Wednesday, September 20, 2006

Torn Maxillary Frenum in a Child

If a young child has hit his mouth, and there is lots of blood especially on his upper teeth lip area, look and see if it might just be a torn maxillary frenum. That's the little piece of tissue that connects the upper lip to the gum between the two front teeth. If it was tight and gets hit and stretched too much it will tear. It bleeds a lot at first, but will likely be fine after 20 minutes or so. Usually no stitches are necessary. In fact there may be no treatment needed at all. This is a very common injury in preschoolers.

More info on dental accidents here:
Dental Accidents (with links to related posts)

64 comments:

Anonymous said...

Thanks for this information. My son tore his frenum & scared me too death. It bled like crazy! I feel much better now after reading this article.

Anonymous said...

Oh, I echo the previous comment. My baby girl is just learning to walk and wants to run already. She tripped and landed mouth first on the floor. She bled so much that we rushed her to the children's hospital. They told us not to worry about it that she would be fine and only had a slightly torn frenum. I was still worried and had to goggle it and found your article. Now I can sleep at night. Thanks soooo much for the clarification!

Anonymous said...

Thanks for the info. The same thing happened to my one year old who was trying to run and landed on her face! There was soooo much blood but after about 20 mins it stopped and she was fine. I was worried about her eating and drinking but it just happened yesterday and she is doing great.

Anonymous said...

Whew! My little guy (11 months) was tired, and rubbed his eyes on my shoulder, got his upper lip caught on my t-shirt, and I heard a tiny little snap. When I looked at him, his mouth was very bloody (as was my shoulder)but he wasn't really in pain. He seems fine now, but I'm wondering: Does it grow back?

Dr. Dean Brandon said...

If it was a frenum tear, yes those heal, but not back quite so tightly, which is usually a good thing.

Anonymous said...

Thank you for the post. My 10 month old just fell and busted her face on the floor. Same thing, lots of blood and a panicky mom. I freaked when I saw her gum tissue torn. I'm currently waiting for the pediatrition to call me, but found this article and it has made me feel better. Thank you!

Anonymous said...

Thanks for your comments. My 8 year old son received a knock to the face and his frenum tore. It is now a hanging loosely. The dentist we took him to was not overly concerned yet I still am a bit. What will happen to the loose bit? You mentioned reattaching, does this happen on it's own or are stitches required?

Anonymous said...

My 12 month old did this a week ago,, she did not tear the fernum but she cut her gums on the top with her bottom teeth... she has no upper teeth yet.. on friday the same week I noticed that the tear was healing,, well the next day i noticed that the flap of skin was GONE,, and her front tooth was showing... I am worried about it, it is around christmas so no dentist is open,,, will her teeth be ok and her gums be ok?? should we be worried?? please help

Dr. Dean Brandon said...

I cannot say, but most young children heal well from such an accident.

angel said...

thanks for ur info it was very useful for me

Anonymous said...

My daughter tore her frenum on the upper lip once, it was a lot of blood and you could see the tear. It healed quite fast.

She actually tore the frenum again today (she is 2 now) by falling on her face. This one appears to be worse from what I remember when it happened last time, though I think she'll be ok now that I read your article.

Anonymous said...

This happened to my son and now there is a gap between his front two teeth. I was wondering if that was coincidence or if that is common.

Dr. Dean Brandon said...

diastemas (space between the fron teeth) are often hereditary not the result of trauma. Heavy frenums often have seperation of the two front teeth.

Anonymous said...

I have a 14 month year old who has torn his frenum from a fall on a coofee table. Right now the gums that cover the front teeth are very uneven. One being much higher than the other. When the swelling goes down and after time will his gums even out and look normal again or will he always have one tooth that shows more?

Dr. Dean Brandon said...

Ask your pediatric dentist. I will say things grow and change in children a good bit over time. When the permanent teeth come in things change then too.

Anonymous said...

My son tore his frenum yesterday and he had a very tight attachment so a lot of it is hanging loose now. My dentist uses a laser to do frenectomies so should he have the hanging tissue lasered off or should it be left until he is older. He is 12 months old.

Dr. Dean Brandon said...

I don't usually anything. I usually give them time to heal and observe. Frenums often heal and migrate up and out of the way in a growing child. Any residual tissue is not a problem.

Anonymous said...

Thank you for the great information... my daughter just hit her mouth and I was worried about her. Your post was a great relief! Thanks so much!

MamaOf5 said...

Today my 9 year old (ADHD\SID) was being too rough with his almost 3 year old brother and spun him around by the hands. My 3 yr old ended up in a "crash landing" mouth to forehead with my 6 yr old son and tore the upper frenum. Scared the heck out of me, he didn't bleed nearly as long or much as described here by your article or the comments from others but thank you for easing a worried mama bear's mind about it.

