Management of Ankyloglossia: Survey of US and Canadian Dental Schools

Consequences and management of ankyloglossia (A-G), the partial or complete fusion of the tongue to the floor of the mouth, is inconsistent. AG prevalence ranges from 4-11%. Because dentists examine the tongue and associated structures during routine visits, they may be first in diagnosing A-G. Clearly, clinicians' and faculty's perception of the management and consequences of A-G affects treatment. Objectives: to examine chairpersons and program directors perceptions regarding AG; and their referral rates for treatment and management. Methods: A three-part survey, designed by the researchers, was e-mailed to US and Canadian department chairs/directors of oral surgery (OS), pediatrics (Ped), orthodontics (Ortho) , general practice (GP), AEGD/GPR. Items pertained to perceptions, student training, and referrals to specialists. Responses used Lickert-scale, yes/no, or were open-ended. Results: Forty-three of 177 chairpersons completed the survey. Table includes selected items.

% Responding that department	GP/GP (n=5)	OS (n=9)	Ortho (n=14)	Pedo (n=15)	p*=
Screens for A-G	20%	57%	86%	86%	0.016
Never/seldom sees A-G	100%	67%	85%	80%	ns
Performs frenotomies/	0%	22%	14%	7%	ns
frenectomies	0%	14%	0%	0%	ns
In contact with speech pathologist	0%	63%	8%	0%	.001
Refer to speech pathologist	0%	25%	8%	7%	ns
Trains students frenotomies/	0%	89%	36%	67%	0.004
frenectomies	20%	67%	21%	73%	0.009
Curriculum on speech/ language development	0%	33%	54%	67%	0.005
% Perceive A-G has no/minimal effect on:
Speech	0%	55%	48%	80%	0.014
Cleansing of teeth	40%	11%	50%	60%	ns
Gingival recession	40%	22%	64%	40%	ns
% Perceive surgeries:
Improve speech Unsure speech improves	40% 60%	67% 11%	36% 57%	47% 27%	ns

* chi-square tests, ns=not significant

Conclusions: US and Canadian department chairs and program directors are inconsistent in their perceptions, student training in and treatment of ankyloglossia. These inconsistencies ultimately impact the treatment of A-G.