Search

Ankyloglossia, which is a congenital condition also referred to as tongue-tie, is described as a small lingual frenum that restricts tongue movement and its function. The main purpose of the frenum is to restrict the movement of the cheek, lip muscles, and tongue throughout the development of fetuses and maintain equilibrium between the developing bones, lip musculature, and tongue. The constriction of the buccal musculature counteracts the outward pressure that the tongue applies to the teeth. Arch width maintenance requires a state of equilibrium between these two muscle groups. Therefore, altering tongue position might additionally have an impact on a mandible's position. A 20-year-old female patient presented to the Periodontics Department with moderate ankyloglossia (Kotlow Class II). For the correction of the tongue-tie, conventional surgery with sutures was scheduled under local anesthesia. One week, one month, and three months follow-up, the patient demonstrated good healing. There was an improvement in speech clarity and tongue movements., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sawai et al.)

Tongue-tie is a continuation of the lingual frenum that is attached to the tip of the tongue. It is a congenital oral anomaly that could restrict tongue movements, caused by a lingual frenum a membrane that originates from the floor of the mouth to the bottom of the tongue that is too thick and short, which limits the natural ability of the tongue to move and function. The tongue is an auxiliary organ that facilitates speaking, mastication, and deglutition. This condition may result in several difficulties including chewing, breastfeeding, speech, and pronunciation of particular words, as well as possessing social and mechanical consequences. Ankyloglossia can be seen in young age groups. The use of lasers has increased in dentistry in recent years. However, in oral and maxillofacial surgery, the use of lasers has been largely restricted to soft tissues, and less focus is placed on the use of hard tissues. Carbon dioxide (CO 2 ) lasers, erbium-doped yttrium aluminum garnet (Er: YAG) lasers, and Er, the erbium, chromium: yttrium: scandium gallium-garnet (Cr: YSGG) lasers are among the several types of lasers that have been utilized in dentistry for correction of soft tissues as well as for hard tissues., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Rakhunde et al.)

Competing Interests: Intérêts concurrents: M. Elise Graham déclare avoir reçu une Subvention catalyseur du département d’otorhinolaryngologie et un financement de l’Academic Medical Organization of Southwestern Ontario, indépendamment des travaux soumis. Aucun autre intérêt concurrent n’a été déclaré.

Background: Breastfeeding behaviors and experiences exist on a continuum. What differentiates normal from dysfunctional is defined by frequency and severity. No current validated tool addresses the subjective experience of dyads with a predictive score that can be followed over time., Research Aim: To create and validate a self-report tool to assess breastfeeding and evaluate its ability to predict risk of breastfeeding dysfunction., Methods: This study used a cross-sectional design to determine the validity of a novel instrument to assess breastfeeding dysfunction. We gave the initial questionnaire to 2085 breastfeeding dyads. We assessed content validity by comparison with other tools. We used exploratory factor analysis with varimax rotation for concept identification and Cronbach's alpha for internal consistency. We employed logistic regression to assess the tool's ability to differentiate between normal breastfeeding and breastfeeding dysfunction., Results: Factor analysis mapped 17 questions to four concepts to create a score (FLIP; flow, latch, injury [to the nipple], and post-feed behavior). Internal consistency and reliability of the scores in these concepts were acceptable (Cronbach's alpha ≥ 0.087 for all measures). A logistic regression model that controlled for infant age, with a breastfeeding dysfunction risk classification threshold of 60%, yielded a correct classification of 88.7%, with 93.1% sensitivity, 64.6% specificity, and a 6.5% false positive rate., Conclusions: The FLIP score was determined to be a valid and reliable instrument for quantifying the severity of breastfeeding dysfunction in children under 1 year old. Further studies will assess its usefulness in the management of breastfeeding dysfunction., Competing Interests: Disclosures and Conflicts of InterestThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: To evaluate breastfeeding symptoms associated with ankyloglossia/tongue-tie., Methods: Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar. Eligible studies reported baseline breastfeeding symptoms/severity from tongue-tied infants. Two reviewers independently screened studies, extracted data, and assessed quality. Low-quality studies were excluded. Main outcomes were weighted mean severity scores for dyads with ankyloglossia relative to reference values for successful breastfeeding. Meta-analyses used inverse-variance-weighted random-effects models., Results: Of 1328 screened studies, 39 were included (5730 infants with ankyloglossia). The mean LATCH score for patients with untreated ankyloglossia, 7.1 (95% CI: 6.7-7.4), was significantly below the good-breastfeeding threshold. The mean Infant Breastfeeding Assessment Tool score, 10.0 (8.2-11.7), was not significantly below the good-breastfeeding threshold. The mean Infant-Gastroesophageal Reflux Questionnaire-Revised score, 18.2 (10.5-26.0), was consistent with gastroesophageal reflux disease. The mean Breastfeeding Self-Efficacy Scale-Short Form score, 43.7 (39.3-48.1), indicated significant risk of cessation of exclusive breastfeeding within 1-3 months. Mean nipple pain was 4.9 (4.1-5.7) on a 0-10 scale, greater than typical scores for breastfeeding mothers without nipple damage. Total prevalence of breastfeeding difficulties was 49.3% (95% CI: 47.3-51.4%). Early, undesired weaning occurred in 20.3% (18.5-22.2%) of cases before intervention., Conclusion: Ankyloglossia is adversely associated with breastfeeding success and maternal well-being., (© 2022 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Purpose: Sialoendoscopic, orthodontic, and surgical interventions within the floor of the mouth require precise knowledge of the topography of the Wharton's duct orifices which is still lacking for the pediatric population. We aimed to establish a normative database for the topography of these orifices in children., Methods: The prospective cross-sectional analytic study was performed during January to December 2021. The distances between the mandible gonions and each orifice and the lingual frenulum were defined as primary outcome variables. The secondary outcome variables were the inter-position of the orifices and their location against the base of the tongue and the mandibular alveolar ridge. The segments of the cohort were classified by sex and age groups (4 to 7, 8 to 14, 15 to 17 years old) as the primary predictor variables. The data were evaluated by a 3-way ANOVA for analysis of selected distances with the level of significance at P ≤ .05. The correlation analysis between sex and locations of the orifices was performed using χ 2 criterion (95% confidence interval) and r ≥ 0.60 was counted as a strong correlation., Results: The study involved 3,000 healthy children from 4 to 17 years of age. The orifices were symmetrical (89.3%), frenulum-independent (78.0%) openings that were usually located in the middle part of the floor of the mouth. The distance between the orifices varied from 0 mm in the frenulum-attached cases to 4.6 ± 1.8 mm for 4 to 7 years old, 7.6 ± 1.9 mm for 8 to 14 years old, and 9.1 ± 2.6 mm for 15 to 17 years old individuals. The orifices were attached to the frenulum (5.7%), were frenulum-related (16.3%), and frenulum-independent (78.0%). The sagittal asymmetry of the orifices was noted in 10.7%, and in 1.6% the lateral asymmetry was detected. No statistically significant sex-related differences were noted., Conclusion: In the pediatric population, the Wharton's duct orifices are usually symmetrical frenulum-independent openings that are located in the middle part of the floor of the mouth. The distance between the orifices normatively varies according to sex and age. The size of the mandible does not influence the positions of the orifices. The position of the duct orifices must be established prior to submandibular sialoendoscopy, orthodontic interventions, frenotomy, and other oral surgeries., (Copyright © 2022. Published by Elsevier Inc.)

