Systematic Review of Tongue Tie Publications: Exponential Rise in Publications Without Exponential Increase in Evidence.

Abstract

Objective: Ankyloglossia and lingual frenotomy in young children and infants remains an area of debate, with a body of research with poor quality-but increasing number-of studies, a trend that has continued into the present day. To systematically review the published literature to identify the number, type, and quality of studies on the evaluation, diagnosis, and treatment of ankyloglossia.

Data sources: In this Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review, a literature search of PubMed, Embase, and Ovid MEDLINE was conducted in 2024 using keywords related to ankyloglossia and frenotomy.

Review methods: Studies from 2017 to 2024 were assessed by two independent reviewers. Articles were included if they focused on ankyloglossia in children and in the English language.

Results: Overall, 462 articles were included for full-text extraction, of which cohort studies were the most common (179, 38.7%), and randomized controlled trials (RCTs; 13, 2.8%) were among the least common. Studies on different frenotomy techniques were common, despite no evidence suggesting that no intervention may be superior. There was an overall lack of study endpoints with objective measures such as breastfeeding duration or infant growth rates postprocedure. Despite the presence of several classification systems for ankyloglossia, none of those described in the literature focuses primarily on function as opposed to appearance or other factors.

Conclusion: This systematic review provides an update demonstrating the continued exponential rise of publications focused on ankyloglossia and lingual frenotomy without a rise in evidence clarifying the controversies surrounding these important topics. Future studies in this area should be quality RCTs with meaningful outcome measures.