Prevalence and clinical decision-making in pediatric ankyloglossia: the role of functional assessment

Background: Ankyloglossia is a congenital condition that may restrict tongue mobility and affect oral functions such as speech and feeding. Variability in diagnostic criteria and the lack of functional assessment tools have led to inconsistent prevalence data and potential overtreatment. This study aimed to determine the prevalence of ankyloglossia in a pediatric population and evaluate its relationship with functional findings and clinical decision-making. Methods: This study included 982 pediatric patients (484 females, 498 males; mean age: 9.56 ± 2.72 years) attending a university pediatric dentistry clinic. Ankyloglossia was assessed using the Coryllos classification alongside functional parameters. Speech disorders and other functional limitations were recorded. Statistical analyses included the chi-square test, Mann-Whitney U test, and logistic regression analysis (Jamovi v2.6). Intra-observer reliability was assessed using weighted kappa (κ = 0.71). Results: Ankyloglossia was identified in 257 of 982 patients (26.2%). No significant association was found between gender and ankyloglossia (p = 0.175). Posterior types (Types 3–4) accounted for 61.5% of cases. Speech disorders were significantly more frequent in patients with ankyloglossia (53/257; 20.6%) than in those without (7/725; 1.0%) (p < 0.001). Logistic regression analysis demonstrated that ankyloglossia was associated with speech disorders (adjusted odds ratio (OR) = 29.1, 95% confidence interval (CI): 12.9–65.7, p < 0.001). Age showed a protective effect (adjusted (OR) = 0.60, p = 0.003). Other functional limitations were infrequent. Clinical management varied significantly by ankyloglossia type (p < 0.001), with conservative approaches predominating. Conclusions: Ankyloglossia was prevalent in this clinical pediatric population and was associated with speech disorders. Functional assessment plays a critical role in guiding clinical decision-making, and not all anatomical types require surgical intervention. Standardized diagnostic criteria and evidence-based management strategies are needed to optimize patient care.

Ankyloglossia; Child; Prevalence; Speech disorders

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