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Acta Paediatrica (Oslo, Norway : 1992) May 2022Tongue tie is a common problem affecting breastfeeding due to poor infant latch and/or maternal pain. Evidence of whether treatment improves breastfeeding outcomes is... (Meta-Analysis)
Meta-Analysis Review
AIM
Tongue tie is a common problem affecting breastfeeding due to poor infant latch and/or maternal pain. Evidence of whether treatment improves breastfeeding outcomes is conflicting. We conducted a systematic review and meta-analysis to examine the effectiveness of tongue-tie treatment on breastfeeding difficulties.
METHODS
We searched peer-reviewed and grey literature in MEDLINE (OVID), PubMed, CINAHL Plus, EMBASE and PsycINFO, from 01/1970 to 09/2019.
INCLUSION
randomised and non-randomised clinical trials, and quasi-experimental study designs, involving breastfeeding interventions for full-term singleton infants, using standardised measure of breastfeeding difficulty.
EXCLUSION
qualitative and purely observational studies, lacked operational definition of breastfeeding difficulty, lacked control/comparison group. We assessed risk of bias, summarised study quality and results and conducted meta-analysis using random effects modelling.
RESULTS
Six studies on tongue-tie division were included (4 randomised and 2 non-randomised). Meta-analysis of standardised mean differences in breastfeeding difficulty scores in four studies showed statistically significant differences in favour of frenotomy (Pooled SMD +2.12, CI:(0.17-4.08)p = 0.03). Similarly, a statistically significant difference in favour of frenotomy was observed for pain (Pooled SMD -1.68, 95% CI: (-2.87- -0.48).
CONCLUSION
Results support that infant frenotomy is effective for improving standardised scores on breastfeeding difficulty and maternal pain scales and could improve breastfeeding outcomes.
Topics: Ankyloglossia; Breast Feeding; Female; Humans; Infant; Lingual Frenum; Pain; Pain Measurement
PubMed: 35150472
DOI: 10.1111/apa.16289 -
Journal of the American Dental... Jan 2024Ankyloglossia is a congenital alteration that affects the tongue's mobility, influencing craniofacial development; however, its association with malocclusion is still... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ankyloglossia is a congenital alteration that affects the tongue's mobility, influencing craniofacial development; however, its association with malocclusion is still unclear. This systematic review and meta-analysis investigated the association between ankyloglossia and malocclusion in patients.
TYPES OF STUDIES REVIEWED
The authors conducted a systematic review and meta-analysis of observational studies that investigated the association between malocclusion and the presence of ankyloglossia in any age group, used any assessment tool to diagnose ankyloglossia, and considered all types of malocclusion. The authors conducted searches in 8 electronic databases through July 1, 2022. They used Joanna Briggs Institute appraisal tools to assess the methodological quality and the Grading of Recommendations, Assessment, Development and Evaluations approach to assess the certainty of the evidence.
RESULTS
Eleven studies (5 cross-sectional, 6 case-control) included 2,904 patients and over 13 occlusal alterations. The certainty of the evidence ranged from low through very low. Patients with Angle Class III malocclusion had similar or more inserted lingual frenula than patients with Class I malocclusion (standard mean difference, 0.37; 95% CI, -0.50 to 1.25) and Class II malocclusion (standard mean difference, 0.55; 95% CI, -0.52 to 1.63). Patients with Class III malocclusion had clinically significant increased mouth opening reduction compared with patients with Class I malocclusion (mean difference, 6.67; 95% CI, 4.01 to 9.33) and Class II malocclusion (mean difference, 5.04; 95% CI, 2.35 to 7.72) patients.
PRACTICAL IMPLICATIONS
There is uncertain evidence that ankyloglossia may be associated with the development of occlusal alterations. Ankyloglossia did not influence the Angle classification. Clinicians should closely follow children with ankyloglossia to evaluate whether this condition interferes with the occlusion. Future research should prospectively follow up on the long-term association between ankyloglossia and malocclusion. The protocol was registered a priori in the PROSPERO database (CRD42021248034). No amendments were deemed necessary after the registration of the protocol. Some subgroup analyses planned a priori were not possible, such as the severity of ankyloglossia, sex, and age, due to the lack of studies reporting data for these subgroups.
Topics: Child; Humans; Ankyloglossia; Cross-Sectional Studies; Malocclusion; Malocclusion, Angle Class III; Malocclusion, Angle Class II
PubMed: 37999659
DOI: 10.1016/j.adaj.2023.09.014 -
Advances in Neonatal Care : Official... Apr 2016Our current culture defines breastfeeding and the use of human breast milk as the preferred criterion standard for infant nutrition. Medical and health professionals... (Review)
Review
BACKGROUND
Our current culture defines breastfeeding and the use of human breast milk as the preferred criterion standard for infant nutrition. Medical and health professionals have a responsibility to support breastfeeding in the mother-infant dyad. This includes the recognition of anatomical barriers to breastfeeding such as a tongue-tie, ankyloglossia.
