Ankyloglossia, which is characterized by a short, tight or thick lingual frenulum, can negatively impact breastfeeding. It has been recognized as a problem for centuries. Frenotomies have traditionally been performed to remove the lingual frenulum when indicated. The use of frenotomies and a focus on ankyloglossia fell out of favor in the twentieth century with renewed attention in the past several decades. Limited high-quality studies have been undertaken on ankyloglossia. There remains no standardized diagnosis or management recommendations. In efforts to promote a standardized approach that is based on current knowledge, this study will involve an educational in-service on ankyloglossia, and the introduction of an objective assessment tool with associated recommendations for management of ankyloglossia within a pediatric primary care setting. Additionally, provider perceptions of ankyloglossia will be explored.



Document Type


Degree Name

Doctor of Nursing (ND)

Level of Degree


First Advisor

Amy Levi

First Committee Member

Felina Ortiz


ankyloglossia, tongue-tie, breastfeeding, frenotomy, lingual frenulum