International Consensus on Tongue Tie Assessment, Diagnosis, and Treatment: A Multidisciplinary Delphi Study

Background: Ankylofrenula, including ankyloglossia (or tongue-tie) is a condition characterized by a restricted lingual frenum, has garnered increasing attention due to its potential impact on breastfeeding, oral function, speech, and overall quality of life. Despite the growing body of literature, significant variability exists in assessment and management approaches among healthcare professionals.

Objective: This study aimed to establish an international consensus on the assessment and management of ankylofrenula through a Delphi methodology, involving a survey of experienced clinicians internationally.

Methods: A two-round Delphi study was conducted, incorporating qualitative and quantitative data. Participants included 91 clinicians from various countries with backgrounds in dentistry, medicine, lactation, speech-language pathology, osteopathy, dental hygiene, occupational therapy and other fields. In the first round, 104 statements were posed to gather feedback. Round two utilized 37 reworded statements that didn’t achieve 75% overall agreement in round 1 to check consensus on key assessment tools and management strategies.

Results: The study identified a set of 91 statements which achieved over 75% consensus by most participants. Consensus was achieved on ankyloglossia definition, diagnosis, assessment, clinical decision-making, non-surgical management, surgical management, labial and buccal frenula assessment and management. 

Conclusion: This was the first international multidisciplinary Delphi study which has successfully established consensus on best practices for the assessment and management of ankylofrenula. Overall, most participants agreed on most of the statements proposed. The findings aim to guide practitioners in delivering consistent and effective interventions, ultimately improving patient outcomes in various clinical settings.

Dr. Sharon Smart is a Senior Lecturer at the Faculty of Health Sciences, the Curtin School of Allied Health, and Senior Research Fellow at St John of God Hospital. She completed her Bachelor of Science studies in Human Communication Science at Curtin University in 2000, and PhD studies in Human Communication Science at the School of Psychology and Speech Pathology, Curtin University in 2008