A frenum is a naturally occurring muscle attachment, commonly seen between the front teeth (either upper or lower). It connects the inner aspect of the lip with the gum. A high (closer to the biting surface) frenum attachment can exaggerate the pull on the gum margin, which can result in recession. Additionally, an excessively large frenum can prevent the teeth from coming together resulting in a gap between the front teeth. If pulling is seen or the frenum is too large, the frenum is surgically released from the gum with a Frenectomy. Most of the time, this can now be done with a dental laser to provide faster and easier healing. Occasionally, the gum may be abnormally reduced by the frenum attachment. This can be corrected with a gingival graft at the time of the frenectomy.
When Orthodontic treatment is planned or initiated, the removal of an abnormal frenum, with or without a gingival graft, can increase stability and improve success of the final orthodontic result.