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Table 1 Hazelbaker Assessment Tool for Lingual Frenulum Function (1998 version)

From: Reliability of the Hazelbaker Assessment Tool for Lingual Frenulum Function

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 when tongue lifted
   2: More than 1 cm OR embedded in tongue
   1: 1 cm
   0: Less than 1 cm
Attachment of lingual frenulum to tongue:
   2: Posterior to tip
   1: At tip
   0: Notched tip
Attachment of lingual frenulum to inferior alveolar ridge
   2: Attached to floor of mouth OR well below ridge
   1: Attached just below ridge
   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 mid-mouth
   1: Only edges to mid-mouth
   0: Tip stays at alveolar ridge or rises to mid-mouth 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 mid-tongue 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
  1. © Alison K. Hazelbaker, MA, IBCLC July 1 1998
  2. 14 = Perfect score (regardless of Appearance Item score)
  3. 11 = Acceptable if Appearance Item score is 10
  4. <11 = Function impaired. Frenotomy should be considered if management fails. Frenotomy necessary if Appearance Item score is <8.