PURPOSE
The purpose of this article is to enrich and expand the clinical knowledge of health professionals about the physical assessment of ankyloglossia and its impact on breastfeeding. Techniques for assessing anterior and posterior ankyloglossia and interventions across the spectrum are discussed. We also explore maternal emotional experiences of breastfeeding an infant with ankyloglossia.
METHODS/SEARCH STRATEGY
A systematic literature search from MEDLINE, CINAHL, and Cochrane databases was performed. The search results consisted of qualitative and quantitative studies performed involving infants with anykloglossia and breastfeeding experiences. Data and findings from the search results were analyzed and reviewed.
FINDINGS
Ankyloglossia, commonly referred to as tongue-tied, can result in weight loss, painful breastfeeding, and a cessation of breastfeeding prematurely. Depending on severity, interventions to alleviate breastfeeding difficulties can range from a lactation consultation to surgical intervention. The options for treatment and intervention must be discussed thoroughly with caregivers.
IMPLICATIONS FOR PRACTICE
Thorough assessment of the breastfeeding dyad is essential to discovering ankyloglossia and its role in breastfeeding difficulties. Intervening appropriately can prevent negative outcomes associated with ankyloglossia and breastfeeding.
IMPLICATIONS FOR RESEARCH
Future studies should be focused on developing universal tools for grading ankyloglossia and the effects of ankyloglossia on speech development. There is also a gap in the knowledge regarding ankyloglossia in the preterm infant and its impact on developing breast and bottle-feeding technique in the neonatal intensive care unit.
Topics: Ankyloglossia; Breast Feeding; Humans; Infant, Newborn; Lingual Frenum; Oral Surgical Procedures; Referral and Consultation
PubMed: 27003478
DOI: 10.1097/ANC.0000000000000252 -
Pediatric Clinics of North America Apr 2003Ankyloglossia is an uncommon oral anomaly that can cause difficulty with breast-feeding, speech articulation, and mechanical tasks such as licking the lips and kissing.... (Review)
Review
Ankyloglossia is an uncommon oral anomaly that can cause difficulty with breast-feeding, speech articulation, and mechanical tasks such as licking the lips and kissing. For many years the subject of ankyloglossia has been controversial, with practitioners of many specialties having widely different views regarding its significance. In many children, ankyloglossia is asymptomatic; the condition may resolve spontaneously, or affected children may learn to compensate adequately for their decreased lingual mobility. Some children, however, benefit from surgical intervention (frenotomy or frenuloplasty) for their tongue-tie. Parents should be educated about the possible long-term effects of tongue-tie while their child is young (< 1 year of age), so that they may make an informed choice regarding possible therapy.
Topics: Child; Humans; Lingual Frenum; Speech Disorders; Tongue
PubMed: 12809329
DOI: 10.1016/s0031-3955(03)00029-4 -
The Journal of Contemporary Dental... Apr 2021Breastfeeding plays a key role in the development of the baby, in addition to the benefits to the mother and this dyad. Among the possible difficulties in this process,... (Review)
Review
OBJECTIVE
Breastfeeding plays a key role in the development of the baby, in addition to the benefits to the mother and this dyad. Among the possible difficulties in this process, we have ankyloglossia. Some professionals opt for the frenotomy, although the literature is controversial. This paper aims to present how the literature provides subsidies for health professionals' decision and action in the intersection of the themes: breastfeeding, ankyloglossia, and frenotomy.
MATERIALS AND METHODS
The research on the platforms SciELO and PubMed used the terms: "ankyloglossia," "frenotomy," and "lingual frenulum" and the same ones associated with "breastfeeding." A specific inclusion and exclusion criteria were applied and validated by the American Speech-Language-Hearing Association to reduce any bias in the analysis. In the end, 16 papers were included and, by thematic equivalence, divided into two domains: association between lingual frenulum alteration and breastfeeding and between frenotomy and breastfeeding.
RESULTS
The literature does not assure that the frenotomy is the "standard conduct" to be adopted in cases of difficulty in breastfeeding and ankyloglossia.
CONCLUSION
Further studies are needed on the different types of ankyloglossia and their direct influence on the sucking function and lactation difficulties.
Topics: Ankyloglossia; Breast Feeding; Female; Humans; Inclusion Bodies; Infant; Lingual Frenum; United States
PubMed: 34267016
DOI: No ID Found -
Revista Paulista de Pediatria : Orgao... 2017To critically examine the existing Brazilian and International scientific literature regarding the influence of short lingual frenulum over growth and development of the... (Review)
Review
OBJECTIVE
To critically examine the existing Brazilian and International scientific literature regarding the influence of short lingual frenulum over growth and development of the stomatognathic system, as well as how it impacts the achievement of the shape-function balance.
