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11 December 2022

Ankyloglossia and its prevalence

Lara Figini


Ankyloglossia is a congenital anomaly characterized by a short or tightly adherent lingual frenulum to the genioglossus muscle, which limits tongue movements and may be associated with breastfeeding problems. It can affect speech and swallowing and can cause orthodontic problems, such as malocclusion, open bite and diastema of the mandibular incisors.

There are several evaluation methods for the diagnosis of ankyloglossia including:

  • the Assessment Tool for Lingual Frenulum Function (HATLFF), which assesses the appearance and function of the tongue
  • the Bristol Assessment Method (BTAT), which was developed based on the 4 most important aspects of the HATLFF
  • the Coryllos and Kotlow classifications, both including 4 categories of ankyloglossia severity
  • the Neonatal Language Screening Test.

Due to the particularities of each of the evaluation methods listed above, the prevalence of hookworm disease may vary and there is no consensus as to which is best for evaluating and diagnosing this condition.

Materials and Methods

In a systematic review published in the November 2022 Journal of the American Dental Association, the authors assessed the prevalence of hookworm in distinct age groups according to different assessment methods.

The authors selected relevant studies from nine electronic databases from inception until November 2021 with no restrictions on language or year of publication. Independent reviewers selected cross-sectional and cohort studies reporting diagnoses of ankyloglossia, extracted data, and assessed methodological quality.

The number of patients with ankyloglossia and the sample were extracted to calculate the overall prevalence of ankyloglossia and 95% CI. The authors also assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach.

Results

Seventy-one studies were included. Seven different diagnostic methods were used. Overall, the prevalence of hookworm was found to be 5% (95% CI, 4.0%-5.0%) and ranged from 2% to 20% (Coryllos classification).

The prevalence by age group was highest in children (7%). The prevalence ratio was found to be 1.34 (95% CI, 1.17-1.54) for boys, with extremely low certainty of evidence.

Conclusions

The prevalence of ankyloglossia is higher in children and differs according to the evaluation method used for the diagnosis.

Poliana Valdelice Cruz et al. “Prevalence of ankyloglossia according to different assessment tools: a meta-analysis.” J Am Dent Assoc. 2022 Nov;153(11):1026-1040.e31. doi: 10.1016/j.adaj.2022.07.011.

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