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Bristol Tongue Assessment Tool (BTAT) for Tongue Tie

Purpose: To evaluate a neonate or young infant for tongue-tie (ankyloglossia) using the Bristol Tongue Assessment Tool (BTAT) of Ingram et al.

Description

Ingram et al developed a simple instrument to screen a young infant for tongue-tie (ankyloglossia). This can help to identify an infant who may benefit from frenotomy. The authors are from the University of Bristol, Southmead Hospital and University Hospitals Bristol.


The BTAT is based on 4 items from the Hazelbaker Assessment Tool for Lingual Frenulum Function (ATLFF).

 

Parameters:

(1) tongue tip appearance

(2) attachment of frenulum to lower gum ridge (attachment of lingual frenulum to inferior alveolar ridge)

(3) lift of tongue with mouth wide

(4) protrusion of tongue (extension of tongue)

 

Parameter

Finding

Points

tongue tip

heart-shaped

0

 

notched, slight cleft

1

 

rounded

2

attachment of frenulum to lower gum ridge

attached at top of gum ridge

0

 

attached to inner aspect of gum

1

 

attached to floor of the mouth

2

lift of tongue

minimal

0

 

edges only to mid mouth

1

 

full tongue lift to mid mouth

2

protrusion of tongue

tip stays behind gum

0

 

tip over gum

1

 

tip can extend over lower lip

2

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 8

• A score <= 3 is associated with a severe reduction of tongue function.


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Specialty

Objective

ICD-10