Background: Prevalence of ankyloglossia may vary depending on the assessment tool. This systematic review aimed to evaluate the prevalence of ankyloglossia in distinct age groups according to different assessment tools., Types of Studies Reviewed: Nine electronic databases were searched from inception through November 2021 without restrictions of language or year of publication. Paired independent reviewers selected cross-sectional and cohort studies reporting the diagnosis of ankyloglossia, extracted data, and assessed methodological quality. The number of patients with ankyloglossia and the sample were extracted to calculate the overall prevalence of ankyloglossia and 95% CI. The authors calculated the prevalence of ankyloglossia per assessment tool, age group, and sex. They assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach., Results: Seventy-one studies were included. Seven different diagnostic tools were used. The overall prevalence of ankyloglossia was 5% (95% CI, 4.0% to 5.0%) and ranged from 2% (using an unspecific tool) to 20% (Coryllos classification). The prevalence per age group was higher in infants (7%). The prevalence ratio was 1.34 (95% CI, 1.17 to 1.54) for boys, with very low certainty of evidence., Practical Implications: The prevalence of ankyloglossia is higher among infants and differs depending on the assessment tool used for the diagnosis. It is uncertain whether boys are more affected by ankyloglossia than girls., (Copyright © 2022 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Background: Ankyloglossia is commonly reported as one of the major causes of breastfeeding difficulty. There is a lack of research on infant growth and latching performance with clinical measures., Cases Presentation: We describe a series of eight clinical cases (three female and five male infants) in a specialized breastfeeding center in a tertiary hospital in Northeast Brazil. The mothers were of mixed race and ranged from 13 to 41 years of age. Ankyloglossia was diagnosed within the first 48 hours after delivery. We measured the standards of growth, the mothers' perception of breastfeeding, and a pain indicator, and performed an assessment of breastfeeding. The regularity of breastfeeding was maintained despite the early diagnosis of ankyloglossia. Growth indicators were not affected in the sixth month in any of the babies, with only one measuring below expectations in the third month, with no impact on general health., Conclusions: In the cases reported in this paper, the infants overcame the initial difficulties in breastfeeding and maintained their normal growth course in the first 6 months of life., (© 2022. The Author(s).)

Ankyloglossia is a pathology of the tongue in which the frenulum appears anchored to the floor of the mouth. The treatment of choice for this pathology is frenectomy, but myofunctional therapy is emerging in recent years as a complement to surgical intervention. This systematic review aims to synthesize the scientific evidence and assess its quality regarding the use of myofunctional therapy in ankyloglossia. The Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, Pubmed, Web of Science and Scopus were searched. Study quality was determined using the PEDro scale, STROBE statement and single-case experimental design scale. Eleven studies were selected. Based on the studies included in this review, surgery is more effective than myofunctional therapy, although better results are achieved if both are combined. Improvements have been found in maternal pain, weight gain of babies, duration of breastfeeding, tongue mobility, strength and endurance, sleep apnea, mouth breathing and snoring, quality of life, clenching teeth, myofascial tension, pain after surgery and speech sound production. These findings must be taken with caution because of the small number of articles and their quality. Future clinical trials using larger sample sizes and with higher methodological quality are needed.

Objective: Ankyloglossia is characterized by an abnormally short lingual frenulum, which impairs tongue movement. Ankyloglossia has been related to craniofacial growth disturbances and dental malocclusion. But even though there is a clear biological plausibility for this hypothesis, available evidence is scarce., Methods: A case-control design was followed. Patients between 4 and 14 years old were routinely screened for short lingual frenulum and recruited from the pediatric Otolaryngology consultation of 3 Spanish tertiary referral hospitals. Lingual frenulum was assessed with the Marchesan system. A cohort of cases with short lingual frenulum and a cohort of healthy controls matched for sex and age were included. Both cases and controls had pictures of occlusion. Occlusion was evaluated by an expert in orthodontics, blinded for the frenulum assessment., Results: A total of 100 participants were included, 70 males and 30 females. The proportion of malocclusion in the short lingual frenulum group was 48%, while it was 24% in the normal frenulum group. The odds ratio of malocclusion for the short lingual frenulum patients was 2.92 (CI 95% 1.15-7.56). The difference was statistically significant (p=.012). This difference was significant for patients with class III occlusion (p=.029). There was no difference for patients with class II (p=.317)., Conclusions: This work supports the hypothesis that relates class III malocclusion with a short lingual frenulum., (Copyright © 2021 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Published by Elsevier España, S.L.U. All rights reserved.)

