Incidence of oral tie diagnosis and treatment in Southwestern Ontario: A survey study

Abstract

Background

Ankyloglossia describes a short lingual frenulum restricting tongue mobility. There are no universally accepted diagnostic criteria, and the rate of diagnosis and treatment are increasing. Many frenotomies are performed in the outpatient setting, making it difficult to estimate ankyloglossia incidence. This study aims to estimate the rate of diagnosis and common indications cited for treatment of ankyloglossia in a large catchment in Southwestern Ontario, Canada.

Methods

A survey was administered to all patients presenting to a pediatric otolaryngology clinic and five community pediatric clinics querying oral tie diagnosis, indications for treatment communicated to parents, recommended treatments, providers involved, procedure-related complications, and cost.

Results

Of the 266 respondents, 53.0 % (n = 141) were diagnosed with an oral tie. The most common reason to seek assessment was breast feeding difficulties (69.7 %, n = 92). The majority (78.8 %, n = 104) of patients diagnosed with a tongue tie were recommended to receive treatment, primarily frenotomy (69.7 %, n = 92). Complications included pain (24.2 %) and mild/moderate bleeding (11.0 %). Most patients paid out-of-pocket for this procedure, with only 22.6 % (n = 21) of procedures being covered by provincial insurance and 19.4 % (n = 18) by private insurance. Overall, 84.4 % (n = 76) of parents were satisfied or very satisfied with their decision to pursue treatment.

Conclusion

The rate of tongue tie diagnosis in survey respondents was more than double the national rate (22.6 %), possibly representing over diagnosis or overtreatment in Southwestern Ontario. Public health and education efforts may be required to ensure patients are appropriately selected for frenotomy procedures, to limit adverse outcomes and cost to patients.