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Line 46: According to Horton ''et al.'',<ref name="Horton" /> [[diagnosis]] of ankyloglossia may be difficult; it is not always apparent by looking at the underside of the tongue, but is often dependent on the range of movement permitted by the [[genioglossus]] muscles. For infants, passively elevating the tongue tip with a [[tongue depressor]] may reveal the problem. For older children, making the tongue move to its maximum range will demonstrate the tongue tip restriction. In addition, palpation of genioglossus on the underside of the tongue will aid in confirming the diagnosis.{{citation needed|date=May 2022}} Some signs of ankyloglossia can be difficulty speaking, difficulty eating, ongoing dental issues, jaw pain, or migraines.<ref>{{Cite web |date= 20 July 2022|title=Symptoms and Best Treatments for Adults with Tongue Tie |url=https://takehomesmile.com/adults-with-tongue-tie/ A severity scale for ankyloglossia, which grades the appearance and function of the tongue, is recommended for use in the Academy of Breastfeeding Medicine.<ref>Hazelbaker AK: The assessment tool for lingual frenulum function (ATLFF): Use in a lactation consultant private practice Masters thesis, Pacific Oaks College, 1993</ref><ref>ABM Protocols: Protocol #11: Guidelines for the evaluation and management of neonatal ankyloglossia and its complications in the breastfeeding dyad</ref> Line 53: There are varying types of intervention for ankyloglossia. Intervention for ankyloglossia does sometimes include surgery in the form of [[Lingual frenectomy|frenotomy]] (also called a [[frenectomy]] or [[Frenectomy|frenulectomy]]) or [[Frenuloplasty of tongue|frenuloplasty]]. This relatively common dental procedure may be done with [[Soft-tissue laser surgery|soft-tissue lasers]], such as the [[Carbon dioxide laser|CO<sub>2</sub> laser]].<ref>{{Cite web|url=https://lightscalpel.com/laser-surgery/dental-laser/|title=Laser Surgery - Soft Tissue Dentistry|website=LightScalpel}}</ref> A frenotomy can be performed as a standalone procedure or as part of another surgery. The procedure is typically quick and is performed under local anesthesia. First, the area under the tongue is numbed with an injection. Once the patient is numb, a small incision is made in the tissue and the tongue is freed from its tether. The incision is then closed with dissolvable sutures. Recovery from a frenotomy is typically quick and most patients experience little to no pain or discomfort.<ref>{{Cite web |date= 20 July 2022|title=Symptoms and Best Treatments for Adults with Tongue Tie |url=https://takehomesmile.com/adults-with-tongue-tie/ According to Lalakea and Messner, surgery can be considered for patients of any age with a tight frenulum, as well as a history of speech, feeding, or mechanical/social difficulties. Adults with ankyloglossia may elect the procedure. Some of those who have done so report post-operative pain.{{citation needed|date=May 2022}} | |||