises and aftercare begins the same day and will continue for 4-6 weeks. Daily or Weekly check ins from myofunctional therapist.

• Pain and tenderness at the site of the frenectomy, the base of tongue, under the chin, in neck and ears are common. This will start to subside within 3-4 days but may last up to one week

• Difficulty chewing and managing food in the mouth is common for the first 2-3 days

• Soreness when speaking is common for the first 2-3 days

• Considerations for Adults: Can return to work the next day, but ensure a proper schedule and ability to perform AWM; clean hands, space to do stretches,etc

How can I manage pain?

● Follow the directions from your frenectomy provider regarding pain medication 

• ∙ Have plenty of frozen or cold foods on hand (popsicles, freezies, ice cream, sorbet, etc) – this will help with swelling and pain

● Drink plenty of water

● Ice packs under chin first day

● Warm moist heat or warm pack under chin, on neck and ears will help starting the next day (day 2)

● Warm salt water rinses 3-4x/day for 1 week

• Serrapeptase : Herbal pain wound management https://www.amazon.ca/gp/product/B0C9P64ZV7/ref=ewc_pr_img_1?smid=A1YNFJ9H8N5JAV&psc=1 

Wound management without sutures

● The frenectomy provider will make the decision as to whether sutures are needed or not at the time your frenectomy procedure is performed

● If sutures are not used, the wound should resemble the shape of a diamond. The diamond shape should be kept open as long as possible and the healing should be slow so new tissue has time to form

● Use manual lift and stretch and open the edges of the diamond. Do this 4-6 times per day (or approx every 3-4 hours). You do not need to wake during the night to do this, but make sure to break up and stretch out any reattachment in the morning

● Tongue trace, tongue in cheek, reach up, open wide and gentle tongue caves may resume on day one.

● We will meet 2-3 days post op to review care and next exercises for best healing

Wound management with sutures

● Keep gauze under your tongue as much as possible for the first 24-48 hours (You may have to change it as it gets soaked with saliva. Some light or spotted bleeding is normal)

● Gentle movements and stretching only for the first 3 days. No strenuous or straining movements

● On day 3, resume tongue trace, tongue in cheek stretches and reach up, open wide tongue tip up to the spot – Do this 3-4x per day

● We will meet at 3-7 days post-op to review care and next exercises for best healing

● Sutures will fall out on their own within 3-7 days

● If sutures fall out early(within 1-2 days) please notify me and send a picture. It is possible after care instructions may need to be changed to the management without sutures below.