Trends in maxillary frenulum pathology and treatment from 2009 to 2023

Objective

To determine the rates of lip tie (LT) diagnosis and maxillary frenotomy (MF) in the US.

Methods

Using TriNetX, queries targeted pediatric patients with a LT diagnosis (ICD-10: Q38.0) or MF (CPT: 40806). Frequency and rate of LT and MF were collected between 2009 and 2023. Frequencies were collected for those with potential health hazards related to socioeconomic circumstances (ICD Z55-65), or low socioeconomic status (LSES). Demographics were collected and rates were stratified by age.

Results

13,340 patients were diagnosed with LT and 3771 had MF during the study period. The rate of LT diagnosis increased by 3500 % (0.002 %–0.070 %) and MF increased by 390 % (0.004 %–0.017 %). The mean age at diagnosis was 1.02 years (SD = 1.99) and of MF was 1.14 years (SD = 1.94). 28.3 % of those with LT underwent MF. These increases were predominantly seen in children 0–4 years old. Those with LSES were more likely to be diagnosed (OR = 1.71, 95 % CI = 1.60–1.84, p < .001), but less likely to undergo MF (OR = 0.65, 95 % CI = 0.54–0.77, p < .001).

Conclusion

The increase in LT and MF suggests growing acceptance of LT as a pathology, despite the lack of clear evidence supporting its classification as such. Socioeconomic status is related to the chance of undergoing MF following LT diagnosis. Good quality research to determine the value of MF in young children is urgently needed.