The frenum is a small piece of tissue between the lips and jaw, or between the tongue and the lower jaw. Some people have a large frenum that restricts the movement of their tongue or lips. This may not result in noticeable symptoms however research has shown this restriction movement to have adverse systemic effects. 

Reasons why the labial and tongue frenum should be cut when they are tight:

The tongue should be able to hit the roof of the mouth because doing that the pituitary gland gets stimulated. The tongue touches the palate at the sphenobasilar synchondrosis (where the pituitary gland is located). The tongue allows the stimulation of the pituitary gland and the pituitary gland has a lot of functions with our hormones. When the tongue can’t touch the roof of the mouth there is tension and the pituitary is not stimulated correctly, so it affects hormonal function. Stress in this area can disrupt pituitary function and congest the flow of pituitary hormones traveling into the body’s circulation. This can lead to muscle aches, weight gain, or even atypical growth.

Another reason is that having the tongue and/or lip tight, tension is produced and those frenums restrict mobility causing neck pain and obstruction of the air way, because the brain (dura matter, pia, aracnoid) is covered by a shield that goes to the spinal cord and it is connected to the tail bone. That mobility restriction causes a lot of tension and stress. Cutting the tongue and labial frenum is beneficial to prevent or improve neck pain, to promote stimulation of the pituitary gland, to breath better, avoid gum retraction, diastema, and correct occlusion.

At Family Holistic Dentistry we can perform a procedure called a frenectomy, which means the removal of some of this tissue to allow a more natural movement of the tongue or lips. A frenectomy can be performed with a laser or with traditional methods. With both methods the recovery is quick and there is little discomfort.

Pinhole and Gum Grafting

If you have recession or thin gum tissue then you may notice that your teeth appear “longer” than they used to but the teeth aren’t growing more, really what’s happening is you are losing gum tissue over time. This may also be something that your dentist points out to you. The gums serve to protect your teeth and help to anchor them in the jaw so if you have recession you likely need to have gum treatment to restore the gum tissue and optimize your oral health. When you have a consult, Dr. Pearl will perform a comprehensive exam to assess your oral health and which kind of procedure is best in your case. Usually recession of the gums does not cause pain but may cause sensitivity. It is important to know that the lack of symptoms does not mean lack of disease.

Pinhole Gum Grafting Before and After

Pinhole Gum Grafting Before and After

One technique is to take tissue from the root of your mouth and graft to the recession area using conventional techniques which involve scalpels and sutures. 

Another option is a procedure we refer to as the pinhole surgical technique/pinhole gum rejuvenation or “pinhole” for short. This method was invented and patented by John Chao, D.D.S., and is a scalpel-free, suture-free procedure for treating gum recession.

This procedure is performed by making a small hole in the base of the gum tissue. Using specially designed instruments, the gum tissue is loosened and guided over the receded part of the tooth. Since there is no cutting, no sutures are needed and in most cases the recovery is quicker over traditional techniques.

The pinhole technique may be combined with using your own tissue (from the roof of your mouth) to gain additional thickness of gum tissue, in which case sutures may be needed. 

Some grafting procedures are more comfortable and more esthetic than other techniques and much of this will depend on how much tissue you still have. The sooner this is addressed the more choices you have and the higher likelihood for better results.

Non-Metal Implants

During the exam Dr. Lai will assess the foundation that will support an implant. This means checking to see if you have enough bone and if your gums are healthy and free of disease. This is important because an implant needs to be completely surrounded by bone when it is put in so it can heal and become solid for chewing later. If there is not quite enough bone there may be options for bone grafting to create enough bone to anchor the implant. In that case we will plan to use non-human non-animal sources to build up the bone. 

Example of a Zirconia Non-Metal Implant

Example of a Zirconia Non-Metal Implant

It is also important that your mouth is healthy and there is no gum disease such as gingivitis or periodontitis. In these situations, the bacteria that causes disease around natural teeth can also cause disease and bone loss around an implant. Implants are a great replacement choice but like anything in the medical and dental world nothing is full proof. A healthy mouth increases the likelihood your implant will heal and last many years.

The Non-Metal Implant Procedure with Zirconia Implant and healthy gums visible

The Non-Metal Implant Procedure with Zirconia Implant and healthy gums visible

Conventional implants are made from titanium. At Family Holistic Dentistry we offer zirconia implants to give patients a metal-free option. 

Without an implant or natural tooth your bone does not get the signal that it needs to be there and so disappears and gets thinner and smaller over time. We call this atrophy. How much of it disappears varies in each person but typically the longer there is no natural tooth or implant the less bone there is. Bone grafting and I-PRF and C-PRF often help with this but the more you have of your own bone the sooner you can have an implant and crown and the sooner you canstart chewing in that area again. This is why timely care is beneficial and an advantage over waiting to get treatment. Call for a consult and Dr. Pearl will assess your individual needs and discuss with you your choices for replacing those missing teeth.

 Carlson Bridge

A bridge is the traditional option for replacing a missing tooth. It’s made by cutting down the teeth on each side of the gap to support crowns that hold a false tooth in between.


But why sacrifice two perfectly healthy teeth?

With the Carlson Bridge, this is no longer necessary. For this minimally-invasive procedure, we only need to prepare the surfaces of those two abutment teeth. We don’t have to cut away any living tissue. This is a more Holistic/Biological approach when the adjacent teeth are natural teeth or they are restored with composite. If the adjacent teeth have crowns this bridge cannot be done.

We then attach the false tooth – known as a “winged pontic” – to those teeth with composite, and shape, shade, contour and adjust the bridge as needed so it both looks and functions just like a natural tooth. It is fixed, the patient doesn’t need to remove it to clean it. Super floss or waterpik can be used to clean under the Carlson bridge.

Unlike other bridgework, the Carlson Bridge can be completed in a single visit.

Here’s an up-close view of how the procedure is done – and how the end result looks:

OSHA Content