Frena are mucosal folds that attach the lips or the cheeks to the alveolar mucosa, gingiva, or underlying periosteum. Ectopic frena can cause complications such as gingival recession, decreased vestibular depth, decreased range of lip movement, and involvement of interdental papilla; they also may interfere with oral hygiene. A frenal attachment can be diagnosed by pulling on the patient’s upper lip. If the attachment is abnormal, pulling on the lip will result in movement of the tip of the papilla or blanching of tissue due to ischemia at the site. Frenectomy is indicated in the following situations: when an ectopic frenum results in a midline diastema, when the close vicinity of the frenum to the gingival margin results in gingival recession and impairs oral hygiene, or when an ectopic frenum is associated with inadequate attached gingiva and a shallow vestibule.