Date: Tuesday, November 13, 2007 12:13 AM
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 26 Oct 2007 to 12 Nov 2007 (#2007-81)

There is 1 message totalling 186 lines in this issue.

Topics of the day:

  1. Prophylactic frenectomy

Date: Monday, November 12, 2007 9:59 AM
From: Barry Raphael <drbarry@ALIGNMINE.COM>
Subject: Prophylactic frenectomy

A mother of twin 6 y/o girls and a 7yo girl came to me for a second opinion about the prophylactic frenectomies recommended by her general dentist.  The twins had primary centrals and low freni with pull of the tissue.  The 7yo's permanent centrals had just emerged, also with a low frenum with tissue pull.

When I call the dentist he said that the indication for the frenectomy was not to prevent diastema so much as to prevent distortion of the gingival papilla in the permanent dentition and avoid black triangles (soft tissue windows).

It would be easy to say he is overselling his soft-tissue laser, and even he admits that the procedure is now more saleable because the laser and good topical make the procedure so easy for the patient. 

I would like you to assume that this dentist is operating under the best of intentions and not just out getting ROI for the laser.

My understanding is that the frenum travels apically with growth of the maxilla and is not the problem at age 12 that it appears to be at age 6. 

The question is, is there ANY indication for prophylactic frenectomy in the literature?

Barry Raphael

Clifton , NJ