The Prevalence of Ankyloglossia

The role of soft-tissue position and its activity in the etiology of malocclusion has been well documented in literature. Lingual frenulum is a type of soft tissue which often gets overlooked in routine examination (Kleim R, 2009). A frenulum is a small muscle which covers the mucous membrane that attaches the lips and tongue to the adjacent bones in the mouth (Bai and Anna, 2014). The primary function of frenulum is to keep the lips and tongue in harmony with the growing bones of the mouth during fetal development (Morowati et al., 2010). The lingual frenulum or the tongue’s frenulum is a structure that connects the tongue to the floor of the mouth which allows tongue’s free movement in the oral cavity. It is an anatomic structure which plays an important role in the act of feeding, suction and speech. Any abnormality associated with frenulum attachment alters the deglutition function, tongue’s movements, speech and word’s articulation (Bargale et al., 2014). Lingual frenulum is formed by a dense fibrous conjunctive tissue and, often, by superior fibers of the genioglossus muscle (Bargale et al., 2014). The lingual frenulum migrates towards a central position to occupy its definitive position along with the growth and development of bone and eruption of tooth (Tait P, 2007). At birth the tongue is usually short with the frenulum extending to the tip and at times a bifid like tip of the tongue may also be noted (Morowati et al., 2010). In normal sequence the lingual frenulum recedes during the first 6 months to 6 years of life. Ankyloglossia occurs when the lingual frenulum persists as an anatomical abnormality after 6 years (Ruffoli et al., 2005). The severity of ankyloglossia varies from absence of clinical significance to a completely fixed tongue to the floor of the mouth.

Ankyloglossia is originally derived from a Greek word skolios (curved) and glossa (tongue). Ankyloglossia is also known as tongue-tie which is a congenital developmental anomaly and it is characterized by short, thick lingual frenulum connecting abnormally to the tongue and the floor of the mouth (Bargale et al., 2014). History of tongue-tie was found to be controversial as there was no agreement among professionals on the diagnosis and treatment of this congenital condition. It is typically an isolated anomaly, but can be associated with other craniofacial abnormalities like Orofacial Digital Syndrome, Beckwith Weidman Syndrome, Simpson-Golabi-Behmel Syndrome, X-linked Cleft Palate Syndrome, Kindler Syndrome, Van der Woude Syndrome, Opitz Syndrome, Ehlers-danlos Syndrome, and others (Lalakea and Messner, 2003). Ankyloglossia is a condition which can be observed in neonates, children, or adults. The clinical significance of ankyloglossia is varied as some authors believe it is rarely symptomatic condition (Paradise J, 1990) while others (Marmet C, 1990; Fletcher SG, 1968) feel it may lead to a variety of problems including infant feeding difficulties, speech disorders, lower incisor deformity, malocclusion and various other mechanical and social issues.