The Impact of Ankyloglossia Beyond Breastfeeding: A Scoping Review of Potential Symptoms

Abstract

Objective: The purpose of this study was to evaluate the spectrum of pediatric quality-of-life sequelae associated with ankyloglossia that may affect children who do not undergo tongue-tie release (frenotomy) during infancy. Data Sources: This study contains data from PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar (1961–January 2023). Review Method: The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews reporting guidelines. Experimental and observational studies were eligible if they reported baseline outcomes associated with ankyloglossia in children above a year of age. Two reviewers independently screened studies, extracted data, and assessed quality. Low-quality studies were excluded. Conclusions: Twenty-six of 1,568 screened studies (> 1,228 patients) were included. Six studies were high quality and 20 were medium quality. Studies identified various symptoms that may be partially attributable to ankyloglossia after infancy, including speech/articulation difficulties, eating difficulties, dysphagia, sleep-disordered breathing symptoms, dental malocclusion, and social embarrassment such as oral hygiene issues. Multiple comparative studies found associations between ankyloglossia and risk factors for obstructive sleep apnea; a randomized controlled trial found that frenotomy may attenuate apnea severity. Ankyloglossia may also promote dental crowding. Implications for Practice: Ankyloglossia may be associated with myriad effects on children's quality of life that extend beyond breastfeeding, but current data regarding the impact are inconclusive. This review provides a map of symptoms that providers may want to evaluate as we continue to debate the decision to proceed with frenotomy or nonsurgical therapies in children with ankyloglossia. A continuing need exists for controlled efficacy research on frenotomy for symptoms in older children and on possible longitudinal benefits of early frenotomy for maxillofacial development. Supplemental Material: https://doi.org/10.23641/asha.23900199

Lingual Frenotomy in Pediatric Ankyloglossia: A Diode Laser Approach in Two Case Reports

“…Most ankyloglossia-related evidence is focused on breastfeeding, swallowing, and speech. However, some recent systematic reviews have highlighted the lack of quality evidence on those very aspects [15][16][17]. Besides genetic factors, some environmental factors have been considered responsible for influencing anterior crossbites, such as incorrect postural habits, prolonged tongue-sucking habits, low tongue posture, ankyloglossia, atypical swallowing, airway obstruction, oral breathing, hormonal imbalances, trauma, premature loss of primary teeth, congenital anatomical defects and muscular dysfunction [18][19][20].…”

The influence of tight tongue-ties and tongue-tie clips on speech development

“…Nogle af studierne rapporterer, at ankyloglossi kan føre til nedsat forståelighed af børns tale og problemer med at udtale isaer de lyde, der kraever løft eller en fremadgående bevaegelse af tungen (ofte naevnes sproglydene /r, s, t, l, d/ og den engelske »th«-lyd, /θ/) [8,11,13,17]. Mange af studierne på området er dog ikke af høj kvalitet på grund af få deltagere, manglende kontrolgrupper, manglende beskrivelser af udtalefejlene, manglende angivelser af, om børnene har modtaget logopaedisk intervention, samt manglende formelle logopaediske test eller vurderinger [8,[18][19][20].…”

Ankyloglossia as a Barrier to Breastfeeding: A Literature Review

“…Following the same theory again, another connection between ankyloglossia and solid foods is considered in [58]. Masticatory function is investigated as one more aspect for attaining a better quality of life.…”