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Can Fam Physician
Vol. 53, No. 6, June 2007, pp.1027 - 1033
Copyright © 2007 by The College of Family Physicians of Canada
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Clinical Review

Prevalence, diagnosis, and treatment of ankyloglossia

Methodologic review

Lauren M. Segal, MD, Randolph Stephenson, PhD, Martin Dawes, MB BS MD FRCGP and Perle Feldman, MD FCFP
Dr Segal is a resident in pediatrics at Ste-Justine’s Hospital in Montreal, Que. Dr Stephenson and Dr Feldman are Assistant Professors in the Herzl Family Practice Center at the Jewish General Hospital and McGill University in Montreal. Dr Dawes is an Associate Professor and Chair of Family Medicine at McGill University

Correspondence to: Dr Lauren Segal, 73 Wicksteed Ave, Montreal, QC H3P 1P9; telephone 514 737-6209; e-mail lauren.segal{at}elf.mcgill.ca

OBJECTIVE To review the diagnostic criteria for, the prevalence of, and the effectiveness of frenotomy for treatment of ankyloglossia.

DATA SOURCES MEDLINE and CINAHL databases were searched for articles suitable for a methodologic review of studies on various aspects of ankyloglossia.

STUDY SELECTION Studies that presented data on patients and addressed ankyloglossia in relation to breastfeeding were selected. Case reports, case series, retrospective studies, prospective controlled studies, and randomized controlled trials were included in the analysis. Opinion pieces, literature reviews, studies without data on patients, studies that did not focus on breastfeeding, position statements, and surveys were excluded.

SYNTHESIS There is no well-validated clinical method for establishinga diagnosis of ankyloglossia. Five studies using different diagnostic criteria found a prevalence of ankyloglossia of between 4% and 10%. The results of 6 non-randomized studies and 1 randomized study assessing the effectiveness of frenotomy for improving nipple pain, sucking, latch, and continuation of breastfeeding all suggested frenotomy was beneficial. No serious adverse events were reported.

CONCLUSION Diagnostic criteria for ankyloglossia are needed to allow for comparative studies of treatment. Frenotomy is likely an effective treatment, but further randomized controlled trials are needed to confirm this. A reliable frenotomy decision rule is also needed.






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Copyright © 2007 by The College of Family Physicians of Canada.