Purpose: We aimed to establish a normative database for the topography of Wharton's duct orifices and to indicate the localization and distances of the orifices against other oral structures., Methods: The prospective study involved 3,000 healthy adults. We measured the cranial index, the distances between the mandible gonions and the orifices and between each orifice and the lingual frenulum, the position of the orifices against each other, and against the base of the tongue and the mandibular alveolar ridge. The segments of the cohort were classified by sex and the headform (dolichocephalic, brachycephalic, and mesocephalic)., Results: The distance between the orifices varied from 0 mm in the frenulum-attached cases to11.0 ± 2.3 mm in cases of the male brachycephalic skull. The correlation with sex was found for the localization of the frenulum-related orifices (r = 0.64 for females). The orifices were attached to the frenulum (5.9%), were frenulum-related (16.2%), and frenulum-independent (77.9%). The sagittal asymmetry of the orifices was noted in 11.8%, and in 2.1%, the lateral asymmetry was detected., Conclusion: In most of the cases, the Wharton's duct orifices are symmetrical frenulum-independent openings that are usually located in the middle part of the floor of the mouth or close to the mandibular alveolar ridge. The distance between the orifices varies according to sex and the type of the skull. The precise position of the duct orifices must be established prior to sialoendoscopy of the submandibular glands, a botulinum toxin injection around the mandible, tongue traction maneuvers, frenotomy, and other oral surgeries., (Copyright © 2022 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objective: To explore parents' plans for infant feeding before birth and their perceptions of feeding success in light of tongue-tie diagnosis for their infants., Design: A qualitative descriptive study design using content and thematic analysis was used., Setting: A dental office in Massachusetts with parent-neonate dyads undergoing infant frenotomy procedures., Participants: Twenty-five parents between the ages of 27 and 40 years with infants from 1 week to 28.6 weeks of age were surveyed., Measurement: Data were collected in an electronic survey using the Research Electronic Data Capture (REDCap) data capture tool., Results: Content analysis of the data from surveys showed themes that correspond to parents' plans for feeding before birth and the ways in which feeding plans or goals may have changed based on the presence of infant tongue-tie. Themes were categorized into three main categories: feeding plans and breastfeeding goals before birth, the parent's experience with breastfeeding an infant with tongue-tie, and how plans or goals changed because of perceived challenges with tongue-tie., Conclusion: Findings suggest that there are challenges feeding infants with tongue-tie and that feeding plans may change as a result of those challenges. Implications for further research and practice include exploring how these perceptions and challenges affect the maternal role, success for individuals wishing to breastfeed, and parental self-confidence., Competing Interests: Author Disclosures The authors report no conflicts of interest or relevant financial relationships., (Copyright © 2021 AWHONN. Published by Elsevier Inc. All rights reserved.)

Ankyloglossia, commonly called "tongue-tie," has been increasingly diagnosed in the breast-feeding infant, with growing numbers of surgical interventions in the last 2 decades. As more practitioners have become involved in the diagnosis and treatment, there has not been a consensus on terminology and indications for intervention. In 2020, the American Academy of Otolaryngology - Head and Neck Surgery Foundation reviewed the bodies of lactation, dental, pediatric, and otolaryngology literature to seek professional consensus and note areas requiring more definitive evidence. This article highlights the findings for the general pediatrician seeking to support breast-feeding dyads. [ Pediatr Ann . 2021;50(8):e310-e312.] .