Anonymous said...

Just returned from the ER with my 11 year old daughter who tore her frenum. Lots of blood, but stopped pretty quickly. ER Dr. said it will heal just fine, but because there was also a lot of dirt in the tear location (swinging upside down, face planted - ouch!) he prescribed penicillin to avoid infections and to do a peroxide wash as it heals. Other than that, treatment is like all the other cases I'm reading...nearly nothing. Huge relief on all angles!

Anonymous said...

my eight month old tore her frenum n shes bleeding alot n im very very worried shes even bleedin while she sleeps n its been longer than 20 mins im so sared should i be worried should i seek medical help....

Mamma Claire said...

My 21/2 year old tore her upper labial frenum about 5 months ago, at the time it bled like crazy and was painful but appeared to have healed well.

Just lately, she has been complaining that it hurts when we brush her upper front teeth. On closer inspection it would appear that it has healed at a much lower point on the gum and appears to be re-attached between the gap in her two front teeth (the gap is a heriditary family trait!)

Should I be concerned about this? My main concern is brushing her teeth well and ensuring that it will correct itself?

Dr. Dean Brandon said...

Most torn frenums heal within a week. If there is a large attchment still there and it runs in the family-you are of course, fighting genetics there as far as the space and frenum. I sometimes see sensitivity with brushing near that area as it is soft sensitive tissue up there, but I usually am not worried abouta little jumpiness just with brushing.

Anonymous said...

My son looks as if the bottom line that connects his tongue to this mouth has torn or something, it has never bled but upon inspection it looks as if it tore and his now healing. I'm not sure how this happened or if it has always been there. Should I take him to the doctore? I'm worried, but he doesn't seem to mind it. Is this normal?

Dr. Dean Brandon said...

Doesn't sound bad from what you said, but it's always good to get something like that checked out.

Cassandra S. said...
This comment has been removed by the author.
Tracy said...

I notice my baby boy had a very tight upper gum area so I kept an eye on it. Spoke with health visitor as was corcerned about how high up his teeth looked as they were coming in. I kept an eye on things and whenever he bumped his mouth on anything it bled, not for long bout 5mins or so. One day he was screaming covered in blood after a fall which calmed down after bout 25mins and stopped after lhr. The doctor checked and said he'd burst his frenulum. It doesnt bleed anymore and he can drink properly, he used to get soaked when drinkin as he tipped his cups into his bottom lip to drink. He has a gap which is closing slightly but several family members have gaps.

Anonymous said...

OMG... seeing so many comments with similar experiences, makes me feel a bit more relieved. My 3yr old tore his frenum, and I was so scared too. He wears dental caps and I think that might have helped his teeth shield the impact of his fall. The dentist told us to come back in 7days when it should have healed, or he would have to get stiches...yikes!!!

SarahsWay said...

I know this blog was posted quite some time ago but it helped me alot. My 20 mth old son fell tonite & I thought he busted his lip but the blood was just too much. I got him to suck on an ice cube wrapped in a washcloth. He fell asleep & I checked his mouth & realized he tore his upper frenum almost completely. When I pulle dhis lip up to look, it's got a pretty good size hole/tear. I was always told you can't get stitches in your mouth but my main concern is food getting in it & he can't gargle anything. Should I take him to dentist tomorrow or wait it out??

Dr. Dean Brandon said...

It's always a good idea to get a trauma checked out. Usually something like that is not a big deal.

Anonymous said...

Is this hereditary?

Anonymous said...

Thanks so much for your comments - I was so upset when my 10month old daughter did a face plant onto the hardwood floor while pushing a plastic container. She also had quite a bit of blood. When she was sleeping i further inspected her mouth and discovered a semi-detached upper labial frenum. Literally it is just dangling over her front teeth. She seems to be eating fine - she loves food!!!!!! Does she need to get this 'flap' or frenum removed? It looks as though there is no more frenum attached to her gums anymore it is just attached to her upper lip :( will this affect her speech?

Dr. Dean Brandon said...

A torn maxillary frenum does not affect speech. Sometimes there is a little small flap of tissue just after healing that does not need to be removed and usually resolves after a while. Still, I advise getting a Pediatric Dentist to look at it to make sure, and to follow over time. Every trauma is different.

boonefucksake said...

Thank you so much for calming my fears. My daughter came running full speed at me earlier ago as I was also getting up and her mouth smashed VERY hard into my forehead (gave me a headache!) and her mouth was bleeding pretty bad. I looked to see where the blood was coming from and sure enough she torn her frenum and made her upper lip swell. Poor kid. I gave her some Tylenol and a popsicle and all seems well her little world now.

