Tongue-Tie

	Score
Appearance Items	0	1	2	Hazelbaker Score
Appearance of tongue when lifted	Heart- or V-shaped	Slight cleft in tip apparent	Round or square
Elasticity of frenulum	Little or no elasticity	Moderately elastic	Very elastic
Length of lingual frenulum when mid-mouth only with jaw closure tongue lifted	<1 cm	1 cm	>1 cm
Attachment of lingual frenulum to tongue	Notched tip	At tip	Posterior to tip
Attachment of lingual frenulum to inferior alveolar ridge	Attached at ridge	Attached just below ridge	Attached to floor of mouth or well below ridge
Total

	Score
Function Items	0	1	2	Hazelbaker Score
Lateralization	None	Body of tongue but not tongue tip	Complete
Lift of tongue	Tip stays at lower alveolar ridge or rises to	Only edges to mid-mouth	Tip to mid-mouth
Extention of tongue	Neither of the above, or anterior or mid-tongue humps	Tip over lower gum only	Tip over lower lip
Spread of anterior tongue	Little or none	Moderate or partial	Complete
Cupping	Poor or no cup	Side edges only, moderate cup	Entire edge, firm cup
Peristalsis	None or reverse motion	Partial, originating posterior to tip	Complete, anterior to posterior
Snapback	Frequent or with each suck	Periodic	None
Total

Adapted with permission from Hazelbaker.26 * The infant’s tongue was assessed using the 5 appearance items and the 7 function items.
Significant ankyloglossia was diagnosed when appearance score total was 8 or less and/or function score total was 11 or less.

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