Introduction  The tongue plays an important role in the development of craniofacial structures. At rest, the light and constant pressure of the tongue against the hard palate, counterbalanced by the pressure provided by proper lip sealing, serves as a guide for maxillary growth. Ankyloglossia makes tongue coupling against the hard palate difficult, impacting maxillary development, which may lead to breathing disorders. Objective  To verify the effect of lingual frenotomy on the resting position of the tongue and lips in infants with ankyloglossia. Methods  The sample consisted of 334 infants aged between 1 and 60 days old diagnosed with ankyloglossia. The groups were divided in: a) experimental group (EG), which consisted of infants whose mothers agreed with lingual frenotomy; b) control group (CG), which consisted of infants whose mothers either refused lingual frenotomy or were waiting for surgery. Both the position of the lips and of the tongue at rest were assessed while the infants were sleeping during the quiet sleep phase. For mothers who refused their infants to undergo the surgical procedure, a follow-up of the infants was proposed to verify possible interference of the frenulum with the resting position of the tongue and lips. Infants whose mothers agreed with surgery were referred for lingual frenotomy. Results  Regarding the position of the tongue and lips at rest at the initial and final assessments, the statistical analysis demonstrated significant differences between both groups. Conclusion  Lingual frenotomy enabled infants diagnosed with ankyloglossia to maintain both tongue coupling against the hard palate and closed lips at rest., (Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Objectives: To investigate and identify the concerns and opinions expressed in both parental and provider posts on social media about ankyloglossia., Methods: In this study, posts on Twitter between 1/1/2008 and 12/31/2018 were collected using search terms and hashtags specific to pediatric ankyloglossia. The search terms included a primary phrase to indicate ankyloglossia along with a pediatric identifier. Tweets that met inclusion criteria were analyzed qualitatively via conventional content analysis. After all tweets were categorized, descriptive statistics were completed to determine frequency of each theme., Results: In total, 5951 tweets were retrieved. Parents authored 982 (16.5%) of tweets, and 782 (13.1%) were by providers. The remaining 4187 tweets did not fit criteria for either the parent or provider groups. Amongst parents, the most common themes mentioned were feeding problems (309 tweets [32.4%]), followed by lip tie (215 [22.5%]), anxiety or emotion (207 [21.7%]), and maternal breastfeeding complications (127 [13.3%]). The number of tweets about ankyloglossia and frenotomy in 2018 had increased by 2395% since 2009. Amongst providers, 215 tweets were judged by the coders to provide an opinion on ankyloglossia, of which 94.4% had a pro-frenotomy sentiment. When a specialty was identified, tweets were most often by dentists (250 [31.9%]), followed by lactation consultants and International Board Certified Lactation Consultants (IBCLCs) (157 [29.7%]) and non-otolaryngologist physicians (79 [10.1%]). Otolaryngologists accounted for 8.7% (68 tweets) of posts about ankyloglossia., Conclusion: Our findings demonstrate the spectrum of opinions that exist among both parents and providers about ankyloglossia. This can aid in shared-decision making by enabling the counseling provider to guide recommendations based on medical evidence with the understanding that there is a large amount of non-scientific information and opinions disseminated that may be shaping decisions., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: A functional definition of ankyloglossia has been based on assessment of tongue mobility using the tongue range of motion ratio (TRMR) with the tongue tip extended towards the incisive papilla (TIP). Whereas this measurement has been helpful in assessing for variations in the mobility of the anterior one-third of the tongue (tongue tip and apex), it may be insufficient to adequately assess the mobility of the posterior two-thirds body of the tongue. A commonly used modification is to assess TRMR while the tongue is held in suction against the roof of the mouth in lingual-palatal suction (LPS)., Objective: This study aims to explore the utility and normative values of TRMR-LPS as an adjunct to functional assessment of tongue mobility using TRMR-TIP., Study Design: Cross-sectional cohort study of 611 subjects (ages: 3-83 years) from the general population., Methods: Measurements of tongue mobility using TRMR were performed with TIP and LPS functional movements. Objective TRMR measurements were compared with subjective self-assessment of resting tongue position, ease or difficulty elevating the tongue tip to the palate, and ease or difficulty elevating the tongue body to the palate., Results: There was a statistically significant association between the objective measures of TRMR-TIP and TRMR-LPS and subjective reports of tongue mobility. LPS measurements were much more highly correlated with differences in elevating the posterior body of the tongue as compared to TIP measurements (R 2 0.31 vs 0.05, P < .0001)., Conclusions: This study validates the TRMR-LPS as a useful functional metric for assessment of posterior tongue mobility., (© 2021 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Purpose: To diagnose ankyloglossia in newborns and compare two lingual frenulum assessment instruments., Methods: This cross-sectional study was carried out in Recife, Pernambuco, Brazil, in 2018, with 147 mothers/newborns aged up to 30 days. The Bristol Tongue Assessment Tool and the Lingual Frenulum Evaluation Protocol for Infants were the instruments used. Sociodemographic data were also recorded. The two ankyloglossia diagnostic methods were compared using the McNemar test, obtaining the kappa agreement value and the confidence interval., Results: Ankyloglossia was present in 4.8% when diagnosed with the Bristol Tongue Assessment Tool, and in 17.0% with the Tongue-Tie Test. Regarding sex, 53.1% of the newborns were males and 46.9% were females; however, there was no association between ankyloglossia and the newborn's sex in either of the assessment methods., Conclusion: The ankyloglossia diagnosis in newborns varied depending on the assessment instrument used.

Tongue-tie is characterized by an abnormally tight, short and thick lingual frenulum restricting the tongue's movement. This functional impairment can hinder a child's ability to maintain an effective latch and suckle and may lead to complex breastfeeding difficulties. The primary aim of this study was to explore the experiences of mothers who have breastfed a child with tongue-tie, including their experiences with the health care system. A qualitative description study design was used. Two semistructured focus groups were conducted in February 2016 with a total of nine participants in the largest metropolitan area of Newfoundland and Labrador, Canada. Content analysis using constant comparison revealed a common incongruity between participants' breastfeeding expectations and their actual experiences of feeding a child with tongue-tie. Three major themes are discussed: mothers' well-being, strained interpersonal relationships and frustration with the health care system., (© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

The aim of present study is a macro evaluation of adjustment to allow homeostasis before and after frenectomy. Macro analysis was done on 7 pediatric patients tested firstly simple surface elettromyography (EMG) to evaluate masticatory muscles, secondly the Romberg's test to assess the posture and thirdly cephalometric analysis according to Giannì and Rocabado to assess orthodontic variations. The frenectomy was performed with diode laser (wavelength 890 nm). Pre-frenectomy EMG outcomes indicate a clear masticatory muscular imbalance with a different electrical activity compared to physiological standard values and functional basal balance. Results after frenectomy EMG show a normalization of basal values with an improvement of mandibular posture. Depending on cephalometric analysis, outcomes reveal a tendency to normalize the cervical lordosis, previously altered. Ultimately, pre-frenectomy Romberg's test shows initial instability in the static posture, which decreases after frenectomy. In conclusion, the short lingual fraenum not only has static correlations with the oral cavity but also dynamic connections with the cervical posture and muscular basal organization. So, homeostasis includes macro alterations involving muscular tone and bone position. Frenectomy could favor the restoration of the basal eutonia achieved by a natural homeostasis., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Background: The lingual frenulum is a mucous membrane fold found underneath the tongue. It helps the tongue to perform its function. There are few anomalies that can affect the lingual frenulum, such as ankyloglossia and absence of the lingual frenulum. We report a case of two lingual frenula to educate practitioners about the presence of such an anomaly., Case Presentation: A 10-year-old healthy Saudi girl came to our dental clinic complaining of "malpositioned frontal teeth." Upon intraoral examination, two lingual frenula were found connecting the tongue with the floor of the mouth. Intraoral examination revealed no other abnormalities., Conclusion: Double lingual frenulum is an existing frenulum anomaly that did not affect normal function of our patient. A search of the literature revealed that this may well be the first reported case of such a condition.

