352 - Ankyloglossia, "Lip tie", and Frenectomies: Prevalence and Management in the United States, 2016-2022.

Publication Number: 3339.352

Fatou J. conteh, Charleston Area Medical Center, charleston, WV, United States; Elizabeth A. Copenhaver, West Virginia University School of Medicine, Charleston, WV, United States; Allison Holstein, Charleston Area Medical Center Vandalia Health, Charleston, WV, United States; Sharon K. Hill, Charleston Area Medical Center, charleston, WV, United States; Stephanie Thompson, Charleston Area Medical Center, Charleston, WV, United States

Background: Lingual and labial frenula are variations of normal newborn physical exam findings. Ankyloglossia is tightening of lingual frenulum and clinically significant if it impacts a newborn’s ability to feed. Previous national analyses demonstrated rising rates of ankyloglossia diagnosis and intervention. While tightening of labial frenulum (“lip tie”) is a controversial diagnosis, it does not impact breastfeeding mechanics. The national frequency of inpatient labial frenectomy is unknown.

Objective: This study aims to determine recent national trends in ankyloglossia-related diagnoses and procedures, as well as determine predictors of frenectomy.

Design/Methods: A retrospective cross-sectional study was conducted using the Healthcare Cost and Utilization Project National Inpatient Sample from 2016–2022. Infant discharges (≤1 year) with a diagnosis of ankyloglossia (Q38.1), those who underwent lingual or lip frenectomy, and those with a feeding disorder diagnosis were identified. Weighted frequencies and annual prevalences were used to quantify demographic and temporal trends. Multivariate binomial logistic regression was performed to identify independent predictors of frenectomy while controlling for potential confounders.

Results: From 2016 to 2022, inpatient diagnoses of ankyloglossia increased by 41.8% (70,455 to 99,945 infants). Lingual frenectomy procedures rose by 5.6% (25,625 to 27,070 cases per year), while labial frenectomy procedures remained stable (550 to 565 cases per year). Feeding-related diagnoses in infants with ankyloglossia increased by 27.6% (9,185 to 11,720), while the total number of births decreased by 7.9% during the same period. Multivariate regression analysis showed Medicaid insurance (OR 1.11; 95% CI 1.08–1.12) and feeding diagnosis (OR 2.39; 95% CI 2.30–2.48) were associated with higher odds of frenectomy, whereas White race (OR 0.92; 95% CI 0.85–0.90) and female (OR 0.87, CI 0.85-0.90) were associated with lower odds. When comparing hospital type rural and nonteaching to teaching hospitals, the odds of having frenectomies was higher among both rural (OR 1.56, CI 1.48-1.63) and nonteaching (OR 1.06, CI 1.03-1.10) hospitals.

Conclusion(s): The prevalence of ankyloglossia diagnosis has continued to rise nationally among infants through 2022. Inclusion of labial frenectomy data provided an updated perspective on national management patterns prior to American Academy of Pediatrics’ Ankyloglossia Clinical Report (2024). Persistent demographic and hospital-level disparities suggested that non-clinical factors influenced surgical decisions.