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Other useful references

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.


Clinical features of intentional and accidental torn frenum in children

  • Be aware of congenital abnormalities of the labial frenum which may be mistaken for a tear 1-3
  • One study recorded the distribution of various types of maxilliary labial frenum attachment 4
  • Twisting and pulling the child’s lip to cause torn frenum was noted in a single case. This study did not meet our inclusion criteria 5
  • Comprehensive guidance for dentists and dental hygienists relating to safeguarding children is available online 6

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  1. Asahina I, Sakakibara T, Miyashin M, Tachikawa N, Enomoto S. Congenital midline sinus of the upper lip: case report and review of literature. Cleft Palate - Craniofacial Journal. 1997;34(1):83-85 [Pubmed]
  2. Chan L, Hodes D. Images in paediatrics. When is an abnormal frenulum a sign of child abuse? Archives of Disease in Childhood. 2004;89(3):277 [Abstract from BMJ]
  3. Seifert VE. Das verkürzte Zungenbändchen und das hypertrophische Oberlippenbändchen. Zentralblatt für Chirurgie. 1969;17:570-575
  4. Boutsi EA, Tatakis DN. Maxillary labial frenum attachment in children. International Journal of Paediatric Dentistry. 2011;21:284–288 [Pubmed]
  5. Sperber ND. Bite marks, oral and facial injuries: harbingers of severe child abuse? Pediatrician. 1989;16(3-4):207-211 [Pubmed]
  6. Child Protection and the Dental Team Website. Dental practioners guidance PDFs [CPDT Website]


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