Purpose: To analyze the quality indicators of the hearing screening program and to evaluate lingual frenulum in newborns, in terms of coverage rates, duration of hearing screening, referral indexes and prevalence of ankyloglossia in a university hospital specializing in mother and child care., Method: This is a cross-sectional study, in which we analyzed the database of the newborn hearing screening and lingual frenulum assessment program for the period between September 2015 and August 2016., Results: During the study period, 2,345 babies were born at the institution, 1,380 (58.8%) underwent newborn hearing screening and 1,350 (57.6%) were diagnosed with a lingual frenulum. Mean gestational age was 39 weeks (± 1.6), birth weight 3478g (± 469.2) and 69% were boys. In newborn hearing screening, 95.7% of the 1,380 babies screened were discharged with guidance, 2.4% were referred for auditory monitoring and 1.9% of babies were referred for auditory diagnosis. In lingual frenulum assessment, 123 (9.1%) of the 1,350 evaluated, had ankyloglossia, 85 were boys and 47 girls., Conclusion: The indicators of the time of life in which the hearing screening is performed, the referral indices and ankyloglossia prevalence are in line with those reported in the literature; however, coverage rates were lower than recommended and do not comply with Brazilian law.

Objective: To characterize the lingual frenulum of full-term newborns using two different protocols and to assess the association of the lingual frenulum with breastfeeding., Methods: This non-probabilistic sample consisted of 449 mother/baby binomials. For the anatomo-functional evaluation of the frenulum, the Neonatal Tongue Screening Test and the Bristol Tongue Assessment Tool were used for the evaluation of the lingual frenulum. Breastfeeding was evaluated using the protocol proposed by UNICEF. Scores were created (good, fair, poor) to evaluate every aspect of the breastfeeding to be observed. The results were analyzed through descriptive and inferential statistics and association tests (Pearson's chi-squared and Fisher's exact test)., Results: The study showed that 14 babies had a lingual frenulum alteration, of whom three had difficulties during suction, requiring frenotomy in the first week of life, whereas 11 had no difficulties during breastfeeding. Regarding the breastfeeding evaluation, 410mother/baby binomials had good, 36 regular, and three had bad scores. There was a statistically significant association between the tongue-tie test protocol and breastfeeding (p=0.028) and between the Bristol Tongue Assessment Tool protocol and breastfeeding (p=0.028)., Conclusion: Alterations in the lingual frenulum are associated with interferences in the quality of breastfeeding and thus, evaluation of the lingual frenulum in newborns is important., (Copyright © 2019 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Congenital bifid tongue is a rare malformation, which is usually present in association with other oral findings such as cleft palate and tongue mass. The authors present a rare case of congenital bifid tongue together with cleft palate, labial-buccal frenulum deformity, absence of lingual frenulum, and 3 hamartomas in the oral cavity. The authors excised oral hamartomas and repaired the palate and tongue with satisfactory results.

The health risks associated with aspiration and ingestion of foreign bodies in children are well known. The increased availability of magnetic toys have added to these risks. A 7-year-old girl presented at the Department of Maxillofacial and Oral Surgery at the University of Pretoria Oral and Dental Hospital with a complaint of pain under the tongue. Examination revealed that magnetic balls had been lodged on either side of the lingual frenum. The patient experienced pain and was unable to dislodge the magnets. This case report documents patient presentation and management and concludes with a brief discussion of potential complications associated with the oral intake of magnets. Though multiple cases documenting the complications associated with ingestion of magnets have been reported, reports of primary oral complications are scant. This case contributes to existing evidence for the dangers associated with high strength magnets used as toys by children.

Objective: The primary purpose of this study was to develop an operational definition of the oral condition of ankyloglossia (also called tongue-tie) that occurs in newborns (i.e., age birth-6 months) and that could consistently be used in research studies., Study Design: This 4-round Delphi survey developed the consensus New York University-Tongue-Tie Case Definition (NYU-TTCD) by using a panel of ankyloglossia treatment experts., Results: This tongue-tie case definition (TTCD) was carefully created in a step-wise manner from the bottom up by expert panelists over 4 rounds of inquiry. As a functioning case definition, it offers the diagnostician 2 separate pathways to identifying a newborn as being tongue tied. One pathway requires but a single pathognomonic anatomic feature, and the other pathway requires a single functional deficit accompanied by at least 2 of 12 other diagnostic items (functional, anatomic, or behavioral)., Conclusions: This Delphi survey, as administered to a panel of ankyloglossia treatment experts, produced the first consensus case definition of tongue-tie for newborns (i.e., age birth-6 months) for use in epidemiologic research studies ranging from descriptive prevalence studies to clinical trials. Next-step studies should establish the validity, reliability, and utility of this novel NYU-TTCD case definition for epidemiologic and clinical purposes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Ankyloglossia, also known as tongue-tie, is an embryological anatomical malformation of the tongue, characterized by an abnormally short and a thick lingual frenum. Tongue-tie restricts the physiologic movements of the tongue and results in various functional, behavioral and speech abnormalities along with the development of frontal and lateral lisps. Ankyloglossia in infants is also linked with the difficulty in breastfeeding difficulty, gagging, choking or vomiting food, delayed development or deterioration of speech and behavioral issues. A lingual frenectomy is a common oral surgical procedure done to correct an ankylosed lingual frenum by severing the abnormal frenal attachment on the ventral surface of the tongue. However, lingual frenectomy is associated with few complications that should be addressed to achieve a good overall prognosis. Though a lot of research is available on the various techniques and rationale to correct ankyloglossia, no paper has yet highlighted the surgical complications associated with lingual frenectomy. Therefore, the present paper for the first time review and highlight the common intraoperative and postoperative complications following lingual frenectomy., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Ankyloglossia is a condition of altered tongue mobility due to the presence of restrictive tissue between the undersurface of the tongue and the floor of mouth. Potential implications of restricted tongue mobility (such as mouth breathing, snoring, dental clenching, and myofascial tension) remain underappreciated due to limited peer-reviewed evidence. Here, we explore the safety and efficacy of lingual frenuloplasty and myofunctional therapy for the treatment of these conditions in a large and diverse cohort of patients with restricted tongue mobility., Methods: Four hundred twenty consecutive patients (ages 29 months to 79 years) treated with myofunctional therapy and lingual frenuloplasty for indications of mouth breathing, snoring, dental clenching, and/or myofascial tension were surveyed. All procedures were performed by a single surgeon using a scissors and suture technique. Safety and efficacy was assessed >2 months postoperatively by means of patient-reported outcome measures., Results: In all, 348 surveys (83% response rate) were completed showing 91% satisfaction rate and 87% rate of improvement in quality of life through amelioration of mouth breathing (78.4%), snoring (72.9%), clenching (91.0%), and/or myofascial tension (77.5%). Minor complications occurred in <5% of cases including complaints of prolonged pain or bleeding, temporary numbness of the tongue-tip, salivary gland issues, minor wound infection or inflammation, and need for revision to excise scar tissue. There were no major complications., Conclusion: Lingual frenuloplasty with myofunctional therapy is safe and potentially effective for the treatment of mouth breathing, snoring, clenching, and myofascial tension in appropriately selected patient candidates. Further studies with objective measures are merited., Level of Evidence: 3., (© 2019 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society.)

