International Variability in the Diagnosis and Management of Ankyloglossia Among Dental Professionals: A Cross-Sectional Study

Background/Objectives: Ankyloglossia diagnosis and management remain widely debated in dentistry, with variability reported in clinical decision-making and treatment approaches. Limited international evidence exists comparing how dental professionals diagnose and manage this condition in early childhood. This study aimed to compare the knowledge, diagnostic criteria, and clinical management of ankyloglossia among dental professionals in six countries and to assess whether shared diagnostic and management approaches exist for babies (≤6 months) and infants (>6 months). Methods: A multicountry cross-sectional study was conducted using a validated 27-item online questionnaire distributed between February 2023 and February 2025 to dental professionals in Spain, Italy, Portugal, Brazil, Ecuador, and Chile. Participants included paediatric dentists, oral surgeons, general dentists, and other dental specialists. Only fully completed questionnaires were analyzed. Primary outcomes included self-reported diagnostic practices, use of classification systems, and management strategies for ankyloglossia. Secondary outcomes included professional training, interdisciplinary collaboration, surgical techniques, and pain management practices. Results: A total of 1188 dental professionals participated. Overall, 80.7% reported routinely examining the lingual frenulum, while 42.4% used formal classification systems. Tongue mobility assessment was the most commonly reported diagnostic method, with significant variation across countries and professional groups (p < 0.001). Specific training in diagnosis was reported by 67.2% of participants, whereas 50.6% reported treatment training, with marked inter-country differences (p < 0.001). Surgical intervention was the most commonly reported management strategy (38.7%), particularly in babies ≤ 6 months, with frenotomy/frenulotomy being the predominant procedure. Considerable variability was observed in surgical techniques, pain management, and recommendations for adjunctive therapies. Conclusions: Substantial international variability exists in the diagnosis, classification, and management of ankyloglossia among dental professionals. These findings highlight gaps in training and the absence of standardized, evidence-based clinical guidelines, underscoring the need for consensus-driven protocols to support consistent and multidisciplinary clinical care.