Surgical & Laser

A lack of attached gingiva is sometimes associated with a high frenum attachment, which exaggerates the pull on the gum margin. A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower). It is normal to have a frenum, but it should not pull on the gum margin or recession will occur. If pulling is seen, the frenum is surgically released from the gum with a frenectomy. Often a new band of hard gum is also added to re-establish an adequate amount of attached gingiva (see below).

Child with naturally occuring high frenum attachment
High frenum with lack of attached gum causing muscle pull and tooth separation	After frenum removal, and addition of adequate attached gingiva

A Fiberotomy is often needed at the completion of orthodontic tooth movement to prevent the relapse of the teeth to there old malposed positions. A straight line incision is made between the affected teeth. This usually heals with little discomfort in 5 to 7 days.