I had some parents ask about frenotomy (frenulectomy? frenuloplasty?) yesterday even though the child is completely asymptomatic that I can tell. She is 4 months old and breastfeeding without difficulty, gaining weight very well, no nipple soreness, etc. I had advised the mom early on that I would not advise this procedure without a good reason. The MGF and 2 uncles are all dentists and were very adamant about having the frenulum clipped because it is transparent with very little risk, etc. The parents are confused and, frankly, so am I now. I went back to the Pedtalk archives and looked through the previous discussions about this topic and the general consensus seemed to be proceed only if there are problems - and revolved mostly around breastfeeding issues. There was mention back then that maybe the AAP ought to have a policy statement on this - there still isn't one that I can find. I'm going to pass on some of the studies that were discussed previously on this list to the parents but a couple questions that I could not/still can't answer: 1. Once a problem has set in (speech difficulties, oral hygiene issues, etc) what is the likelihood that the procedure is "too late"? The corollary question being - isn't it "better" to do when younger wrt pain, anesthesia, etc? 2. The parents are concerned that if it's not done NOW, the transparent frenulum will "become vascularized". I have no idea if that is, indeed, true. 3. How common is scarring following frenulectomy? Anyone seen it? 4. ENT or oral-maxillo-facial surgeon? Eve H. Switzer, MD, FAAP rural peds __________________________________ Do you Yahoo!? Yahoo! Calendar - Free online calendar with sync to Outlook(TM). http://calendar.yahoo.com