The Mobility-Scale Tongue (M-S-Z)

The graphics use the “M-S-Z” to describe the restricted mobility of the tongue due to different shapes of the lingual frenulum. The attempt to correlate the anatomy, i.e. the appearance of the lingual frenulum, with the occurrence of breastfeeding and subsequent problems is not effective. Because in connection with breastfeeding or also drinking, eating and breathing, it is mainly the function of the tongue that is of interest, i.e. the question of whether the child can move the tongue in such a way that he can breastfeed, drink, eat and breathe normally (physiologically) without restrictive compensations.

M-S-Z

The Mobility Scale Lip indicates the extent of the restriction of movement of the tongue in degrees. Grade 0 means a freely movable tongue in all three dimensions and grade 3 a severely restricted tongue mobility.

M-S-Z Grade 3

Manual, stress-free or independent intuitive lifting of the tongue, e.g. when crying, is not possible. The tongue cannot be pulled or moved over the lower lips. Function is not possible or severely limited in all three dimensions, i.e., anterior (ventral), lateral (lateral), and superior (cranial). When crying or lifting the tongue, a heart shape of the tongue develops and usually an indentation is seen in the tip of the tongue. It is an ankyloglossia. When drinking at the breast, the baby does not drink with the tongue, but compensatorily with the chewing muscles and retracted lip.

The likelihood of a problem with physiological suction through the lingual frenulum is high.

The probability for follow-up problems is high.

A frenotomy of the lingual frenulum will likely improve drinking and may prevent subsequent problems. A presentation to the specialist is necessary.

For infants, breastfeeding counseling and a tongue function test with a professional is recommended. The lip band must be evaluated separately!

M-S-L Grade 2

Manual, stress-free or independent intuitive lifting, e.g. when crying the tongue is possible to a small extent, The tongue can be pulled or moved slightly over the lower lips. Function may be limited in all three dimensions, anterior (ventral), lateral (lateral), and superior (cranial). Only the anterior part of the tongue can be moved when crying or manually lifting the tongue. It may be ankyloglossia. When drinking at the breast, the baby does not drink with the tongue, but compensatorily with the chewing muscles and retracted lip.

The likelihood of a problem with physiological sucking through the lingual frenulum is increased.

The likelihood of subsequent problems is increased.

Frenotomy of the lingual frenulum is likely to improve drinking and may prevent subsequent problems. A presentation to the specialist is necessary.

For infants, breastfeeding counseling and a tongue function test with a professional is recommended. The lip band must be evaluated separately!

M-S-L Grade 1

Manual, stress-free or independent intuitive lifting of the tongue, e.g. when crying, is possible to some extent. The tongue can be pulled or moved over the lower lips. Function may be partially limited in all three dimensions, anterior (ventral), lateral (lateral), and superior (cranial). Only the anterior and middle part of the tongue can be moved when crying or manually lifting the tongue. When drinking at the breast, the baby does not drink with the tongue, but compensatorily with the chewing muscles and retracted lip.

The likelihood of a problem with physiological sucking through the lingual frenulum is possible.

The probability for follow-up problems is possible.

Frenotomy of the lingual frenulum may perhaps lead to an improvement in drinking behavior and may be able to prevent secondary problems. A presentation to the specialist is necessary. Frenotomy should be critically evaluated and the benefits weighed.

For infants, breastfeeding counseling and a tongue function test with a professional is recommended. The lip band must be evaluated separately!

M-S-L Grade 0

Manual, stress-free or independent intuitive lifting of the tongue, e.g. when crying, is completely possible. The tongue can be pulled or moved a little the lower lips. The function can be performed in all three dimensions, i.e. forward (ventral), to the side (lateral) and upward (cranial) is well possible. The whole tongue can be moved when crying or manually lifting the tongue. When breastfeeding or drinking, sucking is done with the tongue, relaxed chewing muscles with mouth wide open and lips turned down.

There is no likelihood of a problem with physiological suction through the lingual frenulum.

There is no likelihood of consequential problems.

A frenotomy of the lingual frenulum cannot improve drinking behavior and cannot prevent secondary problems. It is not necessary to see a specialist.

For infants, breastfeeding counseling with a professional is recommended. The lip band must be evaluated separately!