Association Between Maxillary Labial Frenum Attachment Types and Early Childhood Caries: A Cross-Sectional Study

This study aimed to evaluate the distribution of maxillary labial frenum (MLF) attachment types and their potential association with the development of early childhood caries (ECC) in children aged 2 to 5 years who presented to our clinic for routine check-ups or treatment.

A total of 92 children aged 24-71 months (53 girls and 39 boys) were included in the study. Clinical oral examinations were performed, and MLF attachment types were recorded using Placek's classification. Standardised intraoral photographs were taken to document the anterior maxillary region and frenum attachments. Children were categorised into ECC and caries-free groups based on clinical findings. Statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS) v26.

The mean age of the participants was 52.7 ± 11.7 months. In the ECC group, the mean dmft score was 9.8 ± 4.3. Although no statistically significant relationship was found between overall frenum attachment types and caries formation in the anterior maxillary region, papillary and mucosal attachment types were more common in children with anterior caries, while the gingival type was more prevalent in the caries-free group (P 0.05).

A statistically significant association was observed between certain MLF attachment types and anterior caries; however, the presence of caries in mucosal-type attachments - typically considered low-risk - suggests that other aetiological factors play a more prominent role in ECC development. Therefore, clinicians should focus on comprehensive caries risk assessment before considering surgical interventions such as frenectomy.