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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.