Jessica L said...

My son has a very tight frenum, it bleeds every time we brush and is very painful and an unpleasant experience for him. Is there anything I can do?

Dr. Dean Brandon said...

Usually tight frenums are not much of a problem. Of course there could be more going on than just that. Gingivitis leads to bleeding on brushing for example. An ulcer? Anyways, usually I'd get a pediatric dentist to take a look if a problem persists.

Anonymous said...

Thanks for the info my 2 yr old just fell face first on her sippy cup she was crying face down and I lifted her up there was a puddle of blood. I looked and she tore her frenulum completely, hers is big and comes into the front teeth spreading them apart so maybe it's a good thing that's it's cut now....we'll see

A said...

My first grader doesn't seem to have a labial frenulum at all! When he smiles and talks you can see all of his gums. What is this called?

Dr. Dean Brandon said...

It's normal to "nat have a frenum" just as it is normal to have one. They are all different. Or, if someone might have torn it earlier in life it would not be as prominent. I suspect the comment all gums, may mean some kind or orthodontic growth pattern. In a severe form it is called VME, (vertical maxillary excess). Probably not, just have your dentist follow it. From your comment it does not sound like anything.

Anonymous said...

last evening my 14 month was playing at the playground and one of the older kids ran into him it was so sudden like a car crash i couldnt do anything. there was so much blood we examined him and it was the maxillary today he much better but i wanted to know if we would have to do surgery thanks to this article i can sleep tonight.

Dr. Dean Brandon said...

Yea. My daughter fell at the same age. Nothing I could do and I was 2 feet away. Good luck.

Anonymous said...

So I was playing water balloons and smack I trip and fall on my teeth and hurt them on a brick! They hurt so much! I can't eat nor brush those two teeth! It's one of the front teeth and the one next to it! The top teeth. I feel them loose! I dont want them to fall! I'm only 15 and theyre my permanent teeth! Now can i brush them? And well my toP lip on the inside is like bruised it's purple and the tooth next to the front tooth is crooked !

Dr. Dean Brandon said...

Sorry to hear that. Of course my recommendation is to see your dentist.

Anonymous said...

My 15 year old son was injuried in football practice where his bottom lip was disconnected from his gum. He had to have oral surgery with many stitches. The swell went down but he still has the dissolvable stitches in his mouth. My concern is once the stitches dissovle will the lip stay attached to the gum line. The oral surgeon said it's healing fine but for us to come back in 1 month for him to look at my son's mouth. I hear the mouth heals quickly but I still have concerns. I never saw anything like this before.

Dr. Dean Brandon said...

I would go on the oral surgeon's advice. Usually dissolvable stitches will not go away till the tissues are pretty much healed. Silk non dissolvable stitches are usually removed after about 5 days. Ask your doctor what he thinks in your case. Good luck.

Anonymous said...

My 12 month old tore his Frenum tonight. Is there any worry while they are sleeping if the tear keeps re opening and bleeding? When he smiles or cries, it starts bleeding again. The Frenum is basically just hanging there.

Dr. Dean Brandon said...

By the time you read this, I bet things are a little better. If you still have concerns, please see your pediatric dentist.

Anonymous said...

My 9 month old looked like she may have needed a frenectomy anyways, but today she tore it on her sippy cup somehow. It tore pretty far, and of course, my first instinct is to panic. I didn't want to bother my nurse sister AGAIN because her daughter is really sick, and she needs to be looking after her, not catering to my mommy panic. I'm assuming.g no antibiotics are needed? Anyways, thanks for info. I feel a lot more relaxed knowing this is a normal event among young children.

Anonymous said...

Gosh same here, 10 month old son was playing in his playpen and hit his teeth on the rail and bled a lot and now his top frenum thingy is falppy n loose, I jus put pressure n ice one it to stop the bleeding, but how long should it take to heal???

Anonymous said...

my daughter tore her ferenum at 18mnths she is now 2years and it hasnt grown back i dont like the look of it. do you think it will grow back or can she have it stitched?

Dr. Dean Brandon said...

Frenums do not really "grow back" in my experience. Have your Pediatric Dentist take a look to see if it is within the range or normal. Trauma can cause problems, but usually nothing too much (depending on the extent of the trauma).

Song said...