Ankyloglossia, or tongue-tie, is a congenital malformation, in which a short, lingual frenulum or a tight genioglossus muscle restricts tongue movement. In newborns, the reported prevalence is 2-11%. However, only 18% of newborns, in whom clinical findings suggest ankyloglossia, develop symptoms. Several randomised clinical trials report a significant reduction in maternal nipple pain after frenotomy. Frenotomy is a low-procedure surgery, but the benefits are sparsely documented. Parents should be presented with risk and benefits, before a frenotomy is offered.

During the last decade, increasing awareness of breastfeeding and its health benefits has not been reflected in the provision of lingual frenotomy in neonates with tongue-tie. This could be because of inconsistencies in our understanding of the importance and treatment of ankyloglossia. In this review, we discuss the current clinical guidance on diagnosis and management, and the future of such a service in the early postpartum period., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Background: The lingual frenum is a fold of mucous membrane connecting the ventral tongue to the floor of the mouth. In general, lingual frenum serves multiple roles; its main function is to support the tongue and aid in limiting its movement in different directions. Any anatomical or functional deficiency of lingual frenum may have an impact on tongue functions based on its severity. Historically, the absence of lingual frenum was linked to multiple genetic and developmental conditions such as infantile hypertrophic pyloric stenosis, non-syndromic ankyloglossia diseases, and Ehlers-Danlos syndromes and was never reported in otherwise healthy individuals., Case Presentation: We report the absence of lingual frenum in an otherwise healthy 21-year-old Middle Eastern woman diagnosed during a routine dental examination., Conclusion: To the best of our knowledge, this is the first case to be reported in the literature with similar clinical presentation. Even without a significant impact on tongue movement or speech, it is important for health practitioners to be aware of such conditions and evaluation steps for diagnosis and management.

In this article, the authors propose a specific Myofunctional Therapy Protocol for patients with altered lingual frenulum. In such cases tongue muscles are hypofunctioning and their range of motion is reduced. To compensate for this limitation, dysfunctional lingual motor patterns are established, such as the use of some muscles at the expense of others; this negatively affects the development and functions of the stomatognathic system. The Myofunctional Therapy Protocol presented in this pilot study was developed with the aim of making the muscles of the tongue, the floor of the mouth and the soft palate more coordinated, and increasing muscle contraction strength, in order to produce improvements on the muscle tone, on orofacial and nasal functions and a better wound healing and functional recovery in the case of surgical therapy (frenulotomy).

Objective: The present study aimed to evaluate lingual frenulum in children affected by congenital Zika syndrome (CZS) and to analyze the association of lingual frenulum phenotypes with other variables., Design: This present work had a cross-sectional, descriptive study design., Setting: This study was carried out in Fortaleza (Brazil). The health professionals provided tertiary level of care. Data collection occurred during a multidisciplinary task force for evaluating infants affected by CZS in December 2 to 3, 2016., Patients: Fifty-four patients with CZS (1-12 months old; 32 girls and 22 boys) were recruited from a population of 70 infants., Interventions: A multidisciplinary group comprised of speech-language pathologist/audiologists and pediatric dentists evaluated all patients through an intraoral examination and a specific tongue maneuver protocol for infants., Main Outcome Measures: Lingual frenulum visibility was the primary outcome measure. Before initiating the study, we hypothesized that children with CZS had an absent lingual frenulum., Results: Lingual frenula were visible in 34 (63%) infants, whereas in 20 (37%) infants lingual frenula visibility required a specific maneuver to retract the tongue. Six of 20 infants presented posteriorly positioned lingual frenula that were visible after maneuver. Lingual frenula were covered by mucous tissue in 14 infants. Presence of posterior frenulum was associated with dysphagia ( P = 0.038). However, the presence of dysphagia in a multivariate model did not associate with the presence of a posterior lingual frenulum ( P = .069) or neurologic symptoms ( P = .056)., Conclusion: Children with CZS showed predominance of a posterior lingual frenula covered by an overlapping curtain-like mucous membrane.

