How is ankyloglossia classified?
The severity of ankyloglossia can be classified using various assessment tools. The Kotlow assessment tool categorizes ankyloglossia into four categories or classifications based on the length of the free tongue (the distance from the tip of the tongue to the attachment of the frenum). A distance of greater than 16mm is considered clinically acceptable.
Why be concerned with ankyloglossia?
Ankyloglossia can seriously affect people’s health at any age. To experience what ankyloglossia feels like, try to talk and eat while keeping your tongue on the floor of your mouth. You can see it is challenging!
In infants: ankyloglossia can be associated with breastfeeding difficulties, failure to thrive and difficulty with the introduction of solid foods.
In children: associated with “sloppy” eating secondary to difficulty chewing the food and moving it in the mouth, impaired articulation, poor oral hygiene, dental problems (incorrect teeth eruption or the rotation of bottom teeth inward), change in the development of the face and jaw, and importantly, strong emergence of compensatory incorrect habits such as a tongue thrust.
In adults: associated with continued misarticulation of sounds, clicking or pain in the jaws, migraines, obstructive sleep apnea, effects on social situations (eating out, kissing, relationships) and dental health (inflamed gums, crowding, cavities, extractions).
How can we treat ankyloglossia?
Once a tongue tie has been diagnosed, a recommendation may be made to have the lingual frenum released through a frenectomy; also known as a frenulectomy or a frenotomy. It’s a simple procedure that uses local anesthesia to remove the frenum. It lasts generally 5 minutes using a scalpel or a laser. A laser is usually the preferred approach as it causes little bleeding, requires no sutures and causes very little post-procedure discomfort.