APPENDIX 1

Hazelbaker Assessment Tool for Lingual Frenulum Function (1998 Version)17

Appearance items
    Appearance of tongue when lifted
        2: Round OR square
        1: Slight cleft in tip apparent
        0: Heart shaped
    Elasticity of frenulum
        2: Very elastic (excellent)
        1: Moderately elastic
        0: Little OR no elasticity
    Length of lingual frenulum
        2: >1 cm OR embedded in tongue
        1: 1 cm
        0: <1 cm
    Attachment of lingual frenulum to tongue
        2: Attached to floor of mouth OR well below ridge
        1: Attached just below
        0: Attached at ridge
Function Items
    Lateralization
        2: Complete
        1: Body of tongue but not tongue tip
        0: None
    Lift of tongue
        2: Tip to midmouth
        1: Only edges to midmouth
        0: Tip stays at alveolar ridge or rises to midmouth only with jaw closure
    Extension of tongue
        2: Tip over lower lip
        1: Tip over lower gum only
        0: Neither of above OR anterior or midtongue humps
    Spread of anterior tongue
        2: Complete
        1: Moderate OR partial
        0: Little OR none
    Cupping
        2: Entire edge, firm cup
        1: Side edges only, moderate cup
        0: Poor OR no cup
    Peristalsis
        2: Complete, anterior to posterior (originates at the tip)
        1: Partial, originating posterior to tip
        0: None OR reverse peristalsis
    Snapback
        2: None
        1: Periodic
        0: Frequent OR with each suck
  • A score of 14 is a perfect score (regardless of the appearance item score); a score of 11 is acceptable if appearance item score is 10; a score of <11 refers to impaired function. Frenotomy should be considered if management fails. Frenotomy is necessary if the appearance item score is <9.

  • Total score: ___.