Score Sheet:

Appearance Items 0 1 2 Hazelbaker
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  


Function Items 0 1 2 Hazelbaker
Lateralization                  None Body of tongue but
not tongue tip
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  

Adapted with permission from Hazelbaker.26 * The infantís 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 :

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 ...