The Frenectomy Frenzy: Why Tongue-Tie Surgery Isn’t the Answer for TMD or Sleep Apnea

“Frenectomy is appropriate only for newborns with true ankyloglossia impacting feeding, and even then, only after assessment by appropriate specialists.”

Frenectomy, or the surgical release of the tongue’s lingual frenulum, a band of tissue under the tongue which connects it to the floor of the mouth, is increasingly being marketed by some dental providers as a solution for adult conditions such as temporomandibular disorders (TMD), headaches, neck tension, snoring, and sleep apnea. While this procedure can be medically appropriate for a small subset of infants with true tongue-ties, or ankyloglossia, which impacts their ability to nurse, its widespread use in adults lacks any credible scientific support.

A major exposé by The New York Times in December 2023 revealed how the so-called “tongue-tie industry” has aggressively expanded beyond pediatric care, targeting vulnerable adults and parents with claims of improved breathing, posture, and jaw alignment—claims that remain unproven and often exaggerated (NYT, Dec 18, 2023). Many patients undergo costly surgery and prolonged myofunctional therapy without objective diagnostic criteria or solid evidence of benefit.

Current scientific literature and expert consensus reject the use of frenectomy as a treatment for adult obstructive sleep apnea or TMD. Comprehensive reviews find no reliable evidence that tongue-tie release improves sleep apnea severity, bruxism, or myofascial pain in adults [1,2]. Professional organizations, including the American Academy of Pediatrics and the American Academy of Otolaryngology-Head and Neck Surgery, caution against indiscriminate frenectomy procedures outside clear pediatric indications, warning of potential risks and the lack of demonstrated benefit [3].

Pediatricians have also made statements against the indiscriminate use of frenectomy when not indicated, and have also warned the public that there may be harmful side-effects in a small subset of children. In summary, frenectomy is appropriate only for newborns with true ankyloglossia impacting feeding, and even then, only after assessment by appropriate specialists. Promoting it as a fix for adult pain or sleep disorders is not just scientifically flawed and by extension may be a questionable practice. Patients deserve care grounded in clinical research, not opportunistic pseudoscience. I plan to remain fully tethered to evidence-based clinical practice.

References

[1] Messner, A.H., Lalakea, M.L. (2000). Ankyloglossia: controversies in management. International Journal of Pediatric Otorhinolaryngology, 54(2-3), 123-131.

[2] Klockars, T., & Alanko, O. (2022). The effectiveness of lingual frenectomy in adults: A systematic review. European Journal of Oral Sciences, 130(3), e12849.

[3] American Academy of Pediatrics Section on Oral Health. (2020). Clinical report—Ankyloglossia (tongue-tie) and its management. Pediatrics, 145(2), e20200376.