I'm not sure if the Frenum is what she tore but her mouth was bleeding but I couldnt figure out where. Then I looked in her mouth because she wasnt about to suck on her bottle she had to use a cup and she wont even use a sippy cup. She hasnt really been eating because he was sick and now her mouth is like that. She has REALLY bad breath and I'm not sure if that's from the torn frenum or because she's sick and can't quite breath out of her nose so she uses her mouth to breath. Her breathe is REALLY REALLY bad and she hasnt been eating or drinking much fiulds for 4 days now and lose some weight and her upper lip is kind of swallon... any suggestions?

Dr. Dean Brandon said...

Sometimes I see kids (usually very young kids or babies) who get a primary viral infection that causes sore places, ulcers, in the mouth they are pretty miserable and don't eat well and don't want to brush. I advise seeing your pediatric dentist or pediatrician to check it out. You don't want to go too long before a professiojnal needs to see to avoid dehydration if a young child is not eating or drinking. Most of the kids I see with the virus, well it runs iut's course and they are fine. It's good to see if there is anyhting that be done to make her feel better and to make sure it's not something else.

Anonymous said...

My dd cut her frenulum by accident. Do they reattach? Or will it just heal with the gum and lip seperate?

Dr. Dean Brandon said...

They heal but usually with some separation, sort of like doing their own frenectomy which means it's less likely to happen again.

Anonymous said...

My 12 month old just tore his. Like above mentioned there was tons of blood. 60 min later he was fine, eating. But when I gave him a bottle it completely opened and started bleeding again. He is also on meds for bronchitis and an ear infection. So I know he does need fluids, but how long do I avoid giving him a bottle?

Anonymous said...

sheesh! this just happened to my 14 month old son this morning! i think i had more grief than the length of his cry when i realized what had happened (ironically it was with the toothbrush he had in his mouth when he fell over and banged his mouth). my dentist has the week off, i figure it should be fine as long as the cut doesn't get infected? there is the tissue/muscle hanging from the upper lip...leave it alone for now?

Dr. Dean Brandon said...

Frenum tears usually do not need treatment --and there is no muscle in a frenum.

H. B. said...

Hi Dr. Brandon,

Thank you for this post. I hope you can help me - I'm attaching a link below to a photo I took of my daughter tonight with the following description:

Photo showing thick upper frenulum (top) and how it appears to be affecting other teeth (bottom). This week the gums around L's front eight teeth are swollen, red, and bleed frequently. She isn't eating well (nursing only), she's drooling a little (she never once drooled with the other 12 teeth), she has two sores on the outside of her mouth (lower lip and chin), and her stool has softened back to breastmilk-only consistency. Her breath smells different, too. No fever, no noticeable chewing or biting. After nursing her this afternoon I noticed lots of blood - on her mouth, her arm, myself, so tonight when brushing her teeth I examined her mouth more closely - her very low and tight frenulum appears to be tearing and causing the bleeding. I've not been able to brush or floss her teeth well for about a week, as these pics show (though I did clean them with a wet cotton swab after taking these pics) - every time there's contact with the upper gums, the bleeding starts again. What should I do?

I made an appointment with her pediatrician for this Wednesday, but I would sincerely appreciate your opinion - especially your thoughts on the photo. Thank you!

Photo link: https://picasaweb.google.com/lh/photo/iBamgnTnPclYMNmq_tNgQ2PwqUsjp1blu4OKnKLTFdc?feat=directlink

Dr. Dean Brandon said...

Here is a copy of a comment I made on a previous post: "Can't tell you what it is, but sounds more like a viral infection called primary herpetic gingivostomatitis. I see a lot of little kids get this with ulcers all over and they are pretty miserable..ask your dentist or physician. Fever is sometimes present with this."

Things like that run it's course in 10 to 14 days.

Anonymous said...

my 2yr old son fell off his big sisters bed yesterday and completely tore his top frenulum there was alot of blood stopped within 10 mins but i wasnt overly concerned as its supposedly quite a common injury in babies and toddlers add into that the mouth is self cleaning because of the saliva so i dont need to worry about infection im keeping him away from salty or citrus foods to avoid irritation my question is when does the swelling ease up cause he's not to happy with hot&cold compresses thanks

Anonymous said...

new here but couldnt help noticing how panicked us mothers get when something happens to our little ones i would just like to say minor injuries to the mouth such as a torn frenulum may look worse than what it really is as the mouth is wet when it bleeds your blood gets diluted therefor looks more however if in any doubt at all just take your wee one to his/her doctor/dentist i for one would rather be called over protective and paranoid than be the one who sits and does nothing about it

Dr. Dean Brandon said...

Most swelling from minor oral traumas subsides within two or three days.

Dr. Dean Brandon said...

I am going to shut down the comment section on this post for now, as it has grown very large (over 60 comments). There is a lot of info in the post and the comments on this topic. There is also information in other posts here in this blog on trauma and related topics.