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Ankyloglossia Differential Diagnosis: Tongue-Tie, Retrognathia or Hypotonia?

by Camila Palma, DDS, MSc (Master in Pediatric Dentistry) & IBCLC
  • Duration: 60 Mins
  • Credits: 1 CERP, 1 L-CERP, 1 Dietetic CEU
  • Learning Format: Webinar
  • Handout: Yes
Abstract:

Ankyloglossia is an embryologic variation of the lingual frenulum, which causes a significant restriction in the mobility of the tongue. As such, an altered lingual function is always an essential consideration when faced with breastfeeding challenges. On some occasions however, other anatomic or functional alterations in the babies’ orofacial region can cause breastfeeding problems, similar to those seen in tongue-tie babies. They can be the root of latch difficulties, nipple trauma and/or suction and deglutition issues. In these cases, frenotomy does not solve those problems and therefore, the misdiagnosis and posterior surgical treatment can frustrate parents. From a pediatric dentist perspective, retrognathia (recessed chin) and hypotonia are two common differential diagnosis of tongue tie, which can affect a babies’ suction at the breast. The aim of this talk is to present normal and abnormal orofacial structures so as to differentiate ankyloglossia from two problems that can be part of a “faux tie”, in order to aid breastfeeding consultants, and broaden their perspective on breastfeeding difficulties.

Learning Objectives:

1. Describe the difference between retrognathia and a normal mandible.
2. Explain the impact of retrognathia and hypotonia on breastfeeding.
3. Explain why frenotomy is contraindicated in patients with severe retrognathia.

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