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Ankyloglossia (tongue-tie) in infants and children

Author
Glenn C Isaacson, MD, FAAP
Section Editor
Anna H Messner, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Ankyloglossia, or tongue-tie, is a congenital anomaly in which a short, lingual frenulum or a highly-attached genioglossus muscle restricts tongue movement (ie, restrictive lingual frenulum) (picture 1A-B) [1]. The definition of ankyloglossia is not standardized and there is wide variation of opinion regarding its clinical significance and optimal management [2,3].

Ankyloglossia will be discussed here. Other congenital anomalies of the tongue are discussed separately. (See "Congenital anomalies of the jaw, mouth, oral cavity, and pharynx".)

EPIDEMIOLOGY

The reported prevalence of ankyloglossia varies from <1 percent to 10 percent, depending upon the study population and criteria used to define ankyloglossia [1,4-13]. A uniform definition and objective grading system for tongue-tie are lacking, though standardized measurement techniques and norms have been proposed (figure 1 and figure 2) [14,15].

In most series, the frequency of tongue-tie is higher among boys with a male to female ratio of 1.5:1 to 2.6:1 [4]. While most cases of ankyloglossia are sporadic, mutations in the T box transcription factor TBX22 may lead to heritable (X-linked) ankyloglossia with or without cleft lip, cleft palate, or hypodontia [16].

CLINICAL FEATURES

Ankyloglossia — Clinical features of ankyloglossia may include [1,14,17]:

                

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Literature review current through: Jan 2017. | This topic last updated: Wed Feb 15 00:00:00 GMT 2017.
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