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total of 1500 schoolchildren were examined for the presence of ankyloglossia.
The age group selected was 6 to 14 years. An informed consent was obtained from
all the subjects/parents/teachers, who participated in this study. Children suffering from any disabilities or systemic
diseases were excluded from the study. Oral examination was
done by a single examiner with the help of mouth mirror and periodontal probe
under natural light. The criteria which was used to categorize subjects as
having a tongue-tie included the following (Kotlow, 1999):

a.       The
tip of the tongue could not be protruded outside the mouth without clefting.

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b.      The
tip of the tongue could not sweep the upper and lower lips easily, without

c.       A
diastema was seen between the mandibular central incisors which were created by
the lingual frenulum.

d.      When
the tongue was retruded, it blanched the tissue lingual to the anterior teeth.

 The lingual frenulum did not allow a normal
swallowing pattern.

tongue-tie, if present was then graded according to the classification given by
Kotlow (Kotlow, 1999). The anatomical measurements were used to classify the
tongue-tie which was carried out at the maximum opening of the mouth with the
tip of the tongue touching the palatal papilla. According to Kotlow, the term
“free-tongue” is defined as the length of tongue from the insertion of the
lingual frenulum into the base of the tongue to the tip of the tongue. Free
tongue length was measured with the use of divider and scale in millimeter and then
graded into Grades 1 to 5 according to Kotlow’s classification (Kotlow, 1999):

a.       Clinically
acceptable, normal range of free tongue: greater than 16 mm

b.      Class
I: Mild ankyloglossia: 12 to 16 mm

c.       Class
II: Moderate ankyloglossia: 8 to 11 mm

d.      Class
III: Severe ankyloglossia: 3 to 7 mm

e.       Class
IV: Complete ankyloglossia: less than 3 mm 

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