Background: Over the last decade, a number of studies have demonstrated that early division of tongue-tie (TT) is associated with significant feeding benefits to both mother and baby. Notwithstanding, it remains a controversial procedure. We examined the breastfeeding outcomes of a cohort of babies at 1-2 weeks (follow-up 1) and 3-5 months (follow-up 2), post-TT division., Methods: We undertook a cohort study on all mother/baby dyads who had a TT divided at Canberra Hospital between 1 July 2013 and 30 June 2014. We contacted the mothers of both follow-up groups by telephone, focusing on breastfeeding and maternal pain., Results: Follow-up 1 consisted of 116/182 (63.7%) of mothers in the study; contacted at 12.4+-7.8 days post-division. Of these, 107/116 (92.2%) were still breastfeeding, with 11/15 (73.3%) of the mothers who had ceased breastfeeding before division having re-established it at the time of follow-up (p < 0.00l). Additionally, 90/101 (89.1%) valid responses reported decreased nipple pain following TT division. Follow-up 2 consisted of 112/182 (61.5%) of all mothers in the study; contacted at 3.7+-1.8 months of age. Of these, 86/112 (76.8%) were still breastfeeding, with 11/15 (73.3%) of mothers who had ceased breastfeeding before division having re-established it at follow-up (p < 0.001)., Conclusion: A divided TT was associated with benefits at both periods of follow-up. There was (i) an increase in overall breastfeeding rates and (ii) a decrease in maternal pain.

Background. Occlusal rims are used to determine the jaw relationships in the transverse and vertical dimensions and estimate the inter-occlusal distance in edentulous patients. It is important to find ways to determine the height and shape of the occlusal rims correctly. This study was undertaken to determine the exact distance from the oral cavity floor to the incisal edges of mandibular incisors to serve as a guide for adjusting the height of the mandibular occlusal rim. Methods. Forty patients were selected and special trays were fabricated to prepare accurate stone casts on which the measurements were made at 0.01-mm accuracy. Two marks were placed on the casts at the incisal edges of mandibular incisors and at anterior attachment of lingual frenum. Then the distance between these two marks was determined on the vertical spindle of a surveyor using a digital Vernier measuring tool and recorded. Results. The results showed that the mean and standard deviation of the distances between the oral cavity floor and the incisal edges of lower incisors were 14.35 ± 1.68 mm, with a range of 10.2‒17.02 mm. The mean distances in males and females were 15.42 ± 0.97 and 13.28 ± 1.57 mm, respectively. T-test showed significant differences in this distance between males and females, with greater distances in males. Conclusion. The distance between the oral cavity floor and the incisal edges of mandibular incisors at anterior attachment of lingual frenum might be a proper criterion for the initial adjustment of occlusal rims.

Introduction: Altered lingual frenum modifies the normal tongue mobility, which may influence the stomatognathic functions, resulting in anatomical, physiological and social damage to the subject. It is necessary that health professionals are aware of the process of evaluation, diagnostics and treatment used today, guiding their intervention., Objective: To perform a systematic review of what are the treatment methods used in cases of lingual frenum alteration., Data Synthesis: The literature searches were conducted in MEDLINE, LILACS, SciELO, Cochrane and IBECS, delimited by language (Portuguese, English, Spanish), date of publication (January 2000 to January 2014) and studies performed in humans. The selection order used to verify the eligibility of the studies were related to: full text availability; review the abstract; text analysis; final selection. Of the total 443 publications, 26 remained for analysis. The surgical approach was used in all studies, regardless of the study population (infants, children and adults), with a range of tools and techniques employed; speech therapy was recommended in the post surgical in 4 studies. Only 4 studies, all with infants, showed scientific evidence., Conclusion: Surgical intervention is effective for the remission of the limitations caused by the alteration on lingual frenum, but there is a deficit of studies with higher methodological quality. The benefits of speech therapy in the post surgical period are described from improvement in the language of mobility aspects and speech articulation.

Statement of Problem: The aim of the study is to find the reliability in measuring the distance between the anterior attachment of the lingual frenum and the incisal edge of the mandibular central incisor on casts to be used as a pre-extraction record., Purpose: The objective of this study is to give a range of numerical values from anterior attachment of lingual frenum to mandibular central incisors in a class I ridge relation in south Indian population, which may be used in establishing the vertical dimension of the edentulous patient and also to locate the mandibular incisors in teeth arrangement of complete denture fabrication., Materials and Methods: One hundred subjects (50 males and 50 females) under the age group of 21-28y, with class I dental relationship and who have never undergone orthodontic treatment were selected. Two models were made for each subject using irreversible hydrocolloid impression material and type III gypsum product to obtain an average value for each subject. The distance between the incisal edges of the lower central incisor and the anterior attachment of the lingual frenum is measured using a divider and digital vernier caliper., Statistical Analysis: Mean and Standard deviation using descriptive statistics tool using SPSS software version 18., Result: The distance between the anterior attachment of the lingual frenum and incisal edges of mandibular central incisors among the 100 subjects was 14.50mm ± 2.2245 mm., Conclusion: The value obtained aided in establishing the vertical dimension easier by making a pre-determined height of mandibular occlusal rim.

Clinical Implication: The purpose of this study is to record the vertical distance between anterior attachment of lingual frenum and incisal edge of mandibular central incisors in dentulous subjects and then determine the mean vertical distance and to suggest guidelines for positioning of mandibular central incisors in complete dentures., Method: In this study, 150 dentulous subjects (75 males and 75 females) were chosen based on predecided inclusion criteria. A mandibular cast was obtained from irreversible hydrocolloid impression in modified stock trays for each subject. All subjects were instructed to elevate the tongue while the impressions were made. The vertical distance between the anterior attachment of the lingual frenum and incisal edges of mandibular central incisors was measured on the casts and then the values were statistically analyzed., Result: The distance between anterior attachment of lingual frenum (AALF) mesioincisal edge of mandibular central incisor (CI) in male, female and total (male + female) subjects was measured. In males it ranged from 7.3 to 8.9 mm with mean (±SD) 8.29 ± 0.36 mm while in females it ranged from 7.1 to 9.0 mm with mean (±SD) 8.21 ± 0.38 mm., Conclusion: It is believed that the application of this anatomic relation can provide a reliable point for arranging and checking the position of the mandibular central incisors for complete dentures in patients with class I ridge relationship.

