Case Report

Clinical Guidelines and Management of Ankyloglossia with 1-Year Followup: Report of 3 Cases

Table 2

Hazel baker’s Assessment tool for appearance and function of the tongue.


Appearance of tongue when liftedLateralization

2: Round or square2: Complete
1: Slight cleft in tip apparent1: Body or tongue but no tongue tip
0: Heart or V-shaped0: None

Elasticity of frenulumLift of tongue

2: Very elastic2: Tip to mid-mouth
1: Moderately elastic1: Only edges to mid-mouth
0: Little or no elasticity
0: Tip stays at lower alveolar ridge or rises
to mid-mouth only with jaw closure

Length of lingual frenulum when tongue liftedExtension of tongue

2: >1 cm2: Tip over lower lip
1: 1 cm1: Tip over lower gum only
0: Neither of the above, or anterior or
0: <1 cm mid-tongue humps

Attachment of lingual frenulum to tongueSpread of anterior tongue

2: Posterior to tip2: Complete
1: At tip1: Moderate of partial
0: Notched tip0: Little or none

Attachment of lingual frenulum to inferior alveolar ridgeCupping

2: Attached to floor of mouth or well below ridge2: Entire edge, firm cup
1: Attached just below ridge1: Side edges only, moderate cup
0: Attached at ridge0: Poor or no cup


2: Complete, anterior or posterior
1: Partial, originating posterior to tip
0: None or reverse

14 = Perfect score, 11 = Acceptable if appearance item score is 10. Frenectomy is necessary if function score is <11 and appearance score is <8.