Hazelbaker assessment tool pdf 2025

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14 = Perfect Function score regardless of Appearance Item score. Surgical treatment not recommended. 11 = Acceptable Function score only if Appearance Item score is 8.
Table III. Function itemsAppearance items Extension of tongue Length of lingual frenulum when tongue lifted 2tip over lower lip 21 cm 1 tip over lower gum only 11 cm 0 neither of the above or mid-tongue humps 0
A frenotomy that uses scissors is a short procedure. It only takes about one minute, on average.
Normal to mild on lifting the tongue toward the roof of the mouth the frenulum is between 12 and 16mm.
Measurements were done as recommended by Kotlow [65], by determining the free-tongue (i.e., the part of the tongue above the frenulum top insertion, with measurements considered to be normal when equal to or longer than 20 mm) and by measuring the opening of the mouth with a caliper: The maximum opening was measured
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The study measured tongue frenulum length and found that in the group with skeletal malocclusions (indicating a neutral relationship between maxilla and mandible bone bases), the average frenulum length was 3.3 mm.
Hazelbaker. Tongue-tie, by definition, is an embryological remnant of connective tissue underneath the tongue that failed to recede by apoptosis and that adversely impacts tongue function. Its definition is a functional one rather than based on visual criteria alone (Hazelbaker, 1993, 2010).
Bristol Tongue Assessment Tool (BTAT) provides an objective, clear and simple measure of the severity of a tongue-tie, to inform selection of infants for frenotomy (tongue-tie division) and monitor the effect of the procedure.

hazelbaker assessment tool for lingual frenulum function