The case of sublingual ulceration associated with erupted primary mandibular incisors in a 1-year-old child is presented. Sublingual ulceration is termed as Riga-Fede disease if the patient is less than 2 years old. Generally, the treatment methods for Riga-Fede's disease are discing and extraction of the traumatised teeth. Here, the child was treated with photo-polymerised composite resin coverage of the incisal edges of erupted mandibular incisors. The photo-polymerised resin coverage proved to help in the rapid healing of the ulcerations.

The determination of the occlusal vertical dimension and proper positioning of the anterior teeth are major factors in making complete dentures which will give optimum service. In this study, efforts were made to evaluate the reliability of measurement of vertical distance between the anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors in natural dentition among different age groups and in complete denture wearers. Three hundred dentulous subjects belonging to different age groups and hundred edentulous patients wearing complete dentures were selected. The dentulous group was divided into three groups, group I (20-40 years), group II (41-60 years), group III (61 years and above) and the edentulous subjects being group IV ( 40-60 years). Mandibular irreversible hydrocolloid impression (Alginate) was made using modified stock tray. In edentulous subjects impression was made with denture in position. The vertical distance between anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors was measured on the dentulous casts and casts of complete denture wearer using dental surveyor and the vernier calipers. The values were tabulated and statistically analysed. The mean vertical distance between anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors among dentulous subjects was 12.3 mm and among complete denture wearers was found to be 13.2 mm. There was no significant variation in the mean vertical distance among dentulous subjects belonging to different age groups. At 5 % significance level, statistically there was a significant difference in the mean vertical distance between group I and group IV; group II and group IV.

Background: Ankyloglossia or tongue-tie is a congenital anomaly characterized by an abnormally short lingual frenum. Its prevalence in the newborn population is approximately 4%. Its mode of inheritance has been studied in some articles, but no conclusion has been established. Also, no relevant report has been published in Korea. This study was conducted to elucidate the genetic inheritance of ankyloglossia via pedigree analysis., Methods: In this study, 149 patients with no other congenital anomaly who underwent frenuloplasty between March 2001 and March 2010 were studied. Pedigrees were made via pre- or post-operative history taking, and patients with uncertain histories were excluded. In the patient group that showed a hereditary nature, the male-to-female ratio, inheritance rate, and pattern of inheritance were investigated., Results: One hundred (67.11%) of the patients were male and 49 (32.89%) were female (male-female ratio=2.04:1). Ninety-one (61.07%) patients reported no other relative with ankyloglossia, and 58 (38.93%) patients had a relative with this disease. The inheritance rate was 20.69% in the 58 cases with a hereditary nature. In the group with no family history of ankyloglossia, the male-female ratio was 3.79:1, which significantly differed from that of the group with a family history of ankyloglossia. X-chromosome mediated inheritance and variation in the gene expression was revealed in the pedigree drawn for the groups with hereditary ankyloglossia., Conclusions: Ankyloglossia has a significant hereditary nature. Our data suggest X-linked inheritance. This study with 149 patients, the first in Korea, showed X-linked inheritance in patients with a sole anomaly.

Objective: To evaluate reactions in the oral mucosa after direct contact with Carisolv., Setting: The Faculty of Odontology in Göteborg, Sweden., Subjects: 34 healthy persons for a clinical screening test and 35 Sprague Dawley rats for a histological study., Design: Mixed Carisolv or 0.5 % NaOCl were soaked in paper and applied to either side of the medial frenula of the lower lip of 34 persons. The solutions were left on the oral mucosa for three minutes. Inspection was made and photographs were taken immediately after exposure and also after 1 hour, 24 hours, and 72 hours. Mixed Carisolv was applied in a similar manner as described above to 35 adult Sprague Dawley rats. The animals were killed and biopsies were taken immediately after Carisolv exposure and also after 1 hour, 24 hours, and 48 hours. The biopsies were sectioned and prepared for histomorphometrical evaluation in light microscopy where cells were counted on regions from the epithelium layer deeper into the mucous membrane., Results: Some adverse reactions were detected on the oral mucosa of humans up to 24 hours after Carisolv exposure for 3 minutes. The detected inflammatory reactions were slight and no patient felt any discomfort. The results of the histological study on rat did not show any statistically significant increase of the number of cells at any time after Carisolv exposure., Conclusions: If the oral mucosa gets in direct contact with Carisolv for 3 minutes no or only a weak inflammatory response may be expected.

Gustducin is a transducin-like G protein selectively expressed in taste receptor cells. The alpha subunit of gustducin (alpha-gustducin) is critical for transduction of responses to bitter or sweet compounds. We identified a G-protein gamma subunit (Ggamma13) that colocalized with alpha-gustducin in taste receptor cells. Of 19 alpha-gustducin/Ggamma13-positive taste receptor cells profiled, all expressed the G protein beta3 subunit (Gbeta3); approximately 80% also expressed Gbeta1. Gustducin heterotrimers (alpha-gustducin/Gbeta1/Ggamma13) were activated by taste cell membranes plus bitter denatonium. Antibodies against Ggamma13 blocked the denatonium-induced increase of inositol trisphosphate (IP3) in taste tissue. We conclude that gustducin heterotrimers transduce responses to bitter and sweet compounds via alpha-gustducin's regulation of phosphodiesterase (PDE) and Gbetagamma's activation of phospholipase C (PLC).