Katz et al reported criteria for the diagnosis of tongue-tie (ankyloglossia) in newborns and infants up to 6 months of age. The authors are from NYU College of Dentistry and from multiple institutions from around the United States.

Patient selection: newborn or infant <= 6 months of age


Criterion 1: tip of the tongue is attached directly to the lower gum


In the absence of criterion 1, then both of the following (Criterion #2):

(1) inability to elevate the tongue

(2) >= 2 of the following:

(2a) latch attachment difficulty during breast or bottle feeding

(2b) tight tissue under the tongue

(2c) floor of mouth tenting with tongue elevation

(2d) bifid appearance of tongue tip

(2e) distance from tongue tip to frenulum less than 1 cm

(2f) downward protrusion of tongue cannot reach beyond the lower lip

(2g) upward protrusion of tongue cannot reach beyond the upper lip

(2h) lateral protrusion of tongue cannot reach corner of the mouth

(2i) gumming or chewing the nipple

(2j) breastfeeding pain to mother

(2k) nipple trauma

(2l) noisy breather, starts and stops, pulls of nipple

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