DATA SOURCES
An electronic literature search was conducted in databases, including MEDLINE/PubMed, Google Scholar, LILACS, SciELO, and ScienceDirect, using the key words "lingual frenum" and "development", as well as their equivalents in Brazilian Portuguese. The literature search yielded 51 papers published between January 1997 and the present date; 14 articles of clinical trials were selected for meeting the inclusion criteria and were read in full.
DATA SYNTHESIS
The integrated literature review supported the proposition that some malocclusions are closely related to the presence of ankyloglossia and, although very few clinical trials on this topic have been published so far, there is a consensus among authors concerning the negative effects of functional imbalances over the stomatognathic system's proper growth and development. Half of the studies found state that surgical interventions for releasing the lingual frenum are both safe and effective, concerning improvement in breastfeeding scores. Moreover, 4 out of the 14 studies included in this integrated review, report a negative influence of ankyloglossia over the orofacial muscular system.
CONCLUSIONS
There is a consensus among the authors concerning the negative effects of lingual frenulum's anatomic and functional alterations over craniofacial growth and development. The opinion about the early surgical intervention, however, is not unanimous.
Topics: Adolescent; Ankyloglossia; Child; Child, Preschool; Female; Humans; Infant; Male; Stomatognathic System
PubMed: 28977337
DOI: 10.1590/1984-0462/;2017;35;2;00016 -
CMAJ : Canadian Medical Association... Oct 2023
Topics: Infant; Humans; Female; Ankyloglossia; Breast Feeding; Tongue
PubMed: 37816524
DOI: 10.1503/cmaj.230151 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Aug 2020Ankyloglossia is a congenital condition characterized by a short lingual frenulum, which may result in the restriction of tongue movement and function. Considerable... (Review)
Review
Ankyloglossia is a congenital condition characterized by a short lingual frenulum, which may result in the restriction of tongue movement and function. Considerable controversy regarding the diagnosis, clinical significance, and management of the condition remains, and great variations in practice have been recorded. Indeed, attitudes toward ankyloglossia differ among professional groups, and opinions may vary remarkably even among those within the same specialty. This article reviews the embryology, genetics, diagnosis, clinical presentation, and treatment of ankyloglossia to help physicians better understand and treat the condition.
Topics: Ankyloglossia; Humans; Infant; Infant, Newborn
PubMed: 32865366
DOI: 10.7518/hxkq.2020.04.016 -
Cirugia Pediatrica : Organo Oficial de... Apr 2021
Topics: Ankyloglossia; Humans; Infant
PubMed: 33826256
DOI: No ID Found -
International Journal of Pediatric... Aug 2023To investigate the opinions and practices of health professionals involved in ankyloglossia diagnosis and management in Australia.
OBJECTIVES
To investigate the opinions and practices of health professionals involved in ankyloglossia diagnosis and management in Australia.
METHOD
Two hundred and thirty-seven health professionals across Australia responded to an online survey including their diagnostic and management practice of ankyloglossia. Descriptive statistics, content analysis and thematic analysis were used to analyse quantitative data and open-ended responses, respectively.
RESULTS
Most (91.6%) respondents reported they are responsible for the assessment and diagnosis of ankyloglossia in their clinical practice. A majority (56.7%) reported using more than one assessment tool in clinical practice. Less than half (46.4%) reported providing treatment to manage ankyloglossia. Surgical management was used by 44.5%, and 56.4% used non-surgical management as their primary treatment of ankyloglossia. Of the total sample, 26.6% had completed no further training or professional development in the field. 46% of respondents stated they always educate parents about ankyloglossia diagnoses, whereas 29.5% reported they always educate parents about management of ankyloglossia. Of respondents, a high level of confidence was reported by 62.6% of health professionals in the assessment of infants with ankyloglossia. Of those who perform surgical management, 53.7% reported feeling extremely confident in their skills. Fifty-two percent of respondents reported they were dissatisfied with the current service delivery for infants with ankyloglossia.
CONCLUSIONS
The diagnosis, management and education practices varied greatly amongst health professionals in Australia. Clinical guidelines for all relevant health professionals are needed to ensure standardised diagnosis and management processes. In future, this will help guide evidence-based diagnosis and intervention for infants with ankyloglossia.
Topics: Infant; Humans; Ankyloglossia; Surveys and Questionnaires; Australia; Parents; Health Personnel; Lingual Frenum
PubMed: 37453216
DOI: 10.1016/j.ijporl.2023.111649