Table 2 Hazelbaker’s Assessment Tool for Lingual Frenulum Function

Function Items

Clinical Features

Points

 Lateralization

Complete

2

Body of tongue but not tongue tip

1

None

0

 Lift of tongue

Tip to mid-mouth

2

Only edges to mid-mouth

1

Tip stays at the alveolar ridge or rises only with jaw closure

0

 Extension of tongue

Extends the tip over the lower lip

2

Extends the tip over the lower gum only

1

Neither of above

0

 Spread of anterior tongue

Complete

2

Moderate or partial

1

Little or none

0

 Cupping

Entire edge, firm cup

2

The side edges only, moderate cup

1

Poor or no cup

0

 Peristalsis

Complete, anterior to posterior

2

Partial: originating posterior to the tip

1

None or reverse peristalsis

0

 Snapback

None

2

Periodic

1

Frequent or with each suck

0

Appearance Items

Clinical Features

Points

 Appearance of the tongue when lifted

Round or square

2

A slight cleft in the tip apparent

1

Heart-shaped

0

 Elasticity of frenulum

Very elastic (excellent)

2

Moderately elastic

1

Little or no elasticity

0

 Length of lingual frenulum when tongue lifted

 > 1 cm or embedded in the tongue

2

1 cm

1

 < 1 cm

0

 Attachment of lingual frenulum to tongue

Posterior to tip

2

At tip

1

Notched tip

0

 Attachment of lingual frenulum to tongue

To the floor of the mouth or well below the ridge

2

Just below the ridge

1

At the ridge

0