Assessment of Lingual Function:

  • Lateralization to corners of mouth
  • Lift of tongue to mid-mouth
  • Extension of tongue beyond lower lip
  • Spread of tongue with smooth surface
  • Cupping around gloved finger
  • Peristalsis front to back
  • Lack of snapping sound while sucking

Assessment of Lingual Appearance:

  • Shape of tongue when lifted
  • Elasticity of frenulum
  • Length of frenulum with tongue lifted
  • Site of attachment of frenulum to tongue
  • And to area of alveolar ridge

Interpretation of Hazelbaker Score:

  • Perfect item score - 2 points
  • Perfect Appearance - 10 points
  • Perfect Function - 14 points
  • Function outweighs appearance
    • Function < 11 suggests impaired tongue function
    • Appearance < 8 in the presence of impaired function suggests need for frenotomy

References :

References :
Jeanne L. Ballard, Christine E. Auer and Jane C. Khoury
Ankyloglossia: Assessment, Incidence, and Effect of Frenuloplasty on the
Breastfeeding Dyad J Pediatrics 2002;110;63-DOI: 10.1542/peds.110.5.e63

About Dr. Ballard

Dr. Ballard is an associate professor of Pediatrics, Obstetrics and Gynecology at the University of Cincinnati College of Medicine. More ...