Temporal trends in ankyloglossia and frenotomy in British Columbia, Canada, 2004-2013: a population-based study

Abstract

Large temporal increases and substantial spatial variations in ankyloglossia and frenotomy rates were observed that may indicate a diagnostic suspicion bias and increasing use of a potentially unnecessary surgical procedure among infants.

Frenotomy for tongue‐tie in Australian children, 2006–2016: an increasing problem

“…Our results indicate that frenotomy rates in most of Australia have increased significantly over the past decade. Increases have similarly been reported for British Columbia in Canada (2004–2013: 89% increase) and the United States (1997–2012: 866% increase) 3 , 4 . Medicare data underestimate the frenotomy rate, as this information does not capture frenotomies in public hospitals, where Medicare rebates are usually not applied.…”

“…A range of techniques are employed to treat clinically significant ties surgically (frenotomy or frenectomy), including scissors and laser surgery. Increases in the number of tongue‐tie diagnoses and in lingual frenotomy rates have recently been reported in Canada and the United States 3 , 4 …”

Response to Letter to the Editor regarding the article: Is the neonatal tongue screening test a valid and reliable tool for detecting ankyloglossia in newborns?

“…In the United States and Canada, a huge increase in the frequency of frenectomies was observed in recent decades and it has been suggested that this may be due to diagnostic suspicion bias owing to increased focus on breastfeeding initiation before hospital discharge. 27,28 Unnecessary frenectomies, besides placing an economic burden on families and healthcare systems, can also harm the children themselves. Complications reported include bleeding, recurrence, lip injury, injury to the Wharton ducts, infection, lingual dysfunction, and air-way compromise.…”

Tongue‐tie and frenotomy: what evidence do we have and what do we need?

“…Ankyloglossia in newborns with breastfeeding difficulties has been diagnosed and treated in North America with increasing frequency over the past ten years 1 , 2 . Kapoor and colleagues 3 report in this issue of the MJA that frenotomy rates in Australia increased by 420% between 2006 and 2016, with differences between states and territories in the magnitude of the change.…”

“…Confusing, low quality, and sometimes misleading information propagated by social media and in online resources about ankyloglossia and its effect on breastfeeding possibly also increase the demand for treatment. Personal, societal and cultural expectations of the breastfeeding process are also likely to play roles; ankyloglossia is diagnosed more frequently in first‐born infants and in infants from families of higher socio‐economic